东日本大地震前后护理人员地理分布的趋势：一项纵向研究。
Trends in the geographic distribution of nursing staff before and after the Great East Japan Earthquake: a longitudinal study.
作者信息
Morioka Noriko, Tomio Jun, Seto Toshikazu, Kobayashi Yasuki
机构信息
Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Center for Spatial Information Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo, 153-8505, Japan.
出版信息
Hum Resour Health. 2015 Aug 25;13:70. doi: 10.1186/s12960-015-0067-6.
BACKGROUND
Medical care systems in Iwate, Miyagi and Fukushima prefectures were greatly damaged by the Great East Japan Earthquake (GEJE), which struck on 11 March 2011. The shortage of nurses in this area was concerning; however, temporal trends have not been investigated. This study aimed to investigate the trends in the geographic distribution of total nursing staff per population in the secondary medical areas (SMAs) of these prefectures before and after the GEJE. We also aimed to qualify the above trends.
METHODS
We conducted a longitudinal study at four time points (July 2007, 2010, 2011 and 2013) over 6 years using reports of basic hospitalization charges from all hospitals within Iwate, Miyagi and Fukushima prefectures that experienced severe damage from the GEJE. We calculated the number of total nursing staff per population in the SMAs and compiled descriptive statistics. Changes from 2010 to 2013 were qualified and mapped.
RESULTS
In coastal SMAs, the ratios of total nursing staff per population decreased immediately after the GEJE. In most SMAs in 2013, the ratios increased and exceeded the pre-GEJE level. However, the changes in total nursing staff per population from 2010 to 2013 were negative in Ryouban (-4.0%), Ishinomaki-Tome-Kesennuma (-1.9%), Sousou (-47.7%) and Iwaki (-1.9%). In Sousou, which is closest to the Fukushima Daiichi Nuclear Power Plant, the changes in total nursing staff per population qualified by job role were -33.7% for nurses, -57.7% for associate nurses and -63.2% for nursing aides.
CONCLUSIONS
Our study indicated that the temporal trends in the number of total nursing staff per population due to the GEJE differed between the physically damaged areas and those affected by radiation. We also found the difference in the trend by qualifications: the reduction in total nursing staff per population was larger in Sousou, the area most affected by radiation, than in any other SMAs. Moreover, the number of nursing aides was most affected among the three types of staff. To promote the post-GEJE reconstruction of medical care systems, it might be necessary to develop policies to secure both nurses and nursing aides after nuclear disasters.
背景
2011年3月11日发生的东日本大地震对岩手县、宫城县和福岛县的医疗系统造成了严重破坏。该地区护士短缺令人担忧；然而，尚未对其时间趋势进行调查。本研究旨在调查东日本大地震前后这些县二级医疗区域（SMA）每人口护理人员总数的地理分布趋势。我们还旨在对上述趋势进行量化。
方法
我们利用岩手县、宫城县和福岛县所有因东日本大地震遭受严重破坏的医院的基本住院费用报告，在6年中的四个时间点（2007年7月、2010年、2011年和2013年）进行了一项纵向研究。我们计算了SMA每人口护理人员总数，并编制了描述性统计数据。对2010年至2013年的变化进行了量化并绘制了地图。
结果
在沿海SMA中，东日本大地震后每人口护理人员总数的比例立即下降。在2013年的大多数SMA中，该比例有所上升并超过了东日本大地震前的水平。然而，2010年至2013年每人口护理人员总数的变化在留边蕊（-4.0%）、石卷-富里-气仙沼（-1.9%）、双叶（-47.7%）和磐城（-1.9%）为负。在距离福岛第一核电站最近的双叶，按工作岗位划分的每人口护理人员总数的变化为：护士-33.7%，助理护士-57.7%，护理辅助人员-63.2%。
结论
我们的研究表明，东日本大地震导致的每人口护理人员总数的时间趋势在受物理破坏地区和受辐射影响地区之间存在差异。我们还发现了资质方面的趋势差异：受辐射影响最严重的双叶地区每人口护理人员总数的减少幅度大于其他任何SMA。此外，在这三类工作人员中，护理辅助人员的数量受影响最大。为促进东日本大地震后医疗系统的重建，可能有必要制定政策，在核灾难后确保护士和护理辅助人员的配备。
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