Noji A
Seiroka Kango Daigaku Kiyo. 1997;23:22-8.
There has been a paradigm shift in community health nursing. In 1992, visiting nursing stations were first introduced. In 1994, the Community Health Act came into force and in recent years public health care insurance has become a major issue. In this paradigm shift, one of the roles of nursing in the community is to train people to become more autonomous as consumers of health care services, and to design and implement a system that enhances community members' health and provides support when they are ill. In 1990 and 1996, the national nursing curriculum was revised to reflect changes in the age of the population. Community health nursing now faces the challenge of developing a new nursing model that is in tune with Japanese cultural values. Dr. Katsunuma (1996) proposed two alternative approaches to health care services: the public health approach and the clinical approach. In this paper, it is suggested that home care offers a third alternative, which integrates the clinical approach with the public health approach. This third approach provides a paradigm for community health nursing that integrates individual health care with community health care. New roles and specialties for public health nurses include care management, care planning, community health nursing administration, and supervision. Community-based nursing centers that cooperate with schools of nursing will provide a setting and a concept for community health nursing.
社区健康护理领域发生了范式转变。1992年，首次引入了访视护理站。1994年，《社区健康法》生效，近年来，公共医疗保险已成为一个主要问题。在这一范式转变中，社区护理的作用之一是培训人们成为更自主的医疗保健服务消费者，并设计和实施一个增强社区成员健康并在他们生病时提供支持的系统。1990年和1996年，国家护理课程进行了修订，以反映人口年龄的变化。社区健康护理现在面临着开发一种与日本文化价值观相契合的新护理模式的挑战。胜沼博士（1996年）提出了两种医疗保健服务的替代方法：公共卫生方法和临床方法。本文提出，居家护理提供了第三种选择，即将临床方法与公共卫生方法相结合。这第三种方法为社区健康护理提供了一个将个人医疗保健与社区医疗保健相结合的范式。公共卫生护士的新角色和专业领域包括护理管理、护理规划、社区健康护理管理和监督。与护理学院合作的社区护理中心将为社区健康护理提供一个场所和理念。
