脳神経外科病棟では, 遷延性意識障害をはじめ, 運動あるいは言語障害など何らかの障害を持つ患者が大半を占めている。その患者を日々直接的にケアをしている看護者には, 意欲的に働いている者も燃え尽きている者もいる。この職業意欲に影響をおよぼす要因を明らかにする目的で, 同意を得られた脳神経外科病棟に勤務する看護者15名に, 半構成的面接法による質的な研究を行なった。その結果, 意欲に影響を及ぼしているのは, 「患者の状態」「患者の反応」「家族の姿」「家族の反応」「医師との関わり」「上司の関わり」「同僚の姿」「同僚の反応」「自己の看護の質」「自己の役割遂行」「環境的要因」「第三者の評価・支援」の12要素であった。そのうち, 脳神経外科病棟に特有なのは, 「患者の状態」「患者の反応」「家族の姿」の3要素であることが示唆された。

In most of neurosurgical wards, majority of the patients are suffering from disability in motion and speech as well as from prolonged disturbance of consciousness. In the nursing staff directly taking care of the daily living of those patients, some are working willingly, while others are desperate and exhausted. In order to clarify the factors affecting their working desire, we questioned 15 nursing staff working in the wards, through a semistructured interview. As a result, we found there are 12 factors affecting the working desire : the condition of the patients, reactions of the patients, attitude of their families, reactions of their families, relations with doctors, reactions of their superior staff, reactions of their fellow staff, attitude of their fellow staff, the quality of their own nursing, achievement of their own roles, environmental factors, evaluation and support by others. Among these, there are three factors most commonly cited. They are : condition of the patients, reactions of the patients, and attitude of their families. They have been suggested as the leading factors effecting the working desire of the nursing staff in neurosurgical wards.

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