Furukawa Ayako, Kashiwagi Masayo, Morioka Noriko
Department of Innovation in Fundamental and Scientific Nursing Care, Nursing Innovation Science, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Nursing Health Services Research, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Glob Health Med. 2024 Aug 31;6(4):225-235. doi: 10.35772/ghm.2024.01026.
An aging nursing workforce requires addressing shortages due to retirement. This nationwide descriptive cross-sectional study in Japan clarified the employment status of older nursing staff aged ≥ 55 years by facility type during January-March 2022. Questionnaires were sent to 8,000 nursing directors, with 1,658 valid responses (response rate: 20.7%). Descriptive statistics and Kruskal-Wallis or χ2 tests analyzed inter-facility differences. A violin plot depicted the proportion of older nursing staff across facilities by age group, and generalized estimating equation (GEE) models examined associated factors at the facility level. Older nursing staff's distribution differed significantly across age groups ( < 0.01), from 0% to 100% within the same facility type. Some facilities had high percentages of staff working beyond retirement age. GEE results showed higher percentages of full-time employees and nurses were negatively associated with the percentage of older nursing staff across most facility types ( < 0.05). For those aged ≥ 65 years, the total population was positively associated with employment in bedded clinics (coef. = 0.07, 95% CI: 0.01 to 0.14, = 0.03), but negatively associated with the total population (coef. = -0.06, 95% CI: -0.10 to -0.01, = 0.02) and percentage of the population aged ≥ 65 (coef. = -0.76, 95% CI: -1.43 to -0.08, = 0.03) in long-term care insurance facilities. Working conditions and environments should be improvement to potentially retain older nursing staff. Job seekers should be matched with managers' needs in facilities with a higher proportion of older nursing staff to ensure a sustainable workforce.
老龄化的护理人员队伍需要应对因退休导致的短缺问题。这项在日本开展的全国性描述性横断面研究明确了2022年1月至3月期间不同设施类型中55岁及以上老年护理人员的就业状况。研究向8000名护理主任发放了问卷，共收到1658份有效回复（回复率：20.7%）。采用描述性统计以及Kruskal-Wallis检验或χ2检验分析机构间差异。小提琴图展示了各机构中不同年龄组老年护理人员的比例，广义估计方程（GEE）模型则用于检验机构层面的相关因素。老年护理人员的分布在不同年龄组间存在显著差异（<0.01），在同一设施类型中从0%到100%不等。一些机构中超过退休年龄仍在工作的员工比例较高。GEE结果显示，在大多数设施类型中，全职员工和护士的较高比例与老年护理人员的比例呈负相关（<0.05）。对于65岁及以上的人员，在设有床位的诊所中，总人口与就业呈正相关（系数 = 0.07，95%置信区间：0.01至0.14，P = 0.03），但在长期护理保险设施中，与总人口呈负相关（系数 = -0.06，95%置信区间：-0.10至-0.01，P = 0.02），与65岁及以上人口比例呈负相关（系数 = -0.76，95%置信区间：-1.43至-0.08，P = 0.03）。应改善工作条件和环境，以潜在地留住老年护理人员。在老年护理人员比例较高的设施中，求职者应与管理人员的需求相匹配，以确保有可持续的劳动力。
