被災自治体保健師が災害対応を行うにあたり生じる公私間の葛藤

Conflicts Between Public Health Nurses' Public and Private Lives in Responding to Municipalities Affected by Disasters

要　　旨

目　的：被災地保健師が災害対応を行うにあたり生じる公私間葛藤の内容とその特徴を明らかにし，公私間葛藤への平時からの対策示唆を得る．

方　法：2000年以降に発生した災害の被災地自治体に属する保健師に，公私間で生じた葛藤内容，気持ち，及び対応と結果等について半構造化インタビューを実施した．

結　果：対象は11自治体，24名の保健師で，体験災害は，洪水，地震，崖崩れ，津波，放射線汚染であった．公私間葛藤は急性期から静穏時に生じ，内容は，＜緊急参集と家族の安全確保＞，＜自治体の指揮命令遵守と自己の安全確保＞を含む15のカテゴリが抽出された．

結　論：公私間葛藤の意思決定基軸の中核は，災害時に住民の生命・健康を守るのは自治体保健師の責務であるという意識と使命感，家族・同僚に負担をかけたくないという価値観であった．基軸は平時の公衆衛生活動の中で培われていた．よって自治体保健師は，平時から災害時にどのようなことが起き，自分はそれをどう考え対応するのか想像して活動していく必要がある.

　Objective: This study identified the characteristics of conflicts between the public and private sectors　when local public health nurses in disaster-stricken areas respond to disasters and offered suggestions　on managing conflicts between their public and private lives in times of no disasters.

Methods: Semi-structured interviews were conducted with public health nurses in municipalities affected　by disasters since 2000 to obtain information on the content, feelings, responses and results of conflicts　between their public and private lives.

Results: The participants were 24 public health nurses from 11 municipalities, and the disasters they　experienced included floods, earthquakes, landslides, tsunamis and radiation contamination. Conflicts　between their public and private lives occurred from the acute to the quiescent period, and 15 content　categories were extracted, including emergency attendance and family member safety, compliance with　local government orders and self-safety.

Conclusion: Public-private conflict was centered around the decision-making axes of the awareness of　being a municipal public health nurse; a sense of having a mission as a public health nurse with the　obligation to protect residents' lives, livelihoods and health; and the value of not placing a burden on　family members and peers. These axes were nurtured through district activities during normal times.　Hence, before conducting their activities, municipal public health nurses must imagine what would　happen in disasters and how they would think about and respond to these.