紀要論文 障害者支援施設における「不適切なケア」の因子構造
Factorial structure of "inappropriate care" in support facilities for the disabled

岡本, 健介  ,  山本, まき恵  ,  谷口, 敏代

内容記述
本研究は障害者支援施設における不適切なケアの因子構造を明らかにすることを目的とした。中国地方5県の障害者支援施設217 施設を対象とし、生活支援員577名(有効回答率44.3%)を分析対象とした。不適切なケアを「障害者虐待防止法に定義されている障害者虐待とは言えないが、利用者の尊厳やプライバシーを損なう恐れのある職員による言動」と定義し、先行研究を参考に26項目を選定し、探索的因子分析及び検証的因子分析を行った。その結果、障害者支援施設に従事する生活支援員の不適切なケアは、「不当な言葉遣い」、「施設・職員の都合を優先した行為」、「プライバシーに関わる行為」、「職員の怠慢」、「自己決定侵害」の計17項目からなることが見出された。いずれの因子も利用者の尊厳を支える支援が求められている内容で構成され、不適切なケアの延長線上にある虐待防止に役立つと考えられる。
This study attempts to determine the factorial structure of inappropriate care in support facilities for the disabled. [Method] The present study examined 577 residential support care workers working in 217 support facilities for the disabled in the five prefectures of the Chugoku Region. The valid response rate was 44.3%. Inappropriate care was defined as "language and behavior by employees that does not rise to the level of cruelty as specified in the Act on the Prevention of Abuse of Persons with Disabilities, but carries the risk of violating the privacy and dignity of facility users." Based on this definition, 26 items were selected using past studies as references and subjected to exploratory and confirmatory factor analyses. This resulted in the generation of 17 items concerning inappropriate care by residential support care workers working in support facilities for the disabled that could be organized into the following five factors: "use of unjustified language;" "conduct that prioritizes the convenience of facility and staff member;" "conduct related to privacy issues;" "negligence of staff member;" and "violations of the right to self-determination." All factors contain elements that suggest the need for supporting the dignity of facility users, and are believed to be useful for preventing acts of cruelty manifested through the extension of inappropriate care.
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