訪問看護師の就業継続につながる管理者のリーダーシップ行動の探究

Exploring Leadership Behaviors of Visiting Nurse Managers That Contribute to Job Retention Among Visiting Nurses

要旨

　目的：訪問看護師の就業継続につながる管理者のリーダーシップ行動を明らかにすること．

　方法：訪問看護に従事する管理者10名，看護師10名の計20名に，半構造化面接を実施した．得られたデータは，Steps for Coding and Theorizationを用いて質的帰納的に分析した．

　結果：全事例から管理者のリーダーシップ行動を示す353のセグメントが抽出され，【心理的安全性】，【人を動かす力】，【感情的知性】，【高度な実践力】，【率先垂範】の5カテゴリーと39サブカテゴリーが抽出された．

　結論：本研究で明らかになった訪問看護師の就業継続につながる管理者のリーダーシップ行動は，単一のスタイルにとどまらず，訪問看護の文脈に応じた多次元的かつ実践的な行動の集合体であった．これらの行動は，従来の病院組織におけるリーダーシップ理論では捉えきれなかった要素を包含しており，今後の理論的発展および実践的応用の基盤として意義がある．

　Objective: This study aimed to explore the leadership behaviors of visiting nurse managers that contribute to job retention among visiting nurses.

　Methods: Semi-structured interviews were conducted with 20 participants, including 10 visiting nurse managers and 10 visiting nurses. The data were analyzed qualitatively and inductively using the Steps for Coding and Theorization (SCAT) method.

　Results: A total of 353 segments related to managers' leadership behaviors were extracted for all cases. These segments were categorized into five overarching themes: psychological safety, ability to inspire others, emotional intelligence, advanced practical competence, and leading by example. Additionally, 39 subcategories of leadership behavior were identified.

　Conclusion: The leadership behaviors identified in this study were not limited to a single style. Still, they represented a multidimensional and practical set of actions tailored to the context of home-visit nursing. These behaviors included elements that conventional leadership theories in hospital-based settings have not fully captured and may serve as a foundation for future theoretical development and practical application.