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

Background: 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 communi...

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Bibliographic Details
Authors: Pons-Vigues, Mariona, Berenguera, Anna, Coma-Auli, Nuria, Pombo-Ramos, Haizea, Pujol-Ribera, Enriqueta, March Llull, Sebastià, Asensio-Martinez, Angela, Moreno-Peral, Patricia, Mora-Simon, Sara, Martinez-Andres, Maria
Format: article
Publication Date:2017
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/9789
Online Access:https://hdl.handle.net/20.500.13003/9789
Access Level:Open access
Keyword:Qualitative Research
Health Promotion
Health Personnel
Male
Health Resources
Middle Aged
Humans
Community Participation
Adult
Spain
Aged
Female
Primary Health Care
Attitude of Health Personnel
España
Recursos en Salud
Femenino
Personal de Salud
Promoción de la Salud
Actitud del Personal de Salud
Masculino
Participación de la Comunidad
Humanos
Persona de Mediana Edad
Anciano
Investigación Cualitativa
Atención Primaria de Salud
Adulto
Health
Health assets
Health promotion
Patient participation
Qualitative research
Description
Summary:Background: 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. Methods: 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. Results: 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. Conclusions: 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.