Nonogaki Akiyo, Nishida Tomoko, Kobayashi Kazunari, Nozaki Kayoko, Tamura Haruka, Sakakibara Hisataka
Department of Nursing, Graduate School of Medicine, Nagoya University, Institutional address: 1-1-20, Daiko-minami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan.
Department of Nursing, Sugiyama Jogakuen University, Institutional address: 17-3 Hoshigaoka-Motomachi, Chikusa-ku, Nagoya, Aichi, 464-8662, Japan.
BMC Health Serv Res. 2019 Feb 4;19(1):96. doi: 10.1186/s12913-019-3924-5.
Home-visiting nurses are expected to enhance their ability to provide adequate nursing care in a relatively isolated work environment. However, the isolated work environment leads to less opportunity to share patient information. We investigated factors relevant to better patient information sharing among home-visiting nurses, which would contribute to the improved care performance of these nurses.
A cross-sectional study with anonymous self-administered questionnaire was conducted between June 2015 and September 2015 in two districts of Japan. Home-visiting nurses who were working at home health care agencies were recruited. The questionnaires consisted of items on demographic data, job-related variables, communication in the workplace, the current state of patient information sharing, opportunities (or measures) of patient information sharing in the workplace, and job satisfaction. Descriptive analyses were performed on all variables, using the Chi-square test, Fisher's exact test, or Mann-Whitney U-test. Logistic regression analyses were conducted to identify the factors associated with better information sharing, adjusting the years of home-visiting nursing experience as the control variable.
Of 762 anonymous self-administered questionnaires were mailed, data from 482 participants who consented to this study and had no missing answer were analyzed. Of the total, 77.2% shared the patients' information. Having a friendly adviser (OR = 2.51, 95% CI = 1.14-5.55, p = 0.023), attending some conferences (OR = 2.32, 95% CI = 1.12-4.82, p = 0.024), joining workshops (OR = 1.89, 95% CI = 1.15-3.10, p = 0.012), and years of home-visiting nursing experience (OR = 1.27, 95% CI = 1.03-1.57, p = 0.025) were significantly associated with sufficient sharing of the information. Nurses sufficiently sharing the information were well satisfied with their job (OR = 5.38, 95% CI =3.19-9.09, p < 0.001) and highly preferred a career in home-visiting nursing care (OR = 5.62, 95% CI =3.41-9.27, p < 0.001).
The results suggested that having opportunities to discuss face-to-face such as at conferences and workshops as well as promoting good relationships among colleagues in the workplace will contribute to better information sharing among home-visiting nurses. Home-visiting nurses with less years of experience need to be supported in order to share the information sufficiently. Additionally, sufficient information sharing was also associated with job satisfaction and preference for home-visiting nursing care, which might lead to job retention for home-visiting nurses.
家访护士需要在相对孤立的工作环境中提高提供充分护理的能力。然而，这种孤立的工作环境导致分享患者信息的机会减少。我们调查了与家访护士更好地分享患者信息相关的因素，这将有助于提高这些护士的护理绩效。
2015年6月至2015年9月在日本的两个地区进行了一项采用匿名自填问卷的横断面研究。招募了在家访医疗机构工作的家访护士。问卷包括人口统计学数据项目、与工作相关的变量、工作场所的沟通、患者信息共享的现状、工作场所患者信息共享的机会（或措施）以及工作满意度。对所有变量进行描述性分析，使用卡方检验、Fisher精确检验或Mann-Whitney U检验。进行逻辑回归分析以确定与更好的信息共享相关的因素，并将家访护理经验年限作为控制变量进行调整。
共邮寄了762份匿名自填问卷，对482名同意参与本研究且无缺失答案的参与者的数据进行了分析。其中，77.2%的人分享了患者信息。有一位友好的顾问（OR = 2.51，95%CI = 1.14 - 5.55，p = 0.023）、参加一些会议（OR = 2.32，95%CI = 1.12 - 4.82，p = 0.024）、参加研讨会（OR = 1.89，95%CI = 1.15 - 3.10，p = 0.012）以及家访护理经验年限（OR = 1.27，95%CI = 1.03 - 1.57，p = 0.025）与充分的信息共享显著相关。充分分享信息的护士对工作非常满意（OR = 5.38，95%CI = 3.19 - 9.09，p < 0.001），并且非常倾向于从事家访护理工作（OR = 5.62，95%CI = 3.41 - 9.27，p < 0.001）。
结果表明，有机会在会议和研讨会上进行面对面讨论以及促进工作场所同事之间的良好关系将有助于家访护士之间更好地分享信息。需要支持经验较少的家访护士以充分分享信息。此外，充分的信息共享还与工作满意度和对家访护理工作的偏好相关，这可能导致家访护士留住工作。
