) j ) ) ( ) ( ) ( ) ( j j ( ) ) ( ) gh C i F i lN fH S d Th M lH b d l hP l Th i

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Stud _y o n T h ^e M ^e ⁿtal H e alth P r oble m s a nd T h eir

C a u s ati^{v e} F ^{a c}to rs of H ^{o s}_pital N ^u rs e s

H ir o sb i K A M I G O R I a nd lzu mi T A N A K A

D ep ^{a r}t m e nt of Psy ^ch iatric N u r s l ng , S cho ol of N u r s i ng, Toy^{a m} ^a M edic al a nd P ha r m a c e utic al U niv e r sit y

A bstr a ct

W e in v e sti_gated the m e nt al he alth _pr ob le m ( ^M H P) ^thr o u gh ^t^h^e ^{a n a}^ly^{s e s} ^of v a rio u s r e sp^{o n s e s} ^{o n} the q^{u e s}tio n n air e s a sked to 3 0 7 h o spital n u r s e s in T ok ai^‑H oku rik u

district to attain a de ep ^{e r} in si_ght into t he c a u s ativ e fa cto r s u nde rl_ying ^{o n}to M H P s.

Th e m ain finding^s ^obtain ed fr o m the r e sp ^{o n}ded 3 0 4 n u r s e s a r e s u m m a riz ed a s

follo w s :

1) ^A ^m ^{o n}g ^{r e s}p^{o n}ded n u r s e s, a s m u ch a s 2 4 5 n u r s e s (^{8 1}^%) ^{c o m} plain ed of c e rtain

t y p^{e s} ôf M H P s w hich w e r e m o stl_y b o r n fr o m jô^b ^‑^{r e}^lâ^tê^{d i}^{s s u e s} (â ^tô^tâ^l ô^{f 77}%)

s u ch a s c op^{l n}g Str ateg y,j^o^b ^p ^{e r}^f^{o r m} ^{a n c e} ^{a n}^{d i}ⁿ^t^{e r}^ps e r s o n al r elatio n shi_p_, but in

p ^{a r}t fr o m fa mil_y ^‑r elated is s u e s s u ch a s edu c atio n of ch i dr e n a nd m a r riag^e (^{1 4}

%) ^. ^A ^{c c o m} p ^{a n}ied with the M H D , o n e^‑fifth of th e s e n u r s e s als o c o m plain ed of

eithe r si_g n of _phsyic al o r m e ntal he alth d_y sfu n ctio n s u ch a s sle eple s s n e s s (^{2 5}

%) , la ck of ap p^etite (^{2 0}%) ^{a n}^{d f}^{e e}^liⁿg ^of dep^{r e s s}io n (^{2 0}%) ^.

2) Alth o t lgh fiv e vie w s of _pe r s o n ali_{t y} (being ^op timistic _, p ^{e s s}imistic, s eir o u s minded,

s o ciab^l^e a nd u n s o ciab^le) w e r e cited wit h alm o st t he s a m e r ate s (2 5% to 1 6 %) ^,

op ti mistic n u r s e s r ep r oted ^le s s fr eq ^{u e n}tl_y M H ^P s tha n p ^{e s s}imistic o n e s.

3) C o m p^{a r}ing the c a u s ativ e fa cto r s of M H Ps ba s ed o n the ag^{e s} ^{a n}d le ng th of

n u r sing ^{e x}p^{e r}ie n c e

, a te nde n cy ^{w a s} ^sh o w n that y ^{o u n}g ^{e r} n u r s e s wi th in s ufficie nt

e xp^{e r}ie n c e s find the m in a p r o c e s s ofj^o^b ^p ^{e r}^f^{o r m} ^{a n c e}^, ^w ^h^{e r e a s} ^o^ld ^{e r} ^{o n e s} ^wⁱ^t^h

adeq u at_e _{e x}p ^{e r}ie n c e s fiⁿd iⁿ fa mily^‑r elated is s u e s.

4) ^T ^o ⁱ^m p^{r o v e} p h_ysic al a nd m e ntal d_y sfu n ctio n s_, sle eping ,tal king ,liste ning t^o ^m ^{u s}ic a nd tr a v eling ^w ^{e r e} ^cited a s m aj^{o r} ^m e a s u r e s. H o w e v e r, it w a s sh o w n that

c o n s ultatio n with c e rtain pe r s o n s o r sp ^{e c}ial_{t y} b o oks is e s s e ntial fo r n u r s e s with M H P s to im p ^{r o v e} their situ atio n s.

In li ght of t he s e fi ding ^s^, it is s ug g ^{e s}ted that the m o st im p^{o r}ta nt a nd effe ctiv e m e a s u r e is t he e stablish m e nt of c o n s ultatio n sy^ste m s in the h o spitals t o p ^{r o v}id e m o r e tim el_y a nd e a sie rl_y the cha n c e s of c o n s ultatio n to n u r s e s fa c l ng t^O the s e situ atio n s.

K ey ^{w o r}ds

h o spital n u r s e_, m e ntal he alth _p r oble m _, c op^{i n}g ^Str ateg y^,

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看護婦^の精神保健問題^に関す^る研究

Intr odu ctio n

U nde r t he c o m plic ated situ atio n s of N u r s l ng; ^m ^{o s}t Of n u r s e s a r e exp ^{o s e}dto m a ny k ind s of str e s s o r s s u ch a s diffc ultj^u^dg ^m ^{e n}ts

in a j^o^b ^p^{e r}^f^{o r m} ^{a n c e}^, ^{c o n}^f^{r o n}^tⁱⁿ^g ^d^{e a}^t^h ^o^f

p ^atie nts

, m a ste ring ^{n e w e r} n u r s l n g ^Sk ills,

p e r s o n al r elatio n sh i_p with fello w m e m be r s

in ad ditio n to fa mil_y ^‑r elated is s u e s l) 2)

. It

is w ell kn o w n that the s e str e s s o r sfr eq ^{u e n}tl_y

a ct a s c a u s ativ e fa cto r s af fe cting ^{o n} n u r s l ng p ^{e r}fo r m a n c e s

3)

. N e v e rthele s s, th e m e ntal he alth _p r ob le m ( ^{M H P}) ^o^f ^h^{o s}ⁱ^t^a^l n u r s e s

h a s n ot y^et b e e n studied in detail in Jap ^{a n}^. The r efo r e, th is study ^{w a s} d e si_gn ed to obtain a d e ep ^{e r} in si_ght into the c a u s ativ e fa cto r s u nde rl_ying ^{o n}to M H P a nd dis c u s s ho w th e

h o spital n u r s e s c op ^e ^wit h M H P fo c u s l ng

o n t heir ag^e^, le ng t h ^of n u r s l ng ^{e x}p ^{e r}ie n c e

( ^{r e}^f^{e r r e}^d ^{a s} ^t^o ^{L N E} ⁱⁿ ^t^hi^s ^s^t^u^d^y) ^{a n}^d

p e r s o n ali_{t y}^.

Subj^{e c}^t^s ^{a n}^d ^M ^e^t^h ^o^d^s

A total of 3 0 7 h o spital n u r s e s in Tokai^‑ h oku riku district atte nding ^{s e m} in a r s a nd in ^‑s e r vic e ed u c atio n p ^{r o}g^{r a m} ^s hel d in s u m m e r 1 9 9 8, w e r e a sked to r e sp ^{o n}d to a s elf^‑ad ministr ated _qu e stio n n air e r eg ^{a r}d ing M H P s. T he n u r s e s w e r e a sked t o de s c ri be

(¹) ^t^hê t y pê ôf M H P (^by ^{s e}le ctio n fr o m a

list of ite m s in this c a s e) , (²) ^t^h ^e ^{c a u s a}^tⁱ^{v e}

fa cto r s fo r M H P , (³) ^t^h^e t y p^{e s} ^of m e ntal d_ysfu n ctio n s felt in c o r r elatio n with M H P,

a nd (⁴) ^the str ategie s u s ed to c op^e ^with M 日 P . Th e n u m be r of r e sp^{o n}de r s w a s 3 0 4

c o n sisting ^of 2 9 2 fe m ale a nd 12 m ale n u r s e s with a n ag ^e ^str u ctu r e of 2 0 to m o r e tha n

5 0 y^{e a r s} ^old a nd LN E dist^ri butio n of le s s

t ha n 10 ^t^o ^m o r e tha n 3 0 _y e a r s. D ata w e r e a n aly ^{z e}d statistic ally by the chi^‑sq u a r e te st t o e x m ain e t he s lg ⁿifi_{c a n}t di^{f f}e r e n c e s.

R e s ults

A m o ng t he r e sp^{o n}de r s, a s m u ch a s 2 4 5

n u r s e s (8 0^.6% ) cited c e rtain kinds of M H Ps,

but 5 5 n u r s e s (^{1 8}^.¹^%) a n s w e r ed to be fr e e of this p ^{r o}ble m . F o u r n u r s e s(¹^.³%) ^{s o m} ^e^h^{o w}

di d n ot a n s w e r (^T ^a^bl^e ¹ ) ^. ^{T h}^{e s e} ^{v a}^l^{u e s}

w e r e s lg ⁿific a ntl_y d iffe r e nt in eith e r ag ^e g ^{r o u}p ^{o r} L N E _gr o u p^. A c c o m p ^{a n}ied with this

p ^{r o}ble m , 2 4 5 n u r s e s als o c o m plain ed of

c e rtain ph_ys I C al a nd m e ntal d_y sfu n ctio n s s u ch a s sle eple s s n e s s (2 5%)^,^l^{o s s} ô^f â^{p p} ê^tⁱ^tê (^{2 0} %)^, ^bêⁱⁿg ^{u n s o c}iable (2 0 % ) ^, g^{e n e r a}l fe eling ôf u nhe alth in e s s (1 9% ) ^{a n}d obs c u r e

thinking (^{1 6} % ) ^. Â ^s ^f^{o r} ^{s e}^lf^‑^{e s}^tⁱ^m â^tê^d

p e r s o n ali_{t y}, fiv e vie w s w e r e cited ; being

op timistic (^{2 5}% ), p ^{e s s}imistic (^{2 2}%)^, ^{s e r}ⁱ^{o u s}

minded (2 0% ), u n s o ciable (17%) ^{a n}^d ^{s o c}ⁱ^a^b^l^e (1 6 % ) ^{a s} ^sh o w n in Table 2 . It h a s be e n cle a rl_y d e m o n str ated that M H P o c c u r s m o r e

fr eq ^{u e n}tl_y l n n u r s e s With eithe r p^{e s s}imistic o r s e rio u s minded vie w tha n o n e s with

eit he r op timistic o r s o ciab le vie w .

The c a rdin al c a u s e s fo r M H P a r e s u m m ^‑ a riz ed in Table 3 . In o rd e r of cited r ate,

the s e w e r e c oping ^str ateg y (^{3 1}% ) ^, p r o c e s s of j^o^b ^p ^{e r}^f^{o r m} ^{a n c e} (^{2 4} % ), inte rp e r s o n al

r elatio n shi_p at the w o rking pla c e s (^{2 2} %)

a nd fa mil_y ^‑r elated is s u e s (^{1 4} % ) ^. ^{T h}^{e s e}

r e sp ^{o n s e s} ^sho w ed s lgⁿific a nt diffe r e n c e s

ba s ed o n ag^e ^{a n}d L N E ^. A te nd e n cy ^w ^{a s} s

ho w n that y^{o u n}g^{e r} n u r s e s find their c a u s e s

in the c op^{l n}g ^St_{r a}t eg y ^{a n}d p r o c e s s of j^o^b

p ^{e r}fo r m a n c e, whe r e a s ol de r o n e s find the m

in fa mil_y ^‑r elated is s u e s.

To e xtr a ct u nde rl y iⁿg ^ele m e nts o nto e a ch

c a u s e d e s c ri bed ab o v e

, fu rthe r a n al_ys e s w e r e c a r ried o ut. N u r s e s s uffe r l ng fr o m c op^{i n}g

str ateg y ( ^T â^blê ⁴ ) â^tt^ri buted its c a ll S e eithe r to la ck of tho u gh ^tfû^l ^{c o n s}ⁱ^d ^{e r a}^ti^{o n} (2 3 % ), he sitatio n to offe r ot b e r

'

s h elp (2 3

% ), la ck of c o m p lia n c e (^{2 3} %) , h e sitatio n

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T able1 Exp ^{e r}ie n c e of M e ntal H e alth _p r oble m (M H P)

a nd _psy ^{s I C a}l a nd m e ntal dy ^sf u n ctio n N ⁼3 0 4 N u m be r(^%) ô^f ⁿ^{u r}^s^{e s} ^w^{jt h} ô^r ^w^{it h}ô û^{t M H P}

a nd kinds of p h y^s^{I C}^aland m ental d y^sfu n ction s

C ateg^{o r}y V Vit h M H P V V it h out M H P

Ag ^e(y^e^{a r})

0 7 8

7_.

7 9

Leng t h ôf nur sing ^{e x}p ê^rⁱêⁿ^{c e}(y^{e a}^r)

≦⁹ ^{8 9}

1 0 ^‑ 1 9 8 6

2 0 ^‑ 7 0

Tota1 2 4 5(^{8 0} ^.⁶)

8 3 0 2 ー 3

0 5 4 3 ーー

5 9(^{1 8} ^.¹)

*

S i gⁿ

S le ep l^es s n e s s Lo s s of ap p^etite

Being ^{u n s}^o^ciab le G e n e r al fe e=ng

ofu nhe a一t h in e s s O bs c ur^et h ink iⁿg

Totala n sw er

1 0 9(^{2 5})

8 4(^{2 0})

8 2(^{1 9})

7 3(^{1 6})

4 3 2

n ot ânâ一y^zêd

sig ⁿific a nt d iffr e nt(p ^<0 .0 5) ^b^e^t^w ^{e e n} g^{r o}^up^s

wit h a nd wit h^o ^ut M H P

T ab le 2 R elatio n ofs elf^‑e stim ated _pe r s o n ali_{t y}

with the m e ntal he alth _p r oble m Exp^{e r}ie n c e of M e ntal Pe r s o n alit y N ⁼3 0 4 % He alt h Pr ob le ms

Ye s N o

O p ti^mistic 9 8 2 5 7 2 2 6

Pessimistic 8 8 2 2 7 1 1 7

S^{e r}iou s minded 8 2 2 0 5 4 2 8 *

U^{n s o}^ciabfe 6 8 1 7 5 9 9

Socjable 6 6 1 6 5 5 1 1

Totala n s w e r s 4 0 2

* S igⁿific a nt d iffere nt(p^<0 ^.0 2) ^bê^t^w ê êⁿ g^{r o u}p^s

wjth a nd wit h out M H P