保健師によるグループ支援活動の理論および実証研究に関する課題

Tasks to Develop Theories and Research of ‘Supporting Community Groups’ by Public Health Nurses

はじめに

　保健師活動をキータームにすれば，看護の技術のなかで新たに開拓しうるものがあるのではないだろうか？　これが，地域看護学の勉強会を始めた時の我々の問題意識だった。

　保健師が扱う領域のうち，臨床看護と大きく異なる点は，グループ育成・支援である。グループには，独自の治癒力があり，1対1の援助ではなしえない支援ができる可能性がある。これが，地域でグループを育成する理由である。

　しかし，それだけではない。育成したグループが，単にその治癒力をその集団の成員個々人に及ぼすだけではなく，そのグループが地域社会の資源になり，ひいては地域の健康度や住みやすさにもつながっていくことを期待している。このように考えれば，グループを育成することは，保健師が地域でケアを提供していく際の武器になるともいえる。1つ1つのグループが参加者のニーズにこたえ，かつ，そのなかで参加者が自立すると同時に，グループ自体が自立して活動していけるようになることが望ましい。

　Theories and measures for supporting community groups by public health nurses (PHNs) have not been fully developed. This is partly because theories from other disciplines have been applied to the field of nursing without considering the nature of the practice by PHNs and partly because the process of stimulating of group activities in the community have not been identified completely.

　The following research questions related to above issues may be posed : 1) How to identify the needs of the community and to promote the community-based group activities ; 2) How to develop group activities based on needs of the group ; 3) How to apply established theories and measures into practice ; 4) How to support these groups in order to help promote independent activities by exploring and identifying skills required ; 5) How to develop skills, leading to theories for group work, expanding them into the community project ; 6) How to design the evaluation system for supporting group activities ; and 7) How to develop guidelines for public health activities which are suitable and feasible for the community in Japan.

　It is, therefore, essentisl to compile and organize new knowledge to develop a comprehensive theory. PHNs focus their concerns on the health of communities as front-line workers. Thus, using their knowledge and building their capacity to develop new theories and measures for group work in the community is a necessity. Future research must be conducted in partnership with the researchers from related fields like social welfare as well as the partnership with the community.