新人看護師における就業３年までの職務ストレッサーとストレス反応に関する研究

• Published in: 日本看護研究学会雑誌 Vol. 37; no. 1; pp. 1_123 - 1_131
• Main Authors: 眞鍋 えみ子, 小松 光代, 岡山 寧子
• Format: Journal Article
• Language: Japanese
• Published: Japan Society of Nursing Research 2014; 一般社団法人 日本看護研究学会
• Subjects: burnout; job stressors; newly graduated nurses; stress coping; ストレスコーピング; バーンアウト; 新人看護師; 職務ストレッサー
• ISSN: 2188-3599; 2189-6100
• DOI: 10.15065/jjsnr.20131203008

A study was conducted of job stressors along with changes in reaction to stress and their related factors during the first three years of employment targeted at 34 nurses employed at the same health care institution. The contents of the survey consisted of attributes, job stressors, stress coping, emotional support and reaction to stress, and it was conducted using a selfadministered questionnaire which after 12, 24, 36 months employment. We found that during the first year, the subjects perceived a lack of nursing competency as the primary stressor, and demonstrated a greater decrease in their sense of personal accomplishment the greater the degree of that stressor. During the second year, although stressors relating to their relationships with superiors served to promote a decrease in their sense of personal accomplishment, stressors relating to co-workers and physicians served to curtail decreases in their sense of accomplishment. The behavioral tendencies indicative of depersonalization weakened the greater the extent to which actions were taken to cope with approach issues in the second year. These results suggested the importance of providing support coinciding with stressors, changes in the manner in which stress is coped with and behavioral tendencies, and particularly the need to provide support for improving nursing skills in the first year and acquiring the ability to adapt to personal relationships in the second year. 【目的】　看護学士課程卒業後，同一医療機関で勤務する看護職34名を対象に３年間の〈職務ストレッサー〉と〈心理的ストレス反応〉の変化とその関連要因を検討した。　 【方法】　就業12，24，36か月目の時期に自記式質問紙調査を行い，内容は属性のほかに〈職務ストレッサー〉〈ストレス対処行動〉〈情緒的支援〉〈心理的ストレス反応〉であった。　 【結果】　１年目では「看護能力不足」によるストレッサーを認知し，そのストレッサーが強いほど「個人的達成感の低下」を示した。２年目では，「上司との関係」に関するストレッサーは「個人的達成感の低下」を助長する一方で，「同僚」や「医師」に関するストレッサーは「個人的達成感の低下」を抑制していた。２年目までは，接近型問題対処行動をとるほど「脱人格化」の行動傾向は少なくなった。　 【考察】　ストレッサーやストレス対処行動の質の変化や行動傾向にあわせた支援の重要性，とくに１年目は看護実践能力の向上，２年目は人間関係調整能力の習得支援の必要性が示唆された。