A Study on " The Timing of Intervention by Public Health Nurses" in Supporting High-Risk Families of Neglect

Research Project

Project/Area Number	19K19762
Research Category	Grant-in-Aid for Early-Career Scientists
Allocation Type	Multi-year Fund
Review Section	Basic Section 58080:Gerontological nursing and community health nursing-related
Research Institution	Yamaguchi University (2019, 2022) Oita University of Nursing and Health Sciences (2020-2021)
Principal Investigator	Ogata-Kijima Ayano 山口大学, 大学院医学系研究科, 講師 (70759670)
Project Period (FY)	2019-04-01 – 2023-03-31
Project Status	Completed (Fiscal Year 2022)
Budget Amount *help	¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000) Fiscal Year 2021: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000) Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000) Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Keywords	ネグレクト / 児童虐待予防 / 保健師 / タイミング / 意思決定 / 児童虐待 / 介入 / 虐待予防
Outline of Research at the Start	本研究では、ネグレクトのハイリスク家族に対する保健師の「介入するタイミングを図る技術」を明確化する。この技術は「アセスメントや支援の機会」、「機会の作り方」、「認識・判断」の三つを構成要素とする。さらに、介入するタイミングを逃さず必要な支援ができるように、実践モデルを作成し、現場での実用化を目指す。
Outline of Final Research Achievements	The timing of when to intervene by health professionals who respond to child neglect is intricately related to a variety of backgrounds, suggesting the need to focus on the rationale for intervention decision-making. In addition to case factors, external, supportive decision-makers and organizational factors were found to play a role in decision-making. A literature review on assessment tools for child abuse suggested the need for assessment tools that can clarify the situation and characteristics of the supporters. The characteristics of the supporters' side regarding decision-making were extracted and organized from overseas literature, and the content was modified and refined through interviews, and organized into content related to public health nurses' own skills, values, and attitudes, the workplace to which they belong, and the related organizations with which they collaborate and work together.
Academic Significance and Societal Importance of the Research Achievements	虐待全体の約40%を占めるネグレクトは、健康問題や貧困など複合的要因により改善に時間を要し、介入の遅れも指摘されている。介入のタイミングを図る際には支援者側による意思決定があり、その意思決定には様々な要因があるが、本研究では未解明であった支援者側の特性について検討、整理された。ネグレクトは市町村での対応では最も多く、自治体保健師は日常の母子保健活動を通して児童虐待のハイリスク家庭を早期に発見し、予防的支援ができる立場にある。支援者について保健師に焦点をあてたことで、今後得られた研究成果について信頼性・妥当性を得ることができれば、早期予防・早期対応への貢献が期待できる。