Development of public health nursing practice models through action research to fulfill the needs not covered by the Long-term-care Insurance Law

本研究旨在发展公共卫生护理实务模式，以满足未受长期照护保险法保障之老人及残障人士之健康需求。本研究采行动研究法，以公共卫生护理人员为研究对象。通过观察、实践文献、受试者与研究者的反思性讨论等方法，收集了他们的实践过程的描述性数据，包括需求的界定、计划、实施和评价，并对《公共卫生护理法》未涉及的公共卫生护理专业的需求进行了探讨：1）建立疑难杂症、老年人虐待等专业评估和团队方法的基本制度; 2)规划和执行技能提升培训计划，以提高相关专业的质量，如护理管理人员、家访护士等，3)4）便利各城市的决策，加强公民参与，以改进这些系统和行动，对有效制定的有关主体活动的案例数据进行了分析，以明确满足法律未涵盖的需求的更好的活动方式。现在我们已经讨论了每个需求的实践模型，在创建实验模型后，我们将验证其实用性。

The purpose of this study was to develop public health nursing practice models to fulfill health needs of the elderly and disabled people not covered by the Long-term-care Insurance Law. The method of this study was action research and the subjects were public health nurses. Descriptive data about their practice processes included defining the needs, planning, implementation and evaluation was collected by observation, their practice documents and reflective discussion between subjects and researchers.The needs concerned with the specialty of public health nursing not covered by the Law were addressed as following, 1)Setting the basic system of specialized assessment and team approach for intractable diseases, elderly abuse, etc., 2)Planning and execute the skill up training program for quality improvement of the profession concerned, such as care-managers, home-visiting nurses, etc., 3)Integrating similar serious needs of each case and developing the prevention and support system for solving them in each municipality, 4) Facilitating the decision making of each municipality and enhancing the participation of citizens to improve those systems and actions.These case data about subjects' activities worked out effectively were analyzed to clarify the better ways of activity for fulfilling the needs not covered by the Law. Now we have been discussing about the practice models for each need and after creating the experimental models, we will verify their practicability.