保健師活動におけるグループ支援の特徴と意義―これまでの経緯と今後の方向性

The Characteristics of Group Support Activities by Public Health Nurses

はじめに

　保健師の活動は，個人だけでなく，グループやコミュニティ全体を対象とした支援活動を展開している点が大きな特徴となっている。グループ支援は，ヘルスプロモーションの観点からも極めて重要であると考えられる。これらの活動の意義や必要性の認識は徐々に進んできているものの，どのように展開をしていくべきかの方法論や活動評価の部分では，いまだ十分な検討がされていない。対象とするグループの多様性も相まって，経験の少ない新人保健師には，難しい技術の1つとして認識されている。

　保健師活動におけるグループ支援の理論・技術，およびその評価方法を体系化していくためには，保健師のグループ支援の特徴を明らかにするとともに，心理学や社会福祉学などの他領域からの知見をどのように活かせるか，その位置づけを検証することも必要である。本稿では，まず用語の概念検討を行ない，歴史的経緯や事例等も参考にしながら，保健師活動におけるグループ支援の特徴について論じ，グループ支援活動の枠組みを提示したい。

　The most significant characteristic of group support activities by public health nurses is that of forming groups, focusing not only on individual members but on community groups or the whole community. Group support activities, such as activities for organizing self-support groups are considered to be very important for developing public awareness of health promotion and managing specific health problems in the community. The theories and evaluation methods for these activities, however, have not been fully examined and scrutinized yet. Working on group support activities is regarded as the most difficult task by less experienced public health nurses while the community groups are becoming more and more diversified.

　In order to systematize theories and skills for group support activities by public health nurses and to establish evaluation methods for these activities, it is essential to identify the characteristics and measures of these activities and examine the significance of these activities by applying knowledge from fields such as social psychology and social welfare. The prerequisite for this process is appropriate categorization of the vocabulary usage. On the former part of this article, we examined the classification and categorization of terms for public health nursing activities. On the latter part, we discussed the characteristics of group support activities and suggested the conceptual framework for these activities, the historical background and the relevant case examples.