特別養護老人ホームにおける看護実践能力尺度の開発—信頼性と妥当性の検討

Development of a Nursing Competence Scale of Intensive Care Homes for the Elderly: Reliability and Validity of Scale

抄録

　本研究は，特別養護老人ホーム（以下，特養）における看護実践能力尺度を開発し，信頼性と妥当性を検討することを目的とした．概念分析，半構造化面接法で得られたデータを基に尺度項目を作成し，表面・内容妥当性を検討した結果，特養における看護実践能力尺度原案を作成した．全国の特養194施設の看護師603人を対象に無記名自記式質問紙調査を行い，項目分析，I-T相関分析，探索的因子分析の後，基準関連妥当性の検討，既知グループ法，内的一貫性と安定性を検討した．探索的因子分析の結果，4因子34項目が抽出され，【その人らしい生活を支える】【多職種と連携する力】【変調に気づき対応する力】【望む看取りを支援する力】と命名した．Cronbach's α係数は尺度全体では0.958で，基準関連妥当性では看護実践能力自己評価尺度等といずれも有意な正の相関を示した．既知グループ法では看護管理職と，研修に参加している人が有意に点数は高かった．再テスト法では1回目と2回目の合計得点の間でρ＝0.791（下位因子ρ＝0.510〜0.801）の有意な相関がみられた．以上により，特養における看護実践能力尺度の信頼性および妥当性が確認された．

　The purpose of this study was to develop and evaluate the reliability and validity of a Nursing Competence Scale for use at intensive care homes for the elderly. Scale items which were selected based on the data obtained through concept analysis and semi-structural interviews underwent a review on their face validity and content validity, and 50 of them were included in the draft of evaluation of capability of nurses at special elderly nursing homes. A total of 603 nurses at 194 special elderly nursing homes nationwide answered an anonymous written questionnaire and their answers were put through item analysis, I-T correlation analysis and exploratory factor analysis. The analyzed results were studied in terms of criterion-related validity, known-groups validity, internal consistency and stability. The exploratory factor analysis extracted 34 items of four factors, which were named: “capability to support elderly in living his/her own life”; “capability to collaborate with people of different types of jobs”; “ability to detect a change and cope with it”; and “capability to offer elderly their desired end-of-life care”. Cronbach's α coefficient for the entire scale was 0.958. Regarding criterion-related validity, nursing competence self-evaluation scale and other scales showed significant positive correlation. In terms of known-groups validity, the scores were significantly high with nurses at administrative positions and nurses who have received training. In the test-retest reliability measurement the correlation coefficient ρ between the first and second round total scores was 0.791 (ρ = 0.510-0.801 for subordinate factors), showing a significant correlation between them. The validity and reliability of the Nursing Competence Scale for use at intensive care homes for the elderly were confirmed.