Research on Public Health Nurse's Advocacy for Abuse cases.

本研究旨在厘清公共卫生护士面临“病人权益与倡导”问题的实际情况，找出公共卫生护士在病人权益与倡导中的功能。研究一：本研究的目的是将西方国家的倡导理念作为日本公共卫生护士活动的理论框架。为了检查倡导一词的使用情况，使用CINAHL搜索系统进行文献搜索。1982年至2004年8月期间共鉴定了1,117篇论文。倡导的先决条件之一是“社会文化群体的特点”。这样确定的群体是“健康被剥夺的群体”，如“无家可归的家庭”、“生活在偏远地区的老年人”、“儿童”、“被虐待的孕妇”和“未婚母亲”。他们有共同的特点：没有收入，没有就业，没有交通，没有教育，没有贫困，没有保险。倡导概念的属性已经从以病人-护士或统治者统治为代表的家长式或家长式保护主义或“为某人说话”或“辩护”的概念扩展到满足需求、支持日常生活和就业等“支持他们的生活”的活动。宣传的职能包括促进独立、协调资源、调解、组织、满足未得到满足的需要的政策建议以及制定政策和法律等行动。作为宣传的结果的“日常生活支持”包括“获得卫生保健”、“转诊和获得社会服务”、“咨询”、“提供食物”、“提供教育”和“提供住房或庇护所”。研究二：对日本6名公共卫生护士的宣传访谈。研究三：对1,847名日本公共卫生护士的宣传调查。

The purpose of this study is to clarify the actual conditions of public health nurse facing with problems about "patient's rights and advocacy" and to find public health nurse's function of patient's rights and advocacy.Research 1 : The purpose of this study is to utilize the concept of advocacy used in Western countries as a conceptual framework for theorizing activities of public health nurses in Japan. To look over the use of the term advocacy, literature search was performed using CINAHL search system. One thousand one hundred and seventeen papers were identified between 1982 and August 2004. One of the antecedents of advocacy is "characteristics of socio-cultural groups". The groups thus identified are "health deprived group" such as "homeless families", "elderly people living in the remote areas", "children", "abused pregnant women" and "unmarried mothers". They have common characteristics : no income generation, no employment, no transportation, no education, poverty and no insurance. Attributes of the concept of advocacy has been expanded from paternalism or paternalistic protectionism as represented by patient-nurse or ruler-ruled or the concept of "speaking for someone" or "defense" to the activities to "support their lives" such as satisfying needs and supporting daily lives and employment. The functions of advocacy include such actions as promotion of independence, coordinating resources, mediation, organization, policy proposals to satisfy unmet needs, and policy and law making. "Supports of daily life" as a consequence of advocacy include "access to health care" "referral and access to social services" "counseling" "provision of food" "provision of education" and "provision of housing or shelters"Research 2 : Interview of Advocacy to Japanese 6 Public Health Nurses.Research 3 : Survey of Advocacy to 1,847 Japanese Public Health Nurses.