広域合併自治体における過疎地域での支所保健師活動の構造

The Structure of Activities of Branch Public Health Nurses in Depopulated Areas in Widely Merged Municipalities

要旨

　目的：広域合併自治体における過疎地域での支所保健師活動の構造を明らかにし，保健師人材育成の方向性を探る．

　方法：過疎地域で支所保健師活動経験がある保健師8名に半構造的面接を行い，質的統合法（KJ法）で分析した．

　結果：支所保健師活動の連携には，住民までも含む【広範におよぶ連携構築】とシステム化する【継続できる連携構築】の両面があり，【新たな地域づくりへの進展】を加えて双方向の善き循環を成していた．また【力量形成を要す支所業務遂行】が，保健福祉業務全般を担う【支所勤務での地区担当】と地区診断とPDCAによる【地域特性に基づく事業展開】の基盤となっていた．

　結論：過疎地域の支所保健師活動の構造が明らかになった．長期俯瞰的指導と支所勤務経験者による公認の相談体制のもと，【力量形成を要す支所業務遂行】が全ての基盤となることが示された．今後の人材育成の方向性を見極めるのに寄与すると考える．

　Aim: To clarify the structure of branch public health nurse's activities in depopulated areas in widely merged municipalities.

　Methods: Semi-structured interviews were conducted with eight public health nurses who had experience in working as branch public health nurses in depopulated areas in a broadly merged municipality, and the results were analyzed using the qualitative synthesis method (KJ method).

　Results: The cooperation in the activities of public health nurses at branch offices included both "extensive coalition-building," which included even residents, and "sustainable coalition-building," which was systematized, and formed a good cycle in both directions by adding "Progress towards new regional development." In addition, the "Carrying out branch office work that requires competence building" is the foundation for "District responsibilities in branch office work," which is responsible for overall health and welfare work, and "Project development based on regional characteristics" according to district diagnosis and PDCA cycle.

　Conclusion: The structure of the activities of branch office public health nurses in depopulated areas were clarified. It was suggested that the "Carrying out branch office work that requires competence building" is the foundation of all activities, under the long-term overarching guidance and the authorized consultation system by those who have worked at branch offices. The findings of this study will contribute to identifying the direction of human resource development of public health nurse in the future.