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T. Murai et al.

（和文抄録）

病院看護師の倫理的行動に影響する個人・組織要因

1)

九州大学大学院医学系学府保健学専攻

九州大学大学院医学研究院保健学部門

3)

純真学園大学保健医療学部看護学科

2)

村 井 孝 子1)3)，中 尾 久 子2)，中 野 正 博3)

【目的】本研究の目的は，病院看護師の個人要因，組織要因の相互作用およびこれら各要因の倫理的行

動への影響を明らかにすることである．

【方法】本研究では，全国の 21 病院に勤務する看護師を対象に，無記名の自記式質問紙調査を行った．

調査期間は 2019 年 8 月から 11 月である．先行研究を参考に，看護師の倫理的行動に影響する要因に

関する概念枠組みを作成し，構造方程式モデリングを用いて検証した．また組織風土のタイプ別に多

母集団同時分析を行い，比較を行った．

【結果】1,048 名の対象者に質問紙を配布し，535 名から回答を得，517 名を分析対象とした（有効回答

率 49.3％）

．病院看護師の倫理的行動に影響している個人要因は，Locus of Control と道徳的感受性で

あり，職位は Locus of Control と道徳的感受性を介して影響していた．年齢や性別，看護基礎教育に

おける倫理学習経験は影響していなかった．組織要因では，組織環境のよい風土が看護師の倫理的行

動に影響しており，病床規模や経営母体，病院内の倫理研修や倫理カンファレンスは倫理的行動に影

響していなかった．また個人要因と組織要因間の相互の影響も認められなかった．

組織風土のタイプ別に多母集団同時分析を実施したところ，全てのタイプの組織で，道徳的感受性

は「善いケア」に影響していることが示された．さらに強制・命令的な雰囲気が少なく集団凝集性の

高い組織では，院内の倫理研修が道徳的感受性に影響していること，集団凝集性の低い組織風土では，

職位や経験年数，経営母体などが倫理的行動に影響することが認められた．いずれのモデルも良好な

適合度を得た．

【結論】看護師の倫理的行動には，Locus of Control と道徳的感受性，組織環境のよい風土が影響して

おり，職位は Locus of Control と道徳的感受性を介して倫理的行動に影響していることが示された．

また看護師の倫理的行動に影響する要因には組織風土のタイプごとに違いがあることが明らかになっ

た．

Key words：病院看護師，倫理的行動，組織風土，道徳的感受性，Locus of Control

...