Historical research on expanding the role and professionalization of nursing through medical practices

Research Project

Project/Area Number	17K12097
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Fundamental nursing
Research Institution	Japanese Red Cross College of Nursing
Principal Investigator	Kawahara Yukari 日本赤十字看護大学, 看護学部, 教授 (70308287)
Co-Investigator(Kenkyū-buntansha)	田中幸子東京慈恵会医科大学, 医学部, 教授 (20286371)
Project Period (FY)	2017-04-01 – 2022-03-31
Project Status	Completed (Fiscal Year 2021)
Budget Amount *help	¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000) 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) Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000) Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywords	高度看護実践 / 看護 / 専門職化 / 役割拡大 / 歴史 / ナースプラクティショナー / 専門看護師 / 専門職 / 医行為 / 看護業務法 / 看護登録法 / 歴史研究 / フェミニズム / 看護の歴史
Outline of Final Research Achievements	The purpose of this study is to clarify the development process of advanced nursing practice in foreign countries. The related historical materials and interview data with researchers on history of advanced nursing practice in the U.S. were analyzed. As a result, in U.S., advanced practical nursing has been developed through various conflicts and adjustments with related occupations. It has developed the appropriate education system based on the nursing science, qualification regulations under the related Nurse Act, and acquisition of authorities for medical examination, diagnosis, and prescription including adjustment of the Doctor and Pharmacist Act. In particular, it was considered that it is important to avoid the monopoly on medical practice by doctors and to establish the identity of nursing as a care science and the foundation of nursing practice.
Academic Significance and Societal Importance of the Research Achievements	本研究の学術的意義は、米国での高度看護実践の発展を、戦後の米国における医療ニーズの増大や社会保障費の高騰などの背景、労働運動やフェミニズムなどの後押し、医師などの関連職種との調整などを含む多側面から明らかにした点である。日本でも医療費の抑制は重要な課題であり、今後、医療サービスが行き届かない地域の増加も予想されている。看護には近い将来、地域の第一線で、高度な医療を必要としなくてもよいように、人々の健康を見守る役割を果たすことが求められると考えられる。諸外国での高度看護実践の発展のプロセスで取り組まれた課題、その達成内容を通して、日本での課題を明らかにしたことが本研究成果の社会的な意義といえる。