Division of Health Sciences, Department of Public Health Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan.
Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
PLoS One. 2021 Oct 6;16(10):e0220277. doi: 10.1371/journal.pone.0220277. eCollection 2021.
As population aging progresses, volunteers in health field are expected to play a key role in health promotion and disease prevention, which may improve community residents' health and well-being and at the same time help slow the growth of healthcare cost. The objective of this study is to examine the effects of self-oriented motives and altruistic motives as explanatory factors for Japanese Community Health Workers (CHWs)' desire to continue their service. Unraveling the relative effects of these two types of motivation on CHW retention may lead to policy and practical implications for recruiting, training, and supporting CHWs in Japan. Haddad (2007) observed that citizens in Japan generally have a sense of governmental and individual responsibility for dealing with social problems. Applying these insights to CHWs, we hypothesize that altruistic motives have more potent influence on volunteers' willingness to continue to serve than self-oriented motives.
Three cities in Shiga prefecture, Japan agreed to participate in the study. Anonymous, self-administered questionnaire was mailed to all CHWs who work in the three communities. The survey data were collected in March and April, 2013. A total of 417 questionnaires were mailed to CHWs, of which 346 were completed and returned (response rate 83.0%). Nine questionnaires missing response to the question concerning willingness to continue serving were removed from the analysis. The final analysis used 337 questionnaires (effective response rate 80.8%).
One hundred ninety-nine (59.1%) of the respondents answered the question about willingness to continue CHW affirmatively, and 138 (40.9%) negatively. Controlling for other relevant factors, those with self-oriented motives in serving as CHWs were more likely to state they are willing to continue to serve (OR:1.54, confidence interval 1.00-2.37) than those without such motives. Those with altruistic motives were also more likely to say they want to continue their service (OR 1.56, confidence interval 1.08-2.27) than those without such motives. Contrary to our hypothesis, the two motives, altruistic and self-oriented, were shown to have nearly equal degree of influence on respondents' willingness to continue serving as CHWs.
One practical implication of the research is that learning more about the twin motives, self-oriented and altruistic, of volunteers and tailoring the content of CHW training by municipal health professionals to address those motives may be beneficial.
随着人口老龄化的发展，预计健康领域的志愿者将在促进健康和预防疾病方面发挥关键作用，这可能会提高社区居民的健康和幸福感，同时有助于减缓医疗保健成本的增长。本研究的目的是检验自我导向动机和利他主义动机作为日本社区卫生工作者（CHW）继续服务意愿的解释因素的效果。揭示这两种动机对 CHW 保留的相对影响，可能会为在日本招募、培训和支持 CHW 带来政策和实际意义。Haddad（2007）观察到，日本公民普遍对处理社会问题有一种政府和个人的责任感。将这些见解应用于 CHW，可以假设利他主义动机对志愿者继续服务的意愿比自我导向动机更有影响力。
日本滋贺县的三个城市同意参与这项研究。向在这三个社区工作的所有 CHW 邮寄了匿名、自我管理的问卷。调查数据于 2013 年 3 月和 4 月收集。共向 CHW 寄出 417 份问卷，其中 346 份完成并返回（回复率 83.0%）。9 份问卷在回答是否愿意继续服务的问题时未作回答，因此从分析中删除。最终分析使用了 337 份问卷（有效回复率 80.8%）。
199 名（59.1%）受访者对继续作为 CHW 服务表示肯定，138 名（40.9%）表示否定。控制其他相关因素后，那些有自我导向动机的 CHW 更有可能表示愿意继续服务（OR：1.54，置信区间 1.00-2.37），而那些没有这种动机的 CHW 则不太可能。那些有利他主义动机的人也更有可能表示希望继续他们的服务（OR 1.56，置信区间 1.08-2.27），而那些没有这种动机的人则不太可能。与我们的假设相反，自我导向和利他主义这两种动机对受访者继续担任 CHW 的意愿具有几乎相同的影响。
这项研究的一个实际意义是，了解志愿者的自我导向和利他主义这两种动机，并由市级卫生专业人员根据这些动机调整 CHW 培训的内容，可能会有所帮助。
