地震災害時における市町村保健師の役割の特徴と課題

The roles and tasks of public health nurses in seismic disasters

要約

　本研究の目的は、地震災害における市町村保健師の防災や災害時の役割の特徴と課題を明らかにすることである。A県内各市町村の保健師267名に、防災・災害時の保健師の役割に関する自記式質問紙調査を行った。そして防災担当者を対象にした先行研究の結果と比較検討を行った。その結果、防災担当者は保健師に「避難者の健康チェック」「救急処置」等の役割を期待し、保健師は、「避難者の健康チェック」「家庭訪問」等を自身の役割と考えていた。保健師が考える防災・災害時の役割と防災担当者が期待する保健師の役割の項目比較では16項目中9項目に有意な差を認めた。また保健師が防災担当者から期待されていると考える保健師の役割と防災担当者が期待する保健師の役割の比較では、4項目に有意な差を認めた。地震災害における市町村保健師の役割は、健康保健、医療、管理調整の多岐に、かつ全災害サイクルにわたるという特徴を認めた。そして防災担当者は「医療」を、保健師は「健康・保健」を重視する傾向にあった。防災・災害時の保健師の役割について防災担当者と保健師間の考えには違いがあり、特に災害時の急性期医療に関する分野が保健師に期待される課題であることが示唆された。

Abstract

　This study was aimed to clarify the roles and tasks of public health nurses in disaster prevention and during a disaster, in view of seismic events. A questionnaire survey on the roles of public health nurses in disaster prevention and during a disaster was conducted among 267 public health nurses working in a prefecture and 45 officials in charge of disaster prevention. It was found that the officials expected public health nurses to perform roles such as "health checkup of refugees" and "first-aid treatment," while the nurses considered that their roles should include "health checkup of refugees" and"home visit." Characteristically, the roles of public health nurses regarding seismic disasters ranged over various aspects including health care, medical treatment, and coordination work, throughout the disaster cycle. Officials in charge of disaster prevention tended to emphasize"medical treatment," whereas public health nurses were more likely to emphasize"health care." There is a gap in the recognition of roles of public health nurses in disaster prevention and during a disaster between officials and nurses. Importantly, it is suggested that public health nurses are expected to provide acute-phase care as one of their tasks in the event of a disaster.