癌看護に携わる看護者のケアリングに関する研究—癌看護のケアリングに影響する要因調査

Research on the Caring of the Nurses Concerned With Cancer Nursing : Investigation of the Factors Which Influence Caring Along With Cancer Nursing

要旨

　本研究の目的は，癌看護に携わる看護者のケアリングに対する自己評価（ケアリング評価と略す）のレベルとそれを規定する要因を明らかにすることである．研究方法は大阪府内8総合病院の癌病棟に勤務する看護者500名を対象に自記式質問紙調査を行い，ケアリング評価尺度を従属変数，死に対する態度やケア不安および一般性セルフ・エフィカシー（自己効力感，GSESと略す）など17変数を独立変数として重回帰分析を行った．その結果は，

　1．看護者のケアリング評価および自己効力感のレベルは低く，両者とも経験年数が増す程得点は高く，多重比較（Tukey）により年数間に有意差がみられた．

　2．重回帰分析の結果は，17要因のうち4要因がケアリング評価に起因していた．ケア不安はケアリング評価に起因していなかったが，有意な負の相関（γ＝−0.199，P＜0.001）がみられた．4要因の関係の強い順は，年齢（β＝0.256，P＜0.001），GSES（β＝0.255，P＜0.001），癌看護目標に対するギャップ感（β＝−0.187，P＜0.001），「患者の死と向き合った時，仕事だから仕方なく，事務的に接した態度」（β＝−0.113，P＜0.01）であった．

　3．年齢を除く3要因は，ケアリング評価とケア不安に対して，逆（正，負）の関連要因となっていた．

　以上より癌看護に携わる看護者のケアリング評価を高める要因と要因間の関連性が明らかになったが，今後，経験を積んでいる者の実践的ケアリング能力やその活用方法などについての追跡研究の必要性が示唆された．

Abstract

　The purpose of this study was to identify the level of the caring selfevaluation of nurses concerned with cancer nursing and to verify the factors, which related to caring of nurses by the multiple regression analysis. This was questionnaire investigation and the subjects of this study were 500 nurses who worked in the cancer wards of 8 general hospitals in Osaka. The variables used for the multiple regression analysis were the caring scale of nurses as the subordinate variable and 17 variables(which include the attitude toward death, the care anxieties scale of nurses, general-self-efficacy〈GSES〉, etc), as the independent variable. The main results were as follows :

　1)The levels of the caring self-evaluation and the GSES of nurses were relatively low. These levels became high when the experience years increased and significant differences were noted between the levels of the years by multiple comparison(Tukey).

　2)Results of the multiple regression analysis demonstrated that there was a strong order of the relation of 4 in 17 factors. Care anxieties scale of nurses didn't originate in the caring evaluation, but a significant negative correlation (γ= -0.199, P＜0.001)was noted. The order from strongest factor to weaker factors were age(β = 0.256, P ＜0.001), GSES(β=0.255, P＜0.001), the feeling of the gap for a goal for cancer nursing(β = -0.187, P ＜0.001), unwillingly, facing a patient's death adopting an attitude to care for with a businesslike feeling(β= -0.113, P＜0.01), respectively.

　3)3 factor except for the age was the related factor of the reverse(plus and minus)to the caring self-evaluation and the care anxieties scale of nurses.

　The findings indicated the factors enhancing caring of nurses concerned with cancer nursing, and corelations between the factors. It was also suggested that the need of follow up research about the multiple experienced nurses' practical caring ability and ways of making use of it.