中堅期の市町村保健師の職業的アイデンティティの形成プロセスと影響要因—複線径路等至性モデリング（Trajectory Equifinality Modeling: TEM）による分析

Formative Process of Professional Identity in Mid-career Municipal Public Health Nurses and Influencing Factors: Analysis by Trajectory Equifinality Modeling (TEM)

要旨

　目的：中堅期の市町村保健師の職業的アイデンティティの形成プロセスと影響要因を明らかとする．

　方法：中堅期の市町村保健師7名を対象に半構造化面接を行い，複線径路等至性モデリングの手法を用いて分析した．

　結果：中堅期保健師の職業的アイデンティティの形成プロセスは「自分らしさ発揮までの焦燥期」「保健師としての自信の獲得期」「キャリア移行に対する応変期」の3つの時期に区分された．彼らは力量不足に焦りながらも周囲のサポートを得て，住民との関わりを重ねることによって保健師としての一定の自信を獲得していた．その後，環境や役割等が変化しても，価値観や意識の変容を図りながら，移り変わる状況に対峙していくことで中堅として成長していた．同時に中堅職員と一保健師の間での役割葛藤も抱えていた．

　結論：中堅期保健師の職業的アイデンティティの向上には，役割葛藤に対するサポート体制の強化が重要であることが示唆された．

　Purpose: The purpose of this study is to identify the formative process of professional identity in mid-career municipal public health nurses, and factors that influences its formation.

　Method: A semi-structured interview was carried out targeting seven mid-career municipal public health nurses, and the results were qualitatively and descriptively analyzed using the Trajectory Equifinality Modeling methods.

　Results: The formative process of professional identity in mid-career municipal public health nurses was classified into three phases—first “suffering frustration until establishing one's identity,” second “acquiring confidence as a public health nurse,” and third “responding to career changes.” Although the subjects were frustrated due to their lack of competence, they could acquire confidence as a public health nurse by developing relationships with the residents and getting support from people around them. Later, they experienced mid-career growth, even when their environment and roles changed, by confronting changes in circumstances and adjusting their values and awareness. At the same time, they experienced conflict between their roles as a mid-career staff member and as a municipal public health nurse.

　Conclusion: To improve the professional identity of mid-career municipal public health nurses, reinforcing the support system for role conflict is suggested to be important.