発達障害を有する外国人小児への保健師による早期発見・支援とその困難

• Published in: 日本公衆衛生看護学会誌 Vol. 7; no. 2; pp. 72 - 79
• Main Authors: 鈴木 良美, 森山 ますみ, 五味 麻美, 持田 恵理
• Format: Journal Article
• Language: Japanese
• Published: 一般社団法人 日本公衆衛生看護学会 2018; Japan Academy of Public Health Nursing
• Subjects: child; developmental disorder; early detection; foreign residents; public health nurse; 保健師; 外国人; 小児; 早期発見; 発達障害
• ISSN: 2187-7122; 2189-7018
• DOI: 10.15078/jjphn.7.2_72

Objective: This study aimed to promote the early detection of developmental disorders, support activities related to such conditions, and identify the associated difficulties faced by public health nurses (PHNs) in treating foreign children with developmental disorders in Japan based on the parents’ nationalities.Methods: Self-administered questionnaires were sent to 241 public health centers located in different cities that were included in the top 100 cities with foreign residents.Results: Overall, 48 responses were obtained. Only 60% utilized the foreign-language questionnaires and public interpreters during health check-ups even in cities with numerous foreign residents. PHNs had difficulties in supporting foreign residents during the initial step, which included data collection and assessment, because of differences in culture and language.Discussion: To promote the early detection and seamless support activities for foreign children with developmental delays and disorders, the language support system, mutual understanding between PHNs and foreign residents, and systematization of information that is useful for them must be enhanced. 目的：本研究の目的は，発達障害を有する外国人小児への保健師による早期発見と支援や，その活動上の困難を，親の国籍による違いも踏まえて明らかにすることである．方法：外国人人口の多い上位100市区町村保健センター241ヵ所へ，無記名自記式質問紙を郵送した．結果：48ヵ所から回答を得た．健診での外国語版質問紙や公的通訳の活用は，外国人人口の多い本調査の対象自治体でも6割程度であった．発達障害を有する外国人小児への保健師活動の困難は，言葉や文化の違いを背景に，情報収集や判断という支援の初期段階からすでに生じていた．また南米よりもアジア系外国人が多い自治体の方が，保健師が活動上の困難を感じる割合が高い項目が多かった．考察：今後，発達障害を有する外国人小児の早期発見と切れ目ない支援のためには，さらなる言語的支援体制の整備や，保健師と外国人双方の理解の促進とそのための情報源の体系化などが求められる．