東日本大震災復興期における被災町村保健師による保健師活動の再構築とその支え

Work of public health nurses in smaller municipalities affected by the Great East Japan Earthquake to restore activities and how they were supported during the reconstruction

要約

目的：東日本大震災復興期においてどのように保健師活動を再構築したのか，またその支えは何かを明らかにすることを目的とした．

方法：被災町村保健師8名へ半構造的面接を行った．

結果：保健師活動の再構築について74コードを抽出し，16サブカテゴリー，5カテゴリーを生成した．被災者の度重なる転居や被災による健康課題の複雑多様化に対して【新たな『まちづくり』に向けた保健師活動の積極的準備】等を行い，復興住宅や，新たに住宅再建をした被災者も含めた【地区単位のケアシステムの構築】を行なっていた．また，保健師活動の支えについて35コードを抽出し，9サブカテゴリー，3カテゴリー生成した．被災町村保健師は【保健師活動を継続する使命感と住民ともに歩む覚悟】と，発達させてきた実践コミュニティを支えに保健師活動を展開していた．

結論：復興期における地域診断やケアシステムの再構築等の具体について示唆された．

Purpose: Work of public health nurses in smaller municipalities affected by the Great East Japan Earthquake to restore activities and how they were supported during the reconstruction

This study aims to understand how public health nurses in smaller municipalities affected by the Great East Japan Earthquake restored activities during the reconstruction, and what supported these public health nurses.

Methods: Semi-structural interviews were conducted with eight public health nurses in the affected smaller municipalities.

Results: For the restoration of the public health nurse activities, 74 codes were extracted and narrowed down to 16 subcategories, resulting in 5 categories. To respond to the repeated relocation of disaster victims and complex, diverse health issues due to the disaster, public health nurses conducted [active preparations for public health nurse activities for the new “community development”] and [creation of a care system for their districts including those living in housing for disaster victims and those who rebuilt own houses. For the support of public health nurse activities, 35 codes were extracted and narrowed down to 9 subcategories, resulting in 3 categories.

Conclusions: Public health nurses in affected smaller municipalities conducted their activities together with the community helpers working towards restoration with [a sense of responsibility to continue public health nurse activities and determination to serve the residents]. The findings include details of a regional diagnosis and restoration of the care system during the reconstruction.