佐伯 昌俊

Objective: The objective of this review is to explore the experiences and attitudes of physicians, nurses, and nursing assistants regarding task-shifting and task-sharing in hospitals. Introduction: Despite multiple health care professionals performing overlapping tasks, the need for effective task-shifting and task-sharing remains a concern. Understanding task-shifting and task-sharing experiences, as well as the attitudes of health care providers in hospitals, is essential for providing safe and patient-appropriate care with limited human resources. Inclusion criteria: Qualitative studies that examine the experiences and attitudes of physicians, nurses, and nursing assistants in hospitals regarding task-shifting and task-sharing will be included. The review will include physicians, advanced practice nurses who are nurse practitioners or clinical nurse specialists, registered nurses, and nursing assistants. Midwives, pharmacists, occupational therapists, physical therapists, and students will be excluded. Methods: PubMed, MEDLINE, CINAHL, PsycINFO, Cochrane Database, and Web of Science will be searched as part of a 3-step search strategy. We will search for unpublished research and gray literature using Google Scholar and ProQuest Dissertations and Theses. Inclusion criteria will be studies published in English or Japanese from the time each database was established to the present. The methodological quality of all studies will be evaluated by screening against the inclusion criteria and by at least 2 critical evaluations using the standardized JBI checklist. Synthesized results will be pooled by meta-aggregation and published as a ConQual Summary of Findings. Review registration: PROSPERO CRD42023409612

PURPOSE: This study aimed to investigate the relationship between the expectations of unit-level nurses from nursing assistants (NAs), frequency of individual NAs' information-sharing behaviors with nurses, and the effect of NAs' self-perceived roles on this relationship. NAs provide patient care along with nurses, and their information-sharing behaviors with nurses may be influenced by the expectations of the nurses. METHODS: Nurses and NAs from 104 integrated community care (sub- and postacute) units were included in this Japanese cross-sectional study conducted from July to September 2018. Nurses' expectations from NAs and the NAs' self-perceived roles and information-sharing frequency were measured. Multilevel mediation analysis was performed for NAs' information-sharing behaviors, such as expressing, asking, providing linguistic responses, and providing feedback. RESULTS: Unit-level nurses' expectations from NAs were associated with the frequency of NAs' asking and responding behaviors with nurses (P < .05), mediated by the NAs' self-perceived roles. The frequency of NAs' expressing behaviors and feedback were also associated with their self-perceived roles (P < .001). CONCLUSIONS: High expectations of unit-level nurses from NAs led to better perception by NAs of their roles and led to better information-sharing behaviors. Educating nurses on NAs' roles may improve information-sharing between nurses and NAs that leads to safe and appropriate care to patients.

＜文献概要＞[目的]看護職と看護補助者(以下,補助者)の補助者役割認識を測定する尺度を作成し,信頼性と妥当性を検討する.[方法]2017年6〜9月に地域包括ケア病棟の看護職3,781名と補助者1,316名を対象に調査を行った.補助者役割を示す19項目について,看護職には「補助者に求めているか」,補助者には「看護職から求められていると思うか」,および「補助者として担いたいか」を尋ねた.項目を患者にとっての機能とチームにおける役割に分けて探索的因子分析を行い,看護職と補助者共通の因子構造を採用した後,尺度の信頼性と妥当性を検証した.[結果]<広い視野をもち多様な段階に対応する><ケアを通じて患者の力を引き出す><一員としてネットワークを築く><チームの患者情報を豊かにする>の4因子計16項目を抽出した.各因子のα係数は0.76〜0.85であった.基準関連妥当性なども確認された.[結論]補助者役割認識を測定する尺度を作成し,一定の信頼性と妥当性を確認した.

A自治体ナースセンターにおいて2015年から2016年に開催された復職支援研修を受講した看護職463名のうち、調査時点で看護職として就業中であった者を対象に、離職期間を経て復職した看護職におけるワークライフバランス(WLB)実現度と就業継続意思の関連について質問紙調査を実施した。質問紙を返送してくれた242名のうち、調査時点で看護職として就業中であった175名を分析対象とした。対象者は平均年齢43歳で8割以上に子どもがいた。看護職経験期間と離職期間の平均はともに約8年、正規職員以外の雇用形態の者が8割以上であった。時間の調整および家庭での過ごし方は復職継続意思と有意な正の相関があった。時間の調整と関連する職場・個人要因は、仕事の質的負担、働きがい、子どもの有無、雇用形態、家庭での過ごし方と関連する要因は働きがいであった。WLB実現度は職場のストレスと関連し、職場ストレスに配慮する必要があることなどが示唆された。