宮本 美穂

OBJECTIVES: To compare the characteristic competencies of public health nurses working for the older adult's health and welfare in public administration ("PA") with those at community general support centers ("CGSC") in Japan. METHODS: We conducted a questionnaire survey by mail for PA and CGSC public health nurses. A competency list that was developed to compare three groups (PA, CGSC experts with ≥5 years of experience, and CGSC newcomers with ≤2 years of experience) was used. The following characteristics were examined: (1) competencies acquired early after arriving at the CGSC, (2) competencies acquired through a certain amount of CGSC experience, (3) common competencies, (4) competencies that even experts lacked, and (5) competencies that the newcomers lacked. RESULTS: We examined the responses of 171 PA nurses, 185 CGSC expert public health nurses, and 165 CGSC newcomer public health nurses. The results of comparison of the three groups showed that (1) had no applicable items; (2) had nine items for individual support associated with preventive care management; (3) had 14 items including teamwork among three professionals (social workers, senior care manager, public health nurse)/other professionals and self-improvement; (4) had three items for community development, (5) had two items for individual support and 16 items for community development. CONCLUSION: Initiatives for preventive care and coordination of care teams should be supported and suggested as characteristic competencies for CGSC public health nurses.

目的 手助けや見守りを要する者がいる世帯における主介護者と他の世帯員について,健康とストレスの状況を平成22年国民生活基礎調査の匿名データに基づいて解析した。方法 統計法36条に基づく匿名データを利用した。20歳以上の世帯員から,40歳未満の手助けや見守りを要する者とその世帯員などを除く,72,024人を解析対象者とした。男女ごとに,手助けや見守りを要する者がいない世帯の世帯員を基準として,手助けや見守りを要する者がいる世帯の主介護者と他の世帯員について,通院,健康意識,悩みやストレス,こころの状態のオッズ比をそれぞれロジスティック回帰で年齢を調整して推定した。結果 手助けや見守りを要する者がいない世帯の世帯員を基準とする年齢調整オッズ比をみると,主介護者において,「悩みやストレスあり」は男性で2.14と女性で2.49,「健康意識がよくない」は男性で1.36と女性で1.31,「こころの状態がよくない」は男性で1.86と女性で1.65であり,いずれも有意(p<0.05)に大きかった。他の世帯員において,「悩みやストレスあり」は男性で1.11と大きい傾向(p<0.1),女性で1.26と有意に大きく,「こころの状態がよくない」は女性で1.30と有意に大きかった。結論 手助けや見守りを要する者がいる世帯において,主介護者には健康とストレスによくない状況があることが確認された。他の世帯員には,主介護者と同様に悩みやストレスが生じていること,女性では精神的問題の生ずる可能性が大きいことおよび主介護者と異なり健康意識の低下が生ずる可能性が大きくないことが示唆された。(著者抄録)

<p> Taking action in response to health examination results is important to stay healthy. We aimed to investigate the associations between occupation, employment type and company size, and having a health examination and taking action in response to the results among Japanese employees. We focused on three particular actions by employees in response to health examination results: paying attention to one's health, receiving health guidance, and visiting a medical institution. We used anonymous data from the 2010 Comprehensive Survey of Living Conditions of Japan, a self-administered nationwide questionnaire survey. The data of 23,963 employees (12,938 male and 11,025 female) aged 20–64 yr were analyzed using logistic regression models adjusted by covariates. There were significant changes in odds ratios for receiving a health examination by occupation, employment type and company size. We found significant odds ratios for receiving health guidance by occupation and company size, but there was almost no significant association with paying attention to one's health and visiting a medical institution. These results confirmed that receiving a health examination was associated with occupational factors, and suggested that receiving health guidance after health examination results was associated with occupation and company size.</p>