論文

Limited research has explored how factors related to nurses' personal lives impact their professional quality of life (QOL). The present study aimed to investigate the effects of satisfaction with work–life balance (WLB) and social support from family, friends, and significant others on the professional QOL among nurses providing end-of-life care. This cross-sectional study utilized an online survey to assess nurses in home care settings and palliative care units. WLB and social support were assessed using a 4-point Likert scale, whereas the Professional QOL Scale was utilized to measure secondary traumatic stress (STS), compassion satisfaction (CS), and burnout (BO). In a multigroup analysis, WLB had significant direct effects on STS and BO in both settings. Regarding CS, WLB demonstrated a significant effect only in palliative care unit nurses (β = 0.212). Social support had significant direct effects on STS and BO in home care nurses (β = −0.190 and −0.215, respectively). These results suggest that professional QOL is affected by WLB among nurses providing end-of-life care; however, social support impacts the professional QOL of only those in home care settings.

Purpose: In 2021, we introduced a new simulation-based learning program focusing on a roleplay conference before patient discharge. This study aimed to evaluate the program’s effectiveness and highlight the significance of cross-training in interprofessional education (IPE). Methods: In September 2023, the program included 346 students (98 medical, 110 nursing, and 138 pharmacy students). The students’ reflective writing was analyzed using inductive content analysis to describe their learning and perspectives. The original items, subcategories, and main categories were extracted. The simulation involved the students role-playing various healthcare professionals during a discharge-planning conference for a stroke patient. This allowed them to experience the challenges and dynamics of interprofessional collaboration. Results: Student feedback emphasized the importance of understanding what constitutes a good healthcare team. A total of 203 items were grouped into eight main categories and 17 subcategories, including patient-centered care (related to the importance of patient-centered care, supporting patient decision-making, communicating with patients during conferences, and facilitating decision-making processes), contrasts in patient and interprofessional communication, conference communication (challenge of building consensus, the way to proceed conferences, importance of conference preparation, and process of information aggregation and realization of outcomes), mutual recognition and role contribution, building relationships (importance of daily interprofessional communication), understanding one’s profession (reflection on one’s own profession, understanding the roles of different professions, and communication within one’s own professional context), recursion into learning (motivation for continuous learning and improvement), and understanding other professions (understanding the role and perspectives of other professions and recognizing professional differences). Specific feedback highlighted improved empathy and communication skills. Students recognized the value of each profession’s contribution to patient care. Moreover, students reported a deeper appreciation of patient-centered approaches and the complexities of coordinating care across different healthcare roles. Conclusion: Simulated interprofessional team conferences using cross-training effectively taught junior students to understand the essence of a good healthcare team and the importance of a patient-centered approach. Cross-training significantly enhanced students’ interprofessional competencies, communication skills, and empathy toward other professions. This case underscores the necessity of incorporating cross-training into IPE to prepare healthcare professionals for collaborative practice and improve patient outcomes. Future research should consider expanding the scope to include more diverse scenarios and longitudinal assessments to measure longterm impacts on professional practice.

Background: Nurses providing end-of-life care experience not only burnout and compassion fatigue, but also positive effects such as compassion satisfaction. Nurses' compassion satisfaction was shown to be related to job satisfaction, work engagement, and nurse caring. Studies in emergency departments, intensive care units, oncology wards, and general wards have identified work environmental factors associated with nurses' compassion satisfaction, but no similar studies have been conducted in palliative care units or home care settings. It is also unknown whether work environmental factors associated with compassion satisfaction contribute to end-of-life care quality. Objective: To explore work environmental factors associated with nurses' compassion satisfaction and end-of-life care quality in three types of workplaces: general wards, palliative care units, and home care settings. Design: A cross-sectional survey of nurses providing end-of-life care. Settings: Sixteen general wards, 14 palliative care units, and 25 home-visit nursing agencies in Japan. Participants: There were 347 study participants: 95 nurses in general wards, 128 in palliative care units, and 124 in home care settings. Methods: Compassion satisfaction was assessed using the Professional Quality of Life Scale, and end-of-life care quality was rated on a 4-point scale. Work environments were assessed using the Areas of Worklife Survey, which measures the fit between an individual and their work environment in six areas: workload, control, reward, community, fairness, and values. Results: Compared to nurses in general wards and palliative care units, home care nurses scored statistically significantly higher on all work environmental factors except reward. Work environmental factors that were significantly positively associated with higher compassion satisfaction were values in general wards (β = 0.335, P = 0.007), reward and workload in palliative care units (β = 0.266, P = 0.009 and β = 0.179, P = 0.035), and community and control in home care settings (β = 0.325, P = 0.001 and β = 0.261, P = 0.004). In addition, higher scores for workload in general wards (odds ratio = 5.321; 95 % confidence interval, 1.688–16.775) and for community in palliative units (odds ratio = 2.872; 95 % confidence interval, 1.161–7.102) were associated with higher end-of-life care quality. No associated work environmental factors were found in home care settings. Conclusions: Work environmental factors associated with nurses' compassion satisfaction and end-of-life care quality varied between workplaces. These results may contribute to creating work environments that are appropriate for each workplace type to maintain both nurses' compassion satisfaction and end-of-life care quality. Tweetable abstract: Work environmental factors associated with nurses' compassion satisfaction and end-of-life care quality were identified in three workplaces.

This study aimed to develop a scale focusing on knowledge and attitudes toward palliative care and end-of-life care for nurses and to confirm the scale's validity and reliability. We conducted a self-administered questionnaire survey with 1745 nurses of 10 hospitals all over Japan. We also examined the test-retest reliability of items for 205 of the nurses, 2 weeks after the first survey was completed. We used item-response theory, factor analysis, and intraclass correlation coefficients. The response rate was 44.5% (n = 762). Ninety items in 9 domains about knowledge of palliative care and end-of-life care were selected by using item-response theory. For knowledge items, Kuder-Richardson-20 was 0.85, and intraclass correlation coefficient was 0.84 in all domains. Ten items in 3 domains about attitudes toward palliative care and end-of-life care were selected by using exploratory factor analysis. For attitude items, Cronbach's α coefficient was.90, and intraclass correlation coefficient was 0.80 in all domains. The developed scale, named the End-of-Life Nursing Education Consortium - Japan Core Quiz, has sufficient validity and reliability. This scale may contribute to assessing the effectiveness of the End-of-Life Nursing Education Consortium - Japan Core Curriculum Nursing Education Program in Japan.