母子保健推進員とのパートナーシップを構築する保健師の技術―人口6万人規模の自治体における母子保健活動の実践を通して

Skills of the Public Health Nurses for Building Partnerships with Maternal and Child Health Volunteers: Through the Practice of Maternal and Child Health Activity in the Sixty Thousand Population Local Government

要旨

　母子保健推進員（以下，母推とする）は地域における保健師活動の協力者である．本研究では，保健師が地域から要支援者を発見して支援につなげた際に用いた，母推とのパートナーシップを構築する保健師の技術を明らかにすることを目的とした．

　研究調査地は，農漁村地域と市街地の両方をもつ人口約6万人のA市とし，母子保健活動を担う保健師と母推を対象とした．データはインタビューおよび筆者がA市の保健師として参加観察してデータを収集し，質的分析を行った．研究期間は2009年4月～2010年3月である．

　保健師が母推とのパートナーシップを構築する際に用いた技術は次の5つであった．母推担当保健師が用いた技術は【母推の活動を共につくる】【母推との信頼関係を構築する】であった．地区担当保健師の技術は【母推によるサポートの有効性を判断する】【母推にサポートを依頼する】【母推の活動意欲を支える】であった．

Abstract

　Maternal and Child Health Volunteers (MCHVs) are collaborators with Public Health Nurses (PHNs) in the community. The objective of this study was to clarify the skills of PHNs for building partnerships with MCHVs through community activities with which PHNs find persons needing support and access to care.

　The study was conducted in City A with a population scale of sixty thousand, consisting of a city area and agricultural/fishery area where community health activities for mothers and children were conducted. Data were collected from April 2009 to March 2010 through interviews MCHVs and PHNs in the community, as well as by participating observation by one of the authors as a PHN of the city. We used a qualitative study method to analyze the result.

　The skills of PHNs for building partnerships with MCHVs were categorized into five skills. The skills of a PHN who is in charge of supporting an MCHV's activities are the creating significance in an MCHV's activities together with them and the promoting confidence between MCHVs and PHNs. The skills of PHN who is in charge of a district are the assessing the efficacy of MCHV's support, the relying on for cooperation of MCHVs and the helping to maintain high morale among MCHVs.