Desgroseilliers Valérie, Vonarx Nicolas
Sante Publique. 2014 Jan-Feb;26(1):17-31.
The theoretical frameworks presently dominating health promotion practices mainly focus on the individual's psychosocial and cognitive components. When focusing on environments, these frameworks barely relate contextual elements to the individuals who give them a real existence. Because of the disjunction and reduction they create, the main theoretical readings only partially recognize the complexity of social life and therefore lose the Subject. Lacking theoretical reliance, these readings fail to meet the Ottawa Charter principles. Based on critical analysis of the main theoretical frameworks, we discuss the influence of disciplinary backgrounds on our modes of knowledge, tackling how epidemiological and behavioral thinking affect how we understand, conceive and problematize the objects in these fields. Based on this analysis, we illustrate how these epistemologies oversimplify social realities related to health. In order to encounter the lost subject of health promotion and thereby achieve Ottawa Charter's principles, we propose an innovative theoretical approach based on Schütz' socio-phenomenological thinking and Morin's complexity paradigm. Our theoretical proposal aims to recognize and reconcile significant aspects of individuals' meaningful life experiences, while integrating common sense principles. By transiting through the subject's identity, this theoretical proposal tends to unify all meaningful aspects that subtend social life at the subject's scale.
目前主导健康促进实践的理论框架主要关注个体的心理社会和认知成分。当关注环境时,这些框架几乎没有将情境因素与赋予它们实际存在的个体联系起来。由于它们造成的脱节和简化,主要的理论解读只是部分地认识到社会生活的复杂性,因此忽略了主体。由于缺乏理论支撑,这些解读未能符合《渥太华宪章》的原则。基于对主要理论框架的批判性分析,我们讨论学科背景对我们知识模式的影响,探讨流行病学和行为思维如何影响我们对这些领域中对象的理解、构想和问题化。基于此分析,我们阐明这些认识论如何过度简化与健康相关的社会现实。为了找回健康促进中迷失的主体,从而实现《渥太华宪章》的原则,我们提出一种基于舒茨的社会现象学思维和莫林的复杂性范式的创新理论方法。我们的理论提议旨在认识并调和个体有意义生活经历的重要方面,同时整合常识原则。通过主体身份的转换,这一理论提议倾向于在主体层面统一构成社会生活的所有有意义的方面。