ヘルスプロモーションに向けた産業保健師の働きかけの評価に関する研究

A study on the evaluation of the occupational health nurse's intervention for health promotion

西嶋 真理子

小西 美智子

大成 浄志

脇谷 小夜子

広島大学保健学ジャーナル

Journal of health sciences, Hiroshima University

働き盛り世代への健康づくりに向けた働きかけの示唆を得るため,ヘルスプロモーションを発展させたT社における26年間の保健師の働きかけと社員の変化を分析することにより,ヘルスプロモーションに向かうための保健師の働きかけを評価し,具体的な働きかけ方の手がかりを得ることを目的とした.方法は,50-55歳の社員150名の保健行動や健康意識に関するアンケート調査,安全衛生管理概要34年間分(1967-2000年)とT社保健活動に関する報告書・論文13編の分析,保健師への面接調査を行った.質的分析法に従って報告書・論文及び面接調査から得られたデータを基に保健師の唱道及び身体活動の増加に向けた働きかけについてモデルを用いて分析した.働きかけの評価を唱道に焦点を当てて,PRECEDE-PROCEEDモデルをもとに分析した結果,個人としての人生の開拓や組織の中での自己実現を健康的な行動と結びつけ,持続的な動機づけを図るとともに,受容・報奨的な働きかけと課題を課す働きかけを使い分ける戦略的側面が明らかになった.身体活動の増加をめざした働きかけについて,Marcusらの決定バランス尺度では賛成項目においてより具体的に働きかけられており,体験的プロセスにより多くの内容が見出せた.社員の行動は,変化しやすいものと変化し難いものがあり,運動等変化し難いものには,ストレスや仕事との関連が考えられたが,他調査と比較すると運動を行っているものは多く,長期的な働きかけの影響が示唆された.

The purpose of this study were 1) to evaluate of the occupational health nurse's intervention process over 26 years in an enterprise which succeeded in promoting health, 2)to analyze the transformation of employee's health behaviors in the enterprise, and 3)to consider the occupational health nurse's effectiveintervention in health promotion. Questionnaires were sent to 150 employees in the enterprise who were50-55 years old to investigate their health behavior and sense of health value. We also reviewed documentsabout safety and health in the enterprise during the 1967-2000 period and 13 published literatures abouthealth practices in the enterprise. Data were collected by interview and from the 13 published literatures.Following a qualitative approach design, these data were analyzed to ascertain how the occupationl healthnurse advised and intervened there so as to increase and then sustain the proportion of individuals inadopting regular exercise.As a result of this analysis, we found the following:1) By an analysis based on the framework of a PRECEDE-PROCEED model, the occupational health nurseadvocated health promotion to the individual and the organization by connecting their life and self-realization in the organization with healthy behavior, and encouraged them to maintain their motivation.She advocated both rewarding interventions and imposing a task on them as a strategy.2) By analyzing the Decisional Balance measure for exercise, she emphasized positive features moreconcretely than negative features.3) In employees, there are some behaviors which are relatively easy to transform and others which aremore difficult to transform. It was considered that behaviors which were relatively difficult to transform, forexample exercise, who exercise were related to work and stress. Nevertheless, there are many workerswho exercise and this suggested the efficacy of long-team intervention by the occupational health nurse.

ヘルスプロモーション

産業保健師

唱道

health promotion

occupational health nurse

advocacy

医学 [ 490 ]

日本語

広島大学保健学出版会

[ISSN] 1347-7323

[NCID] AA11601063