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Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients

BACKGROUND: The effects of tobacco, physical exercise, diet, and alcohol consumption on morbidity and mortality underline the importance of health promotion and prevention (HPP) at the primary health care (PHC) level. Likewise, the deficiencies when putting such policies into practice and assessing...

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Autores principales: Calderón, Carlos, Balagué, Laura, Cortada, Josep M, Sánchez, Álvaro
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070625/
https://www.ncbi.nlm.nih.gov/pubmed/21426590
http://dx.doi.org/10.1186/1472-6963-11-62
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author Calderón, Carlos
Balagué, Laura
Cortada, Josep M
Sánchez, Álvaro
author_facet Calderón, Carlos
Balagué, Laura
Cortada, Josep M
Sánchez, Álvaro
author_sort Calderón, Carlos
collection PubMed
description BACKGROUND: The effects of tobacco, physical exercise, diet, and alcohol consumption on morbidity and mortality underline the importance of health promotion and prevention (HPP) at the primary health care (PHC) level. Likewise, the deficiencies when putting such policies into practice and assessing their effectiveness are also widely recognised. The objectives of this research were: a) to gain an in-depth understanding of general practitioners' (GPs) and patients' perceptions about HPP in PHC, and b) to define the areas that could be improved in future interventions. METHODS: Qualitative methodology focussed on the field of health services research. Information was generated on the basis of two GP-based and two patient-based discussion groups, all of which had previously participated in two interventions concerning healthy lifestyle promotion (tobacco and physical exercise). Transcripts and field notes were analysed on the basis of a sociological discourse-analysis model. The results were validated by triangulation between researchers. RESULTS: GPs and patients' discourses about HPP in PHC were different in priorities and contents. An overall explanatory framework was designed to gain a better understanding of the meaning of GP-patient interactions related to HPP, and to show the main trends that emerged from their discourses. GPs linked their perceptions of HPP to their working conditions and experience in health services. The dimensions in this case involved the orientation of interventions, the goal of actions, and the evaluation of results. For patients, habits were mainly related to ways of life particularly influenced by close contexts. Health conceptions, their role as individuals, and the orientation of their demands were the most important dimensions in patients' sphere. CONCLUSIONS: HPP activities in PHC need to be understood and assessed in the context of their interaction with the conditioning trends in health services and patients' social micro-contexts. On the basis of the explanatory framework, three development lines are proposed: the incorporation of new methodological approaches according to the complexity of HPP in PHC; the openness of habit change policies beyond the medical services; and the effective commitments in the medium to long term by the health services themselves at the policy management level.
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spelling pubmed-30706252011-04-05 Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients Calderón, Carlos Balagué, Laura Cortada, Josep M Sánchez, Álvaro BMC Health Serv Res Research Article BACKGROUND: The effects of tobacco, physical exercise, diet, and alcohol consumption on morbidity and mortality underline the importance of health promotion and prevention (HPP) at the primary health care (PHC) level. Likewise, the deficiencies when putting such policies into practice and assessing their effectiveness are also widely recognised. The objectives of this research were: a) to gain an in-depth understanding of general practitioners' (GPs) and patients' perceptions about HPP in PHC, and b) to define the areas that could be improved in future interventions. METHODS: Qualitative methodology focussed on the field of health services research. Information was generated on the basis of two GP-based and two patient-based discussion groups, all of which had previously participated in two interventions concerning healthy lifestyle promotion (tobacco and physical exercise). Transcripts and field notes were analysed on the basis of a sociological discourse-analysis model. The results were validated by triangulation between researchers. RESULTS: GPs and patients' discourses about HPP in PHC were different in priorities and contents. An overall explanatory framework was designed to gain a better understanding of the meaning of GP-patient interactions related to HPP, and to show the main trends that emerged from their discourses. GPs linked their perceptions of HPP to their working conditions and experience in health services. The dimensions in this case involved the orientation of interventions, the goal of actions, and the evaluation of results. For patients, habits were mainly related to ways of life particularly influenced by close contexts. Health conceptions, their role as individuals, and the orientation of their demands were the most important dimensions in patients' sphere. CONCLUSIONS: HPP activities in PHC need to be understood and assessed in the context of their interaction with the conditioning trends in health services and patients' social micro-contexts. On the basis of the explanatory framework, three development lines are proposed: the incorporation of new methodological approaches according to the complexity of HPP in PHC; the openness of habit change policies beyond the medical services; and the effective commitments in the medium to long term by the health services themselves at the policy management level. BioMed Central 2011-03-23 /pmc/articles/PMC3070625/ /pubmed/21426590 http://dx.doi.org/10.1186/1472-6963-11-62 Text en Copyright ©2011 Calderón et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Calderón, Carlos
Balagué, Laura
Cortada, Josep M
Sánchez, Álvaro
Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients
title Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients
title_full Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients
title_fullStr Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients
title_full_unstemmed Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients
title_short Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients
title_sort health promotion in primary care: how should we intervene? a qualitative study involving both physicians and patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070625/
https://www.ncbi.nlm.nih.gov/pubmed/21426590
http://dx.doi.org/10.1186/1472-6963-11-62
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