Cawston Peter G, Mercer Stewart W, Barbour Rosaline S
1Drumchapel Health Centre, Glasgow, UK.
BMC Health Serv Res. 2007 Jun 18;7:88. doi: 10.1186/1472-6963-7-88.
Participation by communities in improving the quality of health services has become a feature of government policy in the United Kingdom. The aim of the study was to involve a deprived community in the UK in shaping quality improvements of local primary care services. The specific objectives were firstly to create participation by local people in evaluating the primary care services available in the area and secondly to bring about change as a result of this process.
The methods of participatory action research was used. The study was set in an area of high socio-economic deprivation served by a 'Local Health Care Co-operative' in a peripheral housing estate in Glasgow, Scotland. 72 local residents took part in 11 focus groups: eight of these were with community groups and three with other residents. 372 local residents completed questionnaires either by brief face-to-face interviews (114) or by self or carer completion (258).
The study group produced recommendations on physical access to the health centre, time constraints in accessing services and problems encountered in individual relationships with health staff. They also highlighted the social gap between health service providers and the daily life of community residents. Action was taken to bring these recommendations to the attention of the Primary Care Organisation.
Participatory action research was used to involve a deprived community in the UK in a 'bottom-up' approach aimed at improving quality of local primary care services. Although successful in creating a partnership between academic researchers and lay researchers and participation by local people in evaluating the primary care services available in the area, the impact of the study in terms of immediate action taken over specific issues has been modest. The possible reasons for this are discussed.
社区参与改善医疗服务质量已成为英国政府政策的一个特点。该研究的目的是让英国一个贫困社区参与塑造当地初级医疗服务的质量改进。具体目标一是让当地人参与评估该地区现有的初级医疗服务，二是通过这一过程带来改变。
采用参与式行动研究方法。该研究在苏格兰格拉斯哥一个外围住宅区由“地方医疗保健合作社”服务的高社会经济贫困地区进行。72名当地居民参加了11个焦点小组：其中8个是与社区团体，3个是与其他居民。372名当地居民通过简短的面对面访谈（114人）或自行或由照顾者填写（258人）完成了问卷。
研究小组就前往健康中心的实际便利性、获取服务的时间限制以及与医护人员的个人关系中遇到的问题提出了建议。他们还强调了医疗服务提供者与社区居民日常生活之间的社会差距。已采取行动将这些建议提请初级医疗保健组织注意。
参与式行动研究被用于让英国一个贫困社区以“自下而上”的方式参与旨在提高当地初级医疗服务质量的活动。尽管该研究成功地在学术研究人员和非专业研究人员之间建立了合作关系，并让当地人参与评估该地区现有的初级医疗服务，但就针对具体问题立即采取的行动而言，该研究的影响不大。文中讨论了可能的原因。
