急性期病院における中堅看護師の専門職組織人としての目標設定に向けた病棟看護管理者の支援行動指標の有用性の検証

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[要旨] 目的 ： 急性期病院における臨床経験５－10年目で職位のない中堅看護師（中堅）の専門職組織人としての目標設定を病棟看護管理者（管理者）が支援するための「支援行動指標（指標）」（能見ら，2018）の有用性を検証する。方法 ： 管理者が中堅との目標面接等で指標を試用して目標設定を支援し，両者に目標設定の過程と３か月後の目標への取り組みに関し，半構成的個人面接調査を行った。目標設定支援の手がかりの獲得，支援の改善，管理者に指標の試用に関する負担感，中堅に専門職組織人としての目標設定と取り組み状況について聴取し，質的に分析した。結果 ： ３施設の管理者10名が中堅13名への目標設定支援に負担感なく指標を試用した。管理者は指標の【状況】と［状況の下位項目］をもとに，中堅の専門職組織人として目標設定困難な状態とその背景を捉えた。管理者は，目標設定支援に関する役割認識が高まり，観察や問いかけを通して，中堅の対象理解を深め，〈支援行動例〉を参考に，将来像を問う，役割期待を伝える等，支援が改善した。中堅は管理者の支援を認識し，キャリアビジョンを描き始め，組織貢献意識が高まり，学習を開始し，全員が専門職組織人として目標設定し取り組んだ。考察：管理者は指標の【状況】と〔状況の下位項目〕をもとに中堅の支援ニードを多面的・全体的に捉え，中堅との対話により，中堅各々の特性と役割期待を合わせた，専門職組織人としての目標設定を支援できたと考える。指標は目標設定支援のための目標面接を改善する上で有用と考える。

[SUMMARY] This study verified the Effectiveness of “Support Behavior Indicators”（Nohmi et al, 2018） for nurse managers toprovide support to mid-career nurses with 5 to 10 years of clinical experience, who do not have a professional title, insetting goals as professional employees in acute-care hospitals. A trial was conducted in which a nurse manager used the indicators through a goal setting interview with amid-career nurse and assisted the nurse in setting goals. This study conducted semi-structured interviews with bothnurse managers and mid-career nurses individually and asked them about the process of goal setting as well as worktoward achieving the three-months goals. Through interviews, questions related to effectiveness were asked to headnurses for obtaining clues to support the setting of goals as well as improve the support. Those asked to mid-careernurses were related to goal setting and the situation of work toward achieving goals as professional employees. Thecollected interview data were qualitatively analyzed.Ten managers in three facilities used the indicators in a trial, in which they provided support to 13 mid-careernurses in setting goals. It was found that managers understand the situation in which mid-career nurses are havingdifficulties in setting goals as professional employees as well as the background there to, based on the indicator “the situation in which mid-career nurses have difficulty in setting goals.”. The managers increased their awareness of theirroles in providing support for setting goals. Furthermore, the support that they provided （e.g., asking the subjects about their image of the future and conveying role expectations to them） improved from a deepening of theirunderstanding of the subjects （mid-career nurses）, which was attained through observation and inquiry and based on〈support behavior examples〉. Mid-career nurses acknowledged support from nurse managers and started building theircareer vision. This helped them increase their awareness of the importance of contributing to the organization and acquire the necessary knowledge. All such nurses set goals as professional employees and worked toward achieving them. The managers were able to provide support for goal setting that addresses the characteristics of each mid-careernurse, nurses who are professional employees with role expectations, by adopting different means. These meansincluded perceiving the support needs of the mid-career nurses multi-laterally and overall based on the［the situation］and （sub-category items of the situation） of indicators and by conversing with the mid-career nurses themselves. The indicators are believed to be effective in improving “goal setting interviews,” which are for providing support for goal setting.