紀要論文 臨床看護師がフィジカルアセスメント技術を習得する過程に関する研究
Research on clinical nurses’ process of acquiring physical assessment skills

渡邉, 光代

(10)  , pp.23 - 32 , 2017-03-31 , 目白大学
ISSN:1882-7047
NII書誌ID(NCID):AA1232537X
内容記述
《目的》臨床看護師がフィジカルアセスメント技術(以下PAという)をどのような経験から習得しているかを明らかにすることを目的とした。《方法》関東周辺の300床以上の総合病院に勤務する1年~3年目までの臨床看護師494名を対象に、無記名による自記式質問紙調査を行った。《結果》臨床で活用しているPA項目は、頻度が高い順に、バイタルサイン、呼吸音聴診、腸蠕動聴診、でありこれらは自信度の高い項目と類似していた。PA自信度の合計点を高低に2分して、これを従属変数とした多重ロジスティック回帰分析を実施した結果、統計学的有意な独立変数(オッズ比(95%信頼区間),P値)は、「PA24項目の活用度合計点」1.23(1.16-1.31),P<0.001,「病棟で業務リーダーである」5.52(1.27-24.06),P=0.023,「病棟でプリセプターである」16.45(3.12-86.63),P=0.001であった。《結論》PA技術の習得を促進する要因として、看護基礎教育課程でのPA経験の活用度、技術習得できる時期での個人の特性や職務内容を考慮したPA経験、卒後教育での集合教育、学習会、プリセプターからの直接的指導や実践力との結びつきなど経験の質が考えられた。このことから、PA 技術の習得には、卒後の継続教育の中で強化されていく必要性が示唆された。
Objective: Clinical nurses learn physical assessment( PA) skills during their basic education courses. This research examines the current status of the process clinical nurses undergo to acquire these skills after graduation and clarifies what factors promote these skills’ acquisition.Methods: At over 300 hospitals in the Kanto area, an anonymous self-reported written questionnaire on the process of physical assessment skills acquisition was administered to 494 clinical nurses in their first through third years of work.Results: Analysis of questionnaire items on basic attributes and PA skills revealed that PA categories most often used in clinical settings were( in order of most to least): vital signs, respiratory sound diagnosis, and intestinal peristalsis auscultation. Results of multiple logistic regression analysis for the degree of confidence as a dependent variable, in which total points were divided into high and low levels, showed that statistically significant independent variables were “total point of utilization of the PA 24 items” [odds ratio (OR), 1.23; 95% confidence interval( Cl), 1.16 - 1.31,( p < 0.001)], “working as a leader in the ward”( OR, 5.52; 95% Cl,1.27 - 24.06, p = 0.023), and “working as a preceptor in the ward”( OR, 16.45; 95% Cl, 3.12 - 86.63, p = 0.001).Conclusions: As factors that promote PA skill acquisition, the following were considered: amount of PA skills used in basic nursing education courses, PA experience based on individual characteristics and work experience during the skills acquisition period, group education as part of post-graduate education, study groups, direct instruction from a preceptor, and quality of experience including connecting with execution ability. These results suggest that in post-graduate continuing education, PA skills acquisition must be strengthened. Continuing to investigate and improve education curricula is also necessary.
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