Research on work formation of public health nurses in municipalities and prefectures : developing community health nursing

Two-year study on health undertaking in 18 municipalities in Osaka and neibouring prefectures reveals that increase in the number of public health nurses who work in the care insurance system.However，no increase in the number of public health nurses who work in the usual community health nursing section.The public health nursing structure in municipalities has changed to business responsibility structure or the mixed business responsibility with district responsibility structure from district responsibility structure.Such a change has affected home visiting activities.Municipalities whose activity structure is the mixed business responsibility with district responsibility structure show the increase in the number of home visits and devised how to work。In small population size municipalities，public health nurses feel difficulties to word in introducing the business responsibility structure。Also，the business responsibility structure causes incapability of district diagnosis due to unconcern to work which nurses do no have initial responsibilities.If，in a municipal，a public health nurse is in the managerial position and he/she carries out beget of community health nursing，public health nurses in the section positively work，set up new projects and easily participate in the outside training at public expenses。The contents of work of public health nurses in the care insurance section varies but many of them do a lot of clerical work compared to the ones in a community health nursing section.Motivation of a change from usual community health nursing section to the care insurance section is very important nurses·eagerness after a change.

Two-year study on health undertaking in 18 municipalities in Osaka and neibouring prefectures reveals that increase in the number of public health nurses who work in the care insurance system. However, no increase in the number of public health nurses who work in the usual community health nursing section. The public health nursing structure in municipalities has changed to business responsibility structure or the mixed business responsibility with district responsibility structure from district responsibility structure. Such a change has affected home visiting activities. Municipalities whose activity structure is the mixed business responsibility with district responsibility structure show the increase in the number of home visits and devised how to work. In small population size municipalities, public health nurses feel difficulties to word in introducing the business responsibility structure. Also, the business responsibility structure causes incapability of district diagnosis due to unconcern to work which nurses do no have initial responsibilities. If, in a municipal, a public health nurse is in the managerial position and he/she carries out beget of community health nursing, public health nurses in the section positively work, set up new projects and easily participate in the outside training at public expenses. The contents of work of public health nurses in the care insurance section varies but many of them do a lot of clerical work compared to the ones in a community health nursing section. Motivation of a change from usual community health nursing section to the care insurance section is very important nurses・ eagerness after a change.