Cohen Benita
Faculty of Nursing, Helen Glass Centre, University of Manitoba, Winnipeg, Canada.
Can J Nurs Res. 2006 Sep;38(3):52-67.
There is growing evidence that population health is influenced by broad socio-environmental factors that require population-focused health promotion strategies. The author reports on a study of the perspectives of public health nurses (PHNs) on the nature of their health promotion practice in the Canadian province of Manitoba, highlighting their perceptions about barriers to population-focused health promotion. A descriptive, exploratory research design was used to conduct standardized open-ended interviews with 24 PHNs in 3 geographically and demographically diverse health authorities. There were remarkable similarities in PHNs' perceptions about their practice. Three categories of barrier to population-focused health promotion were identified: barriers at the level of individual PHNs; organizational barriers (culture, policies, processes); and extra-organizational barriers at the level of the community or province. The results point to a gap between the theory that population-focused health promotion is at the heart of PHN practice and the experience of PHNs at the 3 sites. A concerted effort to address the barriers is needed so that PHNs in Manitoba can play a leadership role in creating a health-care system that truly invests in population health.
越来越多的证据表明，人群健康受到广泛的社会环境因素影响，而这些因素需要以人群为重点的健康促进策略。作者报告了一项关于加拿大曼尼托巴省公共卫生护士（PHN）对其健康促进实践本质的观点的研究，突出了他们对以人群为重点的健康促进障碍的看法。采用描述性、探索性研究设计，对3个地理和人口结构不同的卫生当局的24名公共卫生护士进行标准化开放式访谈。公共卫生护士对其实践的看法存在显著相似之处。确定了以人群为重点的健康促进的三类障碍：个体公共卫生护士层面的障碍；组织障碍（文化、政策、流程）；以及社区或省级层面的组织外障碍。结果表明，以人群为重点的健康促进是公共卫生护士实践核心的理论与这3个地点的公共卫生护士的经验之间存在差距。需要齐心协力解决这些障碍，以便曼尼托巴省的公共卫生护士能够在创建真正投资于人群健康的医疗保健系统中发挥领导作用。
