グループ活動が地域に発展するための理論・技術

Theories and Skills to Support or Development Self-Help Group and Community Partnership Group in Empowering the Community

はじめに

　本稿では，地域看護職が「グループ活動が地域に発展する」という支援活動に関連すると考えられる理論，グループ活動が地域に発展するプロセスとその支援技術について，文献検討にもとづいて記載した。文献検索は1998年から2003年までの国内外について行ない（表1），さらにこの領域の文献に引用されることの多い1998年以前の主要な文献も加えた。

　保健師は，地域づくりをめざしてグループを組織する場合（健康推進員などの地区組織活動や地域の健康日本21推進組織など）はもちろんであるが，健康に関わる問題や境遇を共有する人々を結びつけてセルフヘルプ・グループをつくり，参加者のエンパワーをめざす場合（例えば，肥満教室，痴呆性高齢者の介護者の会など）であっても，グループの活動が地域に発展することを潜在的に，あるいは意図的に考慮して支援していると考えられる。そこでここでは，グループ活動を，地域看護職（保健師）が①セルフヘルプ・グループ活動の地域での発展につなげる場合と，②地域への発展を意図して組織されたグループ活動を支援する場合を想定して，グループ活動が地域に発展するプロセスと支援技術について述べたい。

　The purpose of this article was to identify the processes of having effects of activities of self-help group (SHG) and community partnership group (CPG) on the community, and to describe the intervention strategies to develop such group activities using online searched literatures review.

　It was found similar and different processes of having effects of group activities on the community between the SHG and CPG. Similarities in processes were found to bring about, awareness and identification of community health problems ; development of community care plan ; implementation of activities to solve the health problems and creating a sense of empowerment. Among the different processes, there were clear signals of SHG group being more independent than CPG at beginning of this process. This warranted the need for further training of CPG to become more aware of community problems. In addition, the problems that SHG members were more concerned about the group members' health problems, whereas the CPG identified with broader community health problems when identified through community assessment.

　The philosophies of professionals to support the SHG and CPG included partnership, group members' participation, decision-making and transformation. The intervention strategies to support or develop these groups were networking between community resources and them, providing information, conducting or supporting community assessment, making the CPGs, developing the leadership and providing practical support such as training the members of volunteer group in the community.