Health-care users, key community informants and primary health care workers’ views on health, health promotion, health assets and deficits: qualitative study in seven Spanish regions

International Journal for Equity in Health

Research

Angela Asensio-Martínez¹  Núria Coma-Auli²  Anna Berenguera³  Mariona Pons-Vigués⁴  Enriqueta Pujol-Ribera⁴  Patricia Moreno-Peral⁵  Haizea Pombo-Ramos⁶  Sebastià March⁷  Sara Mora-Simón⁸  Maria Martínez-Andrés⁹ 

[1] Aragon Institute for Health Research (IIS Aragon), Zaragoza, Spain;Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain;Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Av. Gran Via de les Corts Catalanes 587, àtic, 08007, Barcelona, Spain;Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Av. Gran Via de les Corts Catalanes 587, àtic, 08007, Barcelona, Spain;Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain;Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Av. Gran Via de les Corts Catalanes 587, àtic, 08007, Barcelona, Spain;Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain;Universitat de Girona, Girona, Spain;Instituto de Investigación Biomédica de Málaga (IBIMA), Distrito Sanitario Málaga-Guadalhorce, Málaga, Spain;Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Bilbao, Spain;Primary Care Research Unit of Mallorca, Balearic Health Services-IbSalut, Palma, Spain;Instituto de Investigación Sanitaria de Palma, Palma, Spain;Primary Care Research Unit, The Alamedilla Health Centre, Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain;Social and Health Care Research Centre, University of Castilla- La Mancha, Cuenca, Spain;

关键词: Health;    Health assets;    Health promotion;    Patient participation;    Primary Health Care;    Qualitative research;   

DOI  :  10.1186/s12939-017-0590-2

 received in 2016-12-15, accepted in 2017-05-26,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAlthough some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention.MethodsA descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out.ResultsHealth-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants’ profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having implemented some change to promote their health. The most powerful motivators to change lifestyles are having a disease, fear of becoming ill and taking care of oneself to maintain health. Health-care users believe that the main difficulties are associated with the physical, social, working and family environment, as well as lack of determination and motivation. They also highlight the need for more information. In relation to the assets and deficits of the neighbourhood, each group identifies those closer to their role.ConclusionsGenerally, participants showed a holistic and positive concept of health and a more traditional, individual approach to health promotion. We consider therefore crucial to depart from the model of health services that focuses on the individual and the disease toward a socio-ecological health model that substantially increases the participation of health-care users and emphasizes health promotion, wellbeing and community participation.

【 授权许可】

CC BY   
© The Author(s). 2017