ABSTRACT
OBJETIVO: Comprender a qué modelos teóricos se ajusta la práctica actual de la prevención primaria y promoción de la salud en atención primaria de salud en diferentes centros de salud de siete comunidades autónomas de España, según los/las profesionales de distintas disciplinas de este ámbito asistencial. MÉTODO: Investigación cualitativa descriptiva en la que participaron 145 profesionales de 14 centros de salud de siete comunidades autónomas de España. El muestreo fue teórico. Se realizaron 14 grupos de discusión. El análisis de datos se realizó siguiendo procedimientos del análisis de contenido temático y de acuerdo con siete modelos teóricos de promoción de la salud a nivel micro, meso y macro. RESULTADOS: Las prácticas de los profesionales de los centros participantes en relación con las actividades de prevención primaria y promoción de la salud se adhieren principalmente a modelos intrapersonales, centrándose en ayudar a que las personas se empoderen aumentando la conciencia de riesgo y de los beneficios del cambio en los comportamientos, y guiándolas en la implementación de un comportamiento saludable. Algunos/as profesionales realizan actividades que encajan en modelos interpersonales, implicando a la familia y al propio profesional en las estrategias. Solo en algunos casos las prácticas actuales encajan en modelos comunitarios de promoción de la salud. CONCLUSIONES: Las prácticas de prevención primaria y promoción de la salud de los profesionales de atención primaria siguen principalmente modelos intrapersonales, en algunos casos modelos interpersonales y más puntualmente modelos comunitarios. Es necesario potenciar la participación de la ciudadanía y la orientación comunitaria de los servicios de atención primaria de salud
OBJECTIVE: To understand which theoretical models apply to current primary care practice of primary prevention and health promotion in a sample of primary health centres of seven autonomous regions in Spain according to the various professionals involved. METHOD: Descriptive qualitative research with the participation of 145 professionals from 14 primary health centres of seven autonomous regions in Spain. Theoretical sampling was used and 14 discussion groups were carried out. Data analysis followed thematic contents analysis procedures and was based on seven health promotion theoretical models at micro-, meso- and macro-level. RESULTS: Current practice of primary prevention and health promotion activities mainly follow intrapersonal models, which focus on assisting the empowerment of patients by means of raising awareness of risk and benefits of behavioural change and on guiding the adoption of the new healthy behaviour. To a lesser degree, the activities of some professionals adhere to interpersonal models, which involve also the family and the health professional. In only a few instances community models of health promotion were used. CONCLUSIONS: Primary prevention and health promotion practice of primary healthcare professionals follow mainly intrapersonal models, few cases use interpersonal models and community models are only occasionally employed. Advance of public participation and community orientation in primary healthcare services is needed
Subject(s)
Humans , Models, Theoretical , Health Promotion/methods , Primary Health Care , Professional Practice , Primary Prevention/methods , Primary Prevention/statistics & numerical data , Qualitative Research , Focus GroupsABSTRACT
Fundamento: la autogestión se ha relacionado con un incremento de la eficiencia y de la satisfacción profesional. Ante cualquier cambio tendente a una gestión más autónoma es trascendente conocer el posicionamiento de sus profesionales y directivos. El objetivo del trabajo es conocer la importancia atribuida por los coordinadores de los centros de salud (CS) a la autonomía clínica y de gestión, así como su capacidad de decisión y sus expectativas sobre la factibilidad de implantar un proyecto de gestión autónoma. Métodos: Diseño: Descriptivo transversal, aplicación de cuestionario. Emplazamiento: Atención Primaria, año 2009. Participantes: Todos los coordinadores de los CS de Mallorca (47). Intervenciones y mediciones principales: 27 preguntas que exploran la opinión del coordinador sobre la importancia de los componentes de la autogestión, su capacidad de intervención actual, la propensión/aversión al riesgo, la capacidad de liderazgo, y la factibilidad de un proyecto de autogestión. Resultados: Tasa respuestas: 42/47 (89,4%). 42 (100%) atribuyeron la máxima importancia a la gestión de los recursos humanos, 41 (97,6%) a la gestión de la demanda y 40 (95,2%) a la gestión de las listas de espera. 15 (35,7%) asumirían un riesgo financiero, 14 (33,3%) se consideraban capacitados y 18 (42,9%) se mostraban dispuestos a liderar un proceso de autogestión. 14 (33,3%) pensaban que los profesionales de su equipo no estarían interesados en un proceso de autogestión y 29 (69%) creían que otros CS de Mallorca podrían desarrollarlo. Conclusiones: Los coordinadores encuestados manifestaron disponer de una limitada capacidad de decisión sobre los componentes de la autogestión, ser aversos al riesgo y presentar una escasa capacidad y disposición para liderar proyectos de autogestión(AU)
Background: The self-management has been linked with increased efficiency and job satisfaction. Before any changes aimed at a more autonomous management is important to know the position of professionals and managers. Objective: To assess the importance attached by the coordinators of the health centers (HC) to the clinical and managerial autonomy, knowing their decision making capacity and their expectations about the feasibility of implementing a project of self-management. Methods: Design: cross-sectional study, application questionnaire. Location: Primary Care, 2009. Participants: All the coordinators of the HC of Mallorca (N = 47). Interventions and Measurements: 27 questions that explore the coordinator's opinion about the importance of the components of the self-management, its ability to present intervention, the propensity / aversion to risk, leadership, and the feasibility of a selfmanagement. Results: response rate: 42/47 (89,4%). 42 (100%) attaches the highest importance to the management of human resources, 41 (97,6%) to demand management and 40 (95,2%) to the management of waiting lists. 15 (35,7%) would take a financial risk, 14 (33,3%) were considered trained and 18 (42,9%) were willing to lead a process of self-management. 14 (33,3%) thought that the professionals in your team would not be interested in a process of self-management and 29 (69%) believed that others could develop HC of Mallorca. Conclusions: The respondents were coordinators have a limited ability to decide on the components of the self-management, being risk averse and make a little leadership ability and willingness to self-management projects(AU)
Subject(s)
Humans , Male , Female , Health Centers , Personal Satisfaction , Primary Health Care/methods , Primary Health Care , Cross-Sectional Studies , Surveys and Questionnaires , Primary Health Care/organization & administration , Primary Health Care/trendsABSTRACT
BACKGROUND: The self-management has been linked with increased efficiency and job satisfaction. Before any changes aimed at a more autonomous management is important to know the position of professionals and managers. objective: To assess the importance attached by the coordinators of the health centers (HC) to the clinical and managerial autonomy, knowing their decision making capacity and their expectations about the feasibility of implementing a project of self-management. DESIGN: cross-sectional study, application questionnaire. LOCATION: Primary Care, 2009. PARTICIPANTS: All the coordinators of the HC of Mallorca (N = 47). INTERVENTIONS AND MEASUREMENTS: 27 questions that explore the coordinator's opinion about the importance of the components of the self-management, its ability to present intervention, the propensity / aversion to risk, leadership, and the feasibility of a self-management. RESULTS: response rate: 42/47 (89,4%). 42 (100%) attaches the highest importance to the management of human resources, 41 (97,6%) to demand management and 40 (95,2%) to the management of waiting lists. 15 (35,7%) would take a financial risk, 14 (33,3%) were considered trained and 18 (42,9%) were willing to lead a process of self-management. 14 (33,3%) thought that the professionals in your team would not be interested in a process of self-management and 29 (69%) believed that others could develop HC of Mallorca. CONCLUSIONS: The respondents were coordinators have a limited ability to decide on the components of the self-management, being risk averse and make a little leadership ability and willingness to self-management projects.
