Abstract
The purpose of this qualitative study was to describe strategies and activities of public health nurses' management during the process of developing service programs. Seven public health nurses at a municipal health center participated in semi-structured interviews about their work to develop new service programs. Ten cases of developed service programs were examined. Their analysis resulted in the following description of the program development process (core-categories of activities and general strategies describing significant steps in the processes are presented in quotation marks). The process began when the public health nurses (PHNs) extracted "needs which she/he wanted to solve" and, "lack of existing services" and "limits of current organization". At that stage of assessment, the PHNs began collecting more information about the "way residents live" and "social resources which residents were able to use". They developed a "vision of a new service"; then planned "strategies for preparing the services", "for building resident support", "for acquiring administrative approval of administrator" and "for utilizing existing Community resources". During the next stage of implementation, the PHNs first sought an "acquisition of agreement" with key persons, confirmed agreements about "construction (arrangements) related to collaboration. "Second, the PHNs executed the strategies that were devised previously. The PHNs were constantly working to maintain the "motivation" of everyone involved. The PHNs described the evaluation as continuous; throughout, from the beginning and as necessary. The PHNs evaluated and adjusted all aspects of the development process. As a result of analyzing the frequencies at which the core- and sub-categories occurred in the description of PHNs' management of the process of developing new services to meet community needs, four patterns were extracted to characterize their, management. Collaboration of labor, maintain motivation, use of the power of organizations, and empowerment of residents were the four patterns. The management of PHNs who work up the strategies for developing service programs toward their purpose promotes the efficient use of community resources, the empowerment of residents, and the community development.
