Huang C-L, Wang H-H
Department of Nursing, Chang Jung University, Tainan, Taiwan.
Int Nurs Rev. 2005 Mar;52(1):13-7. doi: 10.1111/j.1466-7657.2004.00259.x.
The Department of Health in Taiwan initiated community health development (CHD), a new approach to national community health care. Community-based research and evaluation approaches have recently been shifting from 'traditional' research to 'participatory' research. However, there is vagueness about the theoretical foundation of CHD and the appropriateness of using participatory action research (PAR) to evaluate CHD. This article explores theoretical concepts of CHD and discusses the compatibility of PAR and CHD in the theoretical and philosophical foundations. Community health development is a developing and changing process that involves both the social and the health contexts. It operates on the basis of three approaches to care: primary care, health promotion and community development. Partnership and empowerment between community health nurses and the community are concurrently involved in the entire process of CHD practice. The fundamental tenet of PAR focuses on the development of knowledge through partnership and empowerment between the researcher and the community, and the creation of critical consciousness leading to necessary action and effective change. Unlike empirical community-based research, PAR is flexible enough to capture an understanding of the complex social and health phenomena in the CHD framework. Furthermore, utilizing the PAR approach is appropriate not only for the methodological framework of the CHD evaluation, but also for the enhancement of the CHD actualization.
台湾卫生部门发起了社区健康发展（CHD），这是一种全国性社区医疗保健的新方法。基于社区的研究和评估方法最近已从“传统”研究转向“参与式”研究。然而，社区健康发展的理论基础以及使用参与式行动研究（PAR）评估社区健康发展的适用性尚不明晰。本文探讨了社区健康发展的理论概念，并讨论了参与式行动研究与社区健康发展在理论和哲学基础上的兼容性。社区健康发展是一个不断发展和变化的过程，涉及社会和健康背景。它基于三种护理方法运作：初级护理、健康促进和社区发展。社区健康护士与社区之间的伙伴关系和赋权同时参与到社区健康发展实践的整个过程中。参与式行动研究的基本原则侧重于通过研究者与社区之间的伙伴关系和赋权来发展知识，并创造批判性意识以促成必要的行动和有效的变革。与基于实证的社区研究不同，参与式行动研究足够灵活，能够在社区健康发展框架中理解复杂的社会和健康现象。此外，采用参与式行动研究方法不仅适用于社区健康发展评估的方法框架，也有助于促进社区健康发展的实现。
