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

对大18个社区中18个社区的健康状况进行了为期两年的研究，揭示了在护理保险系统中工作的大量公共健康护士。However，在普通社区健康护理部门工作的公共健康护理人员中，没有增加。公共健康护理结构已从地区责任结构中改变为商业责任结构或具有地区责任结构的混合业务责任结构。这是一个有影响力的家庭访问活动的变化。任何活动结构都是混合的业务响应性结构，显示了increase in the number of home visits and devised how to work的混合业务响应性。在人口规模较小的地方，公共卫生护士在引入商业责任结构时感觉到了不同的词汇。此外，商业责任性结构导致了地区诊断的可承受性不受影响的工作中的护士没有初始责任。如果，在一个州，公共卫生护士处于管理地位，她/她开始从事社区卫生护理，公共卫生护士在该部门积极的工作中，建立新的项目和轻松参与公共支出的外部培训。公共卫生护士在护理保险科的工作内容各不相同，但有许多他们做了很多与社区卫生护理科的工作比较的人。从普通社区健康护理部分到护理保险部分的转变是一个非常重要的护理部分的转变，是一个非常重要的护理部分。

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.