地震発生後市町村保健師が住民の反応を捉えて行う二次的健康被害を予防するための活動

Activities Conducted by Municipal Public Health Nurses to Prevent Secondary Health Problems follwing an Earthquake by Taking Residents' Reactions into Consideration

要約

目的：地震発生後から，市町村保健師が住民の反応を捉えて行われる二次的健康障害を予防するための活動を明らかにする．

方法：中越大震災などの地震を経験した保健師５名に半構成的面接を行い分析した．

結果：住民の反応に対する保健師の認識として【身動きとれない住民の反応を捉える】【怖さの中で我慢する住民の反応を捉える】【住民の生活変化を認識する】【通常の保健師活動とは異なる混乱を認識する】が抽出された．保健師の認識を基礎にした保健師の行動として【安心感を与え続ける】【医療的に緊急性の高い人へ支援する】【潜在する健康被害を予測して関わる】【地震災害の知識・経験を用いて支援する】【被災後の健康の立て直しを支援する】が抽出された．

結論：市町村保健師は，地震災害発生後の住民の反応を捉えて解釈・判断し二次的健康障害を予防する活動を行っており中心的なやりとりは，リスク情報を介在したリスクコミュニケーションであった．

Purpose: To examine the actual state of activities carried out by municipal public health nurses (PHNs) for the prevention of secondary health problems following an earthquake, taking residents' reactions into consideration

Method: Semi-structured interviews with five PHNs who experienced the Nagano-ken Hokubu, Chuetsu-oki, or Chuetsu-daishinsai earthquakes; analysis of the findings

Results: PHNs perceived the reactions of the residents in the following ways: “under standing the reactions of residents who cannot move”, “understanding the reactions of residents experiencing fear”, “recognizing changes in residents' lives”, and “recognizing confusion that is different from normal PHN activities”. PHNs' responses were characterized as follows: “continuing to encourage the victims”, “supporting patients requiring urgent medical care”, “predicting potential health problems”, “making use of disaster knowledge and experience” and “supporting post-disaster health restoration”.

Conclusion: The municipal PHNs were apprehensive about the occurrence of the earthquake, but they understood the varied and layered range of reactions from the residents and completed their tasks in a simultaneous manner. Regarding the transmission of information, they carried out their duties by engaging in risk communication mediated by information on risks.