Abstract
Purpose : To identify elements that constitute the dilemmas of public health nurses assigned to a municipal welfare sector and to clarify the relationships among these elements, focusing on the support of individual psychiatric patients. Method : The participants were public health nurses with more than 1 year of experience supporting individual psychiatric patients. All the participants were assigned to the municipal welfare department of "A" prefecture. The participants were questioned regarding 3 topics: 1) experience of dilemmas, 2) specific examples of dilemmas, and 3) contents of actual dilemmas and final decisions. A semi-structured interview was conducted, and the interview data were qualitatively analyzed using the KJ method. Result : Three elements of dilemmas were clarified: "My life will become intermingled with the life of the patient", "I must act without knowing the correct answer", and "I must perform tasks that fall outside my field of expertise." The interrelation of these 3 elements causes dilemmas. In other words, public health nurses recognize the significance of their effects on the lives of psychiatric patients, which conflicts with their lack of confidence or lack of occupational identity. Discussion : Dilemmas arise from the contradictory relationship between the actual situation of work in the welfare sector and the attitudes affecting psychiatric patients. To overcome these dilemmas, support and education to increase the recognition of the significance of public health nurse activities is important, so as to establish an occupational identity in the welfare sector.
