就労支援を受ける生活困窮者の就労意欲に影響を与える健康特性の構造の明確化

Structure of Health Characteristics that Affect Welfare Recipients' Willingness to Participate in Workfare Programs

要旨

【目的】就労支援を受ける生活保護受給者，生活困窮者自立支援法対象者（以下，生活困窮者）31名への面接調査を通じ，就労意欲に影響を与える健康特性を明確化すること．

【結果】質的分析の結果，【他者から理解されがたい持続的な苦痛】，【ストレスへの脆弱さ】，【社会的適応の困難さ】，【自己流の健康管理】の4カテゴリーを抽出した．また，就労意欲への影響要因として，【就労することへの期待】，【生活保護廃止への不安と葛藤】，【社会から排除されているという感覚】の3カテゴリーを抽出した．これらが関連し〖健康課題を抱えながらの就労と，生活保護受給継続との間での就労意欲のゆらぎ〗を引き起こしていた．

【結論】今回抽出した健康特性からみると，生活困窮者の就労支援に医療や心理の専門職が参加することにより，効果的な就労支援につながる可能性が示唆された．

Workfare programs, which have become prevalent worldwide. In Japan, governments are providing employment assistance for welfare recipients who are considered capable of working. The recipients of these services may have complex health concerns, all of which could be barriers to finding employment. However, there is a lack of research on this matter. The aim of this study is to clarify the structure of health characteristics that affect the willingness of welfare recipients to work via the workfare program. We conducted interviews with 31 welfare recipients in the workfare program and extracted [persistent agony, which is hard for others to understand], [vulnerability to stress], [difficulty of social adaptation], and [health management via their own style] as health characteristics. Additionally, we extracted [expecting to work], [worrying and mental conflict about ending welfare assistance], and [perception of social exclusion] as factors that affect their health and willingness to work. These categories relate to each other and cause «fracturing of willing of work due to work with complicated health problems versus the benefit of being a welfare recipient». The welfare recipients in this study who had physical, mental, and social health problems tended to be isolated; they have anyone to advise them regarding health problems. Health professional's support is needed to alleviate recipients' problems and provide more effective encouragement to strengthen their willingness to work.