2018 Volume 67 Issue 4 Pages 382-393
Objective: The aim of this study was to determine the characteristics of involvement by public health nurses (PHNs) at public health centers in the development of community medical care systems (CMCSs) by comparing the involvement of PHNs with the involvement of members of other occupations.
Methods: A questionnaire survey (to be filled out anonymously) was mailed to public health nurses and others, mainly in charge of duties involving collaboration in community medical care at 372 prefectural public health centers in Japan, to compare involvement by public health nurses with involvement by members of occupations other than public health nursing. The survey consisted of the following: (1) basic information on subjects, (2) overview of the organization in charge, and (3) 32 items related to regional CARE system construction.
Results: Subjects were 148 public health nurses (group A) and 163 non-public health nurses (group B) who had responded to the survey. There were no major differences between the 2 groups with regard to age and administrative experience. With regard to the development stage of CMCSs, both groups had the “development stage (intermediate stage)” at the highest proportion and group A had the “founding stage (early stage)” at the next highest proportion. With regard to conferences by affiliated institutions, both groups had “collaboration promotion associations” the most, and “hospitals” were the most affiliated institutions in collaborations. Group A had more “municipalities,” “health clinics,” “home-visit nursing stations,” etc., than group B. With regard to involvement, 12 items including “to plan seminars on collaboration in community medical care by affiliated parties” were significantly higher for group A than group B (P < .001). As a result of examining these 12 items by dividing them into the “group of strong involvement,” “group of intermediate involvement,” and “group of weak involvement,” it was found that the “group of strong involvement” presented a function to educate professionals in the community, the “group of intermediate involvement” presented a function to manage development of CMCS, and the “group of weak involvement” presented a function to collect and dispatch information.
Conclusions: This study found that PHNs contributed to the development of CMCSs by providing support to small organizations and conferences and serving as advocates for members of other occupations in weaker positions and as coordinators to connect various institutions. They also carried out management functions, such as business/task management, at the early and middle stages of the development of CMCSs. This role serves as an example of how public health nurses function as generalists.
