患者安全のための医療事故防止能力自己診断尺度—ICU看護師用—の開発

Development of a Self-Diagnosis Scale of Medical Accident Prevention Competency for ICU Nurses With the Aim of Ensuring Patient Safety

要旨

　目的：患者安全のための医療事故防止能力自己診断尺度—ICU看護師用—を開発する．

　方法：ICU看護師の医療事故防止行動を解明した質的帰納的研究成果に基づく質問項目の作成と尺度化，項目反応理論を用いた質問項目の選定，郵送法による全国調査を行った．尺度の回収は，無記名個別投函とした．

　結果：ICU看護師907名に尺度を配布し，有効回答304部を分析した．IRTを用いて15項目を選定し，完成版とした．尺度の情報量は，9.24以上，尺度全体のクロンバックα信頼性係数は，.91，主成分分析による第1成分への寄与率は，44.02％であった．既知グループ技法により4仮説が支持された．再テスト法による相関係数は，.50，確証的因子分析の結果は，CFI＝0.88，RMSEA＝0.09であった．

　結論：本尺度は，妥当性のうち構造的側面に課題を残すが，複数の側面から証拠を備えており活用可能である．

　Purpose: Development of a "Self-Diagnosis Scale of Medical Accident Prevention Competency for ICU Nurses" with the aim of ensuring patient safety.

　Methods: Identifying ICU nurses' medical accident prevention behavior through qualitative research, development and scaling of 29 items based on the results of qualitative research, selection of questionnaire items using item response theory, and nationwide mail survey. The scale items were collected individually by anonymous mail.

　Results: A total of 907 questionnaires were distributed and 304 valid datasets were analyzed. 15 items were selected using IRT, and a final version scale was produced therefrom. The information content of the scale was more than 9.24, the Cronbach's alpha was .91, and the contribution to the first component by principal component analysis was 44.02%. Four hypotheses were supported by the known-group technique. The correlation coefficient using the retest method was .50, and the results of the confirmatory factor analysis were CFI=0.88 and RMSEA=0.09.

　Conclusion: Although in terms of validity, the structural aspect of this scale remains an issue, it contains evidence from multiple facets and can be utilized as a measurement tool.