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
Pons-Vigués, Mariona (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Berenguera, Anna (Universitat Autònoma de Barcelona)
Coma-Auli, Núria (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Pombo Ramos, Haizea (Primary Care Research Unit of Bizkaia)
March, Sebastià (Instituto de Investigación Sanitaria de Palma)
Asensio-Martínez, Angela (University of Zaragoza. Department of Psychology)
Moreno-Peral, Patricia (Instituto de Investigación Biomédica de Málaga)
Mora-Simón, Sara (Instituto de Investigación Biomédica de Salamanca)
Martínez-Andrés, Maria (University of Castilla. Social and Health Care Research Centre)
Pujol Ribera, Enriqueta (Universitat Autònoma de Barcelona)

Data:	2017
Resum:	Although 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. A 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. Health-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. Generally, 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.
Ajuts:	Ministerio de Economía y Competitividad PI15-00114
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Health ; Health assets ; Health promotion ; Patient participation ; Primary Health Care ; Qualitative research
Publicat a:	International Journal for Equity in Health, Vol. 16 (June 2017) , art. 99, ISSN 1475-9276

DOI: 10.1186/s12939-017-0590-2
PMID: 28610633

16 p, 456.9 KB

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