Ebina Ryoko, Yamazaki Yoshihiko
Global Health Communications, University of Tokyo.
Promot Educ. 2008 Dec;15(4):5-10. doi: 10.1177/1025382308097692.
This study was guided by the salutogenic model, and aimed to: 1. describe the social contexts of stronger and weaker SOC (sense of coherence) participants who were adolescents or entering adulthood in the war-affected regions in Croatia, and 2. identify how the levels of SOC related to their responses to the stressors in their social context. Qualitative longitudinal study design and methods were used for the analysis. In-depth semi-structured interviews, participant observations and SOC scale were carried out, and data were collected from 17 female participants twice during two years. The general social context of the participants was summarized with published materials on the similar subjects and analysis of the field-notes and the participants' narratives. In the analysis of the qualitative data, comparisons were made between the three SOC levels (low, middle, high levels categorized with SOC scores), relating to the participants' self-described social contexts. Childhood stability, acceptance of own ethnic identity, management of uncertainty, and the meanings of work emerged as the responses and resources that may influence SOC. How Ottawa Charter health promotion strategies can be adapted in the post-conflict regions is discussed and priorities of addressing strategies are suggested. The discussion points include: 1. the importance of re-orienting health services and creating supportive environments from the aspects of building the secure base of children and promoting health of the next generation; 2. the required personal skills that enabled adolescents to exercise control and make choices conducive to health in a social context of the a war-related turbulent society; 3. the needs for building healthy public policies to tackle unemployment and strengthening community action to rebuild social capital through work revenues.
本研究以健康生成模型为指导,旨在:1. 描述克罗地亚受战争影响地区处于青少年期或即将成年的、心理一致感(SOC)较强和较弱的参与者的社会背景;2. 确定心理一致感水平如何与他们对社会环境中压力源的反应相关。采用定性纵向研究设计和方法进行分析。开展了深入的半结构化访谈、参与观察并使用了心理一致感量表,在两年内对17名女性参与者进行了两次数据收集。参与者的总体社会背景通过关于类似主题的已发表材料以及对实地记录和参与者叙述的分析进行总结。在定性数据分析中,对心理一致感的三个水平(根据心理一致感得分分为低、中、高水平)与参与者自我描述的社会背景进行了比较。童年稳定性、对自身民族身份的认同、不确定性的管理以及工作的意义成为可能影响心理一致感的反应和资源。讨论了如何在冲突后地区调整渥太华宪章健康促进策略,并提出了应对策略的优先事项。讨论要点包括:1. 从建立儿童安全基础和促进下一代健康的方面重新定位卫生服务并创造支持性环境的重要性;2. 在与战争相关的动荡社会背景下,青少年在社会环境中行使控制权并做出有利于健康的选择所需的个人技能;3. 制定健康公共政策以解决失业问题以及加强社区行动以通过工作收入重建社会资本的必要性。