がん放射線療法看護の質評価指標の開発

Development of Cancer Radiation Therapy Nursing Quality Evaluation Index

要旨

　本研究の目的は，外部照射による放射線療法を受けるがん患者に対するがん放射線療法看護の質評価指標を開発することである．

　文献検討に基づき，がん放射線療法看護の質評価指標原案を作成し，専門家パネルによる質的な内容妥当性の検討から原案を修正した．さらに，全国のがん放射線療法看護認定看護師128名に項目の関連性と重要性に関する質問紙調査を実施し，Item-level Content Validity Index（以下，I-CVI），Scale's Content Validity Index（以下，S-CVI/Ave）から量的に内容的妥当性を検討した．

　その結果，外部照射におけるがん放射線療法看護の質評価指標は【治療選択に関する意思決定支援】【安全・安楽な治療の提供】【セルフケアを高める支援】【がんと共に自分らしく生きる支援】の4の構成要素，15の上位項目，62項目で構成された．すべての項目が採用基準である0.78以上のI-CVIをもち，上位項目，構成要素，質評価指標全体のいずれも0.90以上のS-CVI/Aveを確保した．十分な内容的妥当性を備えたがん放射線療法看護の質評価指標を開発した．

　質評価指標は，適切な目的に向け意図的にケアを実践しているかを自己評価でき，問題を改善するための適切な目標設定につながる．さらに，看護師の育成に向けた教育的ツールとして活用することで，教育体制の整備や具体的な教育支援の実現が期待される．

　The purpose of this study was to develop a cancer radiation therapy nursing quality evaluation index for cancer patients receiving radiation therapy of external irradiation.

　A cancer radiation therapy nursing quality evaluation index draft was developed based on a literature review and it was modified based on the consideration of qualitative content validity by an expert panel. In addition, we conducted a questionnaire survey about the relevance and importance of the items on 128 [nurses certified in radiation therapy,] and quantitatively examined the content validity using the Item-level Content Validity Index (I-CVI) and Scale's Content Validity Index (S-CVI/Ave).

　As a result, a cancer radiation therapy nursing quality evaluation index was composed of 4 components: “Decision support for treatment selection”, “The provision of safe and comfortable treatment”, “Support to enhance self-care” and “Support to live true to oneself with cancer”; 15 level items, and 62 items. All items reach 0.78 or more in I-CVI acceptance criteria, overall quality evaluation index, components, and the level items were ensured to be 0.90 or more in the S-CVI / Ave. We have developed a cancer radiotherapy nursing quality evaluation index with sufficient content validity.

　Cancer radiation therapy nursing quality evaluation indexes were developed, and practiced care can be selfevaluated which leads to the appropriate setting of goals for improving the problem. Furthermore, the indexes can be used as an educational tool for the training of nurses, and can help achieve the maintenance and support of the education system.