Yokoyama Yoshie, Hatakeyama Noriko, Murakami Nanami
Department of Public Health Nursing, Osaka City University.
Nihon Koshu Eisei Zasshi. 2022 May 24;69(5):357-367. doi: 10.11236/jph.21-066. Epub 2022 Mar 16.
Objectives This study targeted public health nurses in a Japanese municipality that had newly adopted the core components of the Finnish system to provide continuous support to families with children until preschool. It sought to analyze changes in their perceptions for activities in maternal and child health care before and after the adoption.Methods Relevant data were collected through semi-structured focus group interviews, following an interview guide, conducted from September to October 2020. The study protocol was approved by the Ethics Committee of Osaka City University in Japan.Results A total of 12 public health nurses participated. Prior to the adoption of the system modelled on Finnish practice, these nurses were dedicated to addressing the risks regarding families with children (especially those at high risk) through continuous engagement. However, they were hesitant to proactively engage with families at lower risk as non-continuous, one-off engagements resulted in a patchwork response. After the system was adopted, the nurses became aware of the trust cultivated with families under their care, which included those at lower risk, that enabled them to respond to the changing needs flexibly. The nurses recognized that they had acquired the capability to notice the subtle signs of changes, engage more proactively with the families under their care, and deliver the necessary preventive interventions at an early stage. They also demonstrated joy and satisfaction derived from the growth of children and mothers under their care, as well as keen awareness of the need to improve their professional skills, even though they were busy.Conclusion These findings indicate that the continuous support system modelled on the core components from Finland enables public health nurses to proactively engage with families at lower risk and deliver preventive interventions at an early stage. The system also motivated Japanese public health nurses who found greater pleasure in their work.
目标 本研究以日本一个新采用芬兰体系核心要素的自治市的公共卫生护士为对象，该体系旨在为有孩子的家庭提供直至学前阶段的持续支持。本研究旨在分析在采用该体系前后，她们对母婴保健活动认知的变化。
方法 2020年9月至10月，按照访谈指南，通过半结构化焦点小组访谈收集相关数据。本研究方案获得了日本大阪市立大学伦理委员会的批准。
结果 共有12名公共卫生护士参与。在采用芬兰模式的体系之前，这些护士致力于通过持续接触来应对有孩子家庭（尤其是高风险家庭）的风险。然而，她们对于主动接触低风险家庭犹豫不决，因为非持续性的一次性接触导致应对措施杂乱无章。采用该体系后，护士们意识到与所护理家庭（包括低风险家庭）建立的信任，这使她们能够灵活应对不断变化的需求。护士们认识到自己有能力注意到变化的细微迹象，更积极主动地与所护理家庭接触，并在早期提供必要的预防性干预措施。她们还表现出对所护理儿童和母亲成长的喜悦和满足，以及尽管忙碌但对提高专业技能必要性的敏锐认识。
结论 这些发现表明，以芬兰核心要素为蓝本的持续支持体系使公共卫生护士能够主动接触低风险家庭并在早期提供预防性干预措施。该体系还激励了日本的公共卫生护士，她们在工作中找到了更大的乐趣。
