労働者の健康的な生活習慣への改善のプロセス

• Published in: 看護科学研究 Vol. 9; no. 2; pp. 30 - 41
• Main Authors: 高波 利恵, 佐藤 しのぶ, 松尾 太加志
• Format: Journal Article
• Language: Japanese
• Published: 大分県立看護科学大学看護研究交流センター 2011; Oita University of Nursing and Health Sciences The Center for Nursing Education, Research and Collaboration (CNERC)
• Subjects: behavior change for health; occupational health nursing; worker; 労働者; 生活習慣改善; 産業看護
• ISSN: 2424-0052
• DOI: 10.20705/jjnhs.9.2_30

It is needed to establish a concrete theory of workers' process of behavior change for health. The interview of middle aged male workers in a large-scale company was held. A qualitative analysis with " Grounded theory approach" showed 3 steps and the following characteristics of behavior change among workers: Step 1 is "Introduction" which explains the process until behavior start to change. Step 2 is "Approach to take hold" which explains the process from the start of behavior change to the continuing or discontinuing of it. Step 3 is "Decision of advance or retreat" which is the process to make a directional behavior change. It was shown that independence of behavior change can be guessed from "Desire for behavior change" and "Cognition for probability of behavior change realization". When independence is not enough, "Support" by workers' superiors and colleagues back up workers' behavior change. To continue behavior change, it is necessary to enhance the understanding of the advantages of behavior change and to overcome the obstacles that may be encountered. Those who have positive cognition about behavior change can advance behavior change because they have obtained the power to tackle it. The support and approval from workers' superiors and colleagues increase workers' power to tackle it. From the above, public health nurses should focus on workers' cognition about health and behavior change and they should support to build a worksite culture which supports health. 労働者の生活習慣改善プロセスの具体的な理論を構築する端緒として、大規模事業所の男性労働者への面接とグラウンデッドセオリーアプローチによる分析を行った。その結果、生活習慣改善プロセスは、行動開始までの「導入の段階」、行動開始から継続・中断までの「定着化アプローチの段階」、今後の取り組みを方向づける「進退決定の段階」の3段階で示された。「導入の段階」では、生活習慣改善への主体性は「生活習慣改善の願望」と「実行可能性の認識」から推測できることが示された。主体性が低い場合は、他者からの「後押し」がそれを補っていた。「定着化アプローチの段階」における「生活習慣改善のメリットの認識」や「継続の壁の回避・克服」が、「進退決定の段階」で生活習慣改善に「取り組む力の獲得・強化」へと繋がることが示された。保健師はプロセスの進展のため、労働者の認識の変化に着目し、労働者間の良好な人間関係づくり、健康づくり政策の浸透等への支援を行う必要があると考えた。