西班牙初级医疗保健中与促进健康社区活动开展相关的因素：两项病例对照研究
Factors related to the development of health-promoting community activities in Spanish primary healthcare: two casecontrol studies.
作者信息
March Sebastià, Ripoll Joana, Jordan Martin Matilde, Zabaleta-Del-Olmo Edurne, Benedé Azagra Carmen Belén, Elizalde Soto Lázaro, Vidal Mª Clara, Bauzà Amengual María de Lluc, Planas Juan Trinidad, Pérez Mariano Damiana Maria, Llull Sarralde Micaela, Ruiz-Giménez Juan Luís, Bajo Viñas Rosa, Solano Villarubia Carmen, Rodriguez Bajo Maria, Cordoba Victoria Manuela, Badia Capdevila Marta, Serrano Ferrandez Elena, Bosom Diumenjo Maria, Montaner-Gomis Isabel, Bolibar-Ribas Buenaventura, Antoñanzas Lombarte Angel, Bregel Cotaina Samantha, Calvo Tocado Ana, Olivan Blázquez Barbara, Magallon Botaya Rosa, Marín Palacios Pilar, Echauri Ozcoidi Margarita, Perez-Arauta María Jose, Llobera Joan, Ramos Maria
机构信息
Primary Care Research Unit of Mallorca, Baleares Health Services-IB-Salut, Palma, Spain.
Balearic Islands Health Research Institute (IdISBA), Palma, Spain.
出版信息
BMJ Open. 2017 Oct 8;7(10):e015934. doi: 10.1136/bmjopen-2017-015934.
OBJECTIVE
Spanish primary healthcare teams have the responsibility of performing health-promoting community activities (CAs), although such activities are not widespread. Our aim was to identify the factors related to participation in those activities.
DESIGN
Two casecontrol studies.
SETTING
Performed in primary care of five Spanish regions.
SUBJECTS
In the first study, cases were teams that performed health-promoting CAs and controls were those that did not. In the second study (on case teams from the first study), cases were professionals who developed these activities and controls were those who did not.
MAIN OUTCOME MEASURES
Team, professional and community characteristics collected through questionnaires (team managers/professionals) and from secondary sources.
RESULTS
The first study examined 203 teams (103 cases, 100 controls). Adjusted factors associated with performing CAs were percentage of nurses (OR 1.07, 95% CI 1.01 to 1.14), community socioeconomic status (higher vs lower OR 2.16, 95% CI 1.18 to 3.95) and performing undergraduate training (OR 0.44, 95% CI 0.21 to 0.93). In the second study, 597 professionals responded (254 cases, 343 controls). Adjusted factors were professional classification (physicians do fewer activities than nurses and social workers do more), training in CAs (OR 1.9, 95% CI 1.2 to 3.1), team support (OR 2.9, 95% CI 1.5 to 5.7), seniority (OR 1.06, 95% CI 1.03 to 1.09), nursing tutor (OR 2.0, 95% CI 1.1 to 3.5), motivation (OR 3.7, 95% CI 1.8 to 7.5), collaboration with non-governmental organisations (OR 1.9, 95% CI 1.2 to 3.1) and participation in neighbourhood activities (OR 3.1, 95% CI 1.9 to 5.1).
CONCLUSIONS
Professional personal characteristics, such as social sensitivity, profession, to feel team support or motivation, have influence in performing health-promoting CAs. In contrast to the opinion expressed by many professionals, workload is not related to performance of health-promoting CAs.
目的
西班牙基层医疗团队有责任开展促进健康的社区活动（CAs），尽管此类活动并不普遍。我们的目的是确定与参与这些活动相关的因素。
设计
两项病例对照研究。
地点
在西班牙五个地区的基层医疗中进行。
研究对象
在第一项研究中，病例组是开展促进健康的社区活动的团队，对照组是未开展此类活动的团队。在第二项研究（针对第一项研究中的病例组团队）中，病例组是开展这些活动的专业人员，对照组是未开展这些活动的专业人员。
主要观察指标
通过问卷（团队经理/专业人员）以及二手资料收集的团队、专业人员和社区特征。
结果
第一项研究调查了203个团队（103个病例组，100个对照组）。与开展社区活动相关的校正因素包括护士比例（比值比[OR]1.07，95%置信区间[CI]1.01至1.14）、社区社会经济地位（较高与较低相比，OR 2.16，95% CI 1.18至3.95）以及开展本科培训（OR 0.44，95% CI 0.21至0.93）。在第二项研究中，597名专业人员做出了回应（254个病例组，343个对照组）。校正因素包括专业分类（医生开展的活动比护士少，社会工作者开展的活动更多）、社区活动培训（OR 1.9，95% CI 1.2至3.1）、团队支持（OR 2.9，95% CI 1.5至5.7）、资历（OR 1.06，95% CI 1.03至1.09）、护理导师（OR 2.0，95% CI 1.1至3.5）、积极性（OR 3.7，95% CI 1.8至7.5）、与非政府组织的合作（OR 1.9，95% CI 1.2至3.1）以及参与社区活动（OR 3.1，95% CI 1.9至5.1）。
结论
专业人员的个人特征，如社会敏感度、职业、感受到的团队支持或积极性，会影响促进健康的社区活动的开展。与许多专业人员的观点相反，工作量与促进健康的社区活动的开展无关。
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