Ethnographic study on the community health nursing practices in rural Japan

本民族志研究的目的是从公共卫生护士的角度来描述日本农村的社区卫生护理实践。本研究采非结构式访谈法，以24位在农村社区工作的公共卫生护士为研究对象。农村社区保持了传统的价值观和规范，而农村生活迅速改变。发现PHN与社区成员的关系更为密切.发现农村社区卫生护理实践具有“考虑社区整体”、“从实际工作到卫生政策规划”、“创建社区卫生服务体系”、“人、组织、机构联网”、“调查社区实际情况”和“立即实施”等六个方面的特点. "人、组织、机构联网“是农村社区卫生护理的重要实践模式，有5种模式;“与居民联系”、“与其他专业人员或镇（村）办公室工作人员保持关系”、“与客户及其家人联系”，五、“社区卫生服务网络化策略”与“社区内居民组织或邻里网络的建立”。社区卫生护士对"社区卫生护理理念“、”达成目标的满足感“、”农村社区卫生护士工作的劣势“、”对居民和社区的正义感“、"PHN对居民和盗窃社区的责任意识“和”学习和改善社区卫生保健的愿望“。从这些结果来看，明确农村社区卫生护理实践的认识，创建农村社区卫生护理模式显得尤为重要。

The purpose of this ethnographic study was to describe the community health nursing practices in rural Japan from public health nurses' perspectives. Twenty-four public health nurses (PHNs) who were working at rural community participated in unstructured, tape-recorded interviews.The findings were as follows:1. Rural communities have maintained the traditional values and norms, while rural life has rapidly changed.2. It was found the closer relationship between PHNs and community members.3. Six characteristic rural community health nursing practices were found; 'considering the whole of community', 'conducting the practices from the actual work to health care policy planning', 'creating the health care systems in a community', 'networking among the persons, organizations and institutions ', 'surveying the actual condition of community' and 'carrying out immediately '.4. 'Networking among the persons, organizations and institutions' which was the most important community health nursing practice in rural areas had five kinds of modes; 'connecting with the residents', 'maintaining the relationship with other professionals or staff members of town (village) office ', 'connecting with clients and their family members', 'networking strategies when PHNs initiate the health care programs' and 'creating the residents' organizations or neighbors' networks in a community'.5. PHNs were practicing community health nursing activities with the cognitions such as 'philosophy of community health nursing practices', 'a sense of satisfaction to attain the aim', 'disadvantages of PHNs working at rural community ', 'a sense of justice for residents and their community', 'awareness of PHN's responsibilities for residents and theft community' and 'desire to learn and improve the health care of one's community'.From these results, it seems important to clarify the knowledge about rural community health nursing practices and create the rural nursing modal.