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在农村和偏远地区工作的初级卫生保健人员如何获得技能发展和专业知识以支持健康促进实践。

How primary health care staff working in rural and remote areas access skill development and expertise to support health promotion practice.

作者信息

McFarlane Kathryn A, Judd Jenni, Wapau Hylda, Nichols Nina, Watt Kerrianne, Devine Sue

机构信息

College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville QLD 4811, Australia

School of Human Health and Social Sciences, Central Queensland University, Bundaberg QLD 4670

出版信息

Rural Remote Health. 2018 May;18(2):4413. doi: 10.22605/RRH4413. Epub 2018 May 18.

Abstract

INTRODUCTION

Health promotion is a key component of comprehensive primary health care. Health promotion approaches complement healthcare management by enabling individuals to increase control over their health. Many primary healthcare staff have a role to play in health promotion practice, but their ability to integrate health promotion into practice is influenced by their previous training and experience. For primary healthcare staff working in rural and remote locations, access to professional development can be limited by what is locally available and prohibitive in terms of cost for travel and accommodation. This study provides insight into how staff at a large north Queensland Aboriginal community controlled health service access skill development and health promotion expertise to support their work.

METHODS

A qualitative exploratory study was conducted. Small group and individual semi-structured interviews were conducted with staff at Apunipima Cape York Health Council (n=9). A purposive sampling method was used to recruit participants from a number of primary healthcare teams that were more likely to be involved in health promotion work. Both on-the-ground staff and managers were interviewed. All participants were asked how they access skill development and expertise in health promotion practice and what approaches they prefer for ongoing health promotion support. The interviews were transcribed verbatim and analysed thematically.

RESULTS

All participants valued access to skill development, advice and support that would assist their health promotion practice. Skill development and expertise in health promotion was accessed from a variety of sources: conferences, workshops, mentoring or shared learning from internal and external colleagues, and access to online information and resources. With limited funds and limited access to professional development locally, participants fostered external and internal organisational relationships to seek in-kind advice and support. Irrespective of where the advice came from, it needed to be applicable to work with Aboriginal and Torres Strait Islander remote communities.

CONCLUSIONS

To improve health outcomes in rural and remote communities, the focus on health promotion and prevention approaches must be strengthened. Primary healthcare staff require ongoing access to health promotion skill development and expertise to increase their capacity to deliver comprehensive primary health care. Practice-based evidence from staff working in the field provides a greater understanding of how skill development and advice are accessed. Many of these strategies can be formalised through organisational plans and systems, which would ensure that a skilled health promotion workforce is sustained.

摘要

引言

健康促进是全面初级卫生保健的关键组成部分。健康促进方法通过使个人能够增强对自身健康的掌控力来补充医疗保健管理。许多初级卫生保健人员在健康促进实践中发挥着作用,但他们将健康促进融入实践的能力受到其先前培训和经验的影响。对于在农村和偏远地区工作的初级卫生保健人员而言,获得专业发展的机会可能会受到当地可提供资源的限制,并且在差旅和住宿费用方面过高。本研究深入探讨了昆士兰州北部一个大型原住民社区控制健康服务机构的工作人员如何获取技能发展和健康促进专业知识以支持其工作。

方法

开展了一项定性探索性研究。对阿普尼皮马约克角健康理事会的工作人员(n = 9)进行了小组和个人半结构化访谈。采用目的抽样方法从一些更有可能参与健康促进工作的初级卫生保健团队中招募参与者。对一线工作人员和管理人员都进行了访谈。所有参与者都被问及他们如何获取健康促进实践中的技能发展和专业知识,以及他们更喜欢何种持续健康促进支持的方式。访谈内容逐字记录并进行了主题分析。

结果

所有参与者都重视获得有助于其健康促进实践的技能发展、建议和支持。健康促进方面的技能发展和专业知识来自多种来源:会议、研讨会、指导或与内部和外部同事的共同学习,以及获取在线信息和资源。由于资金有限且当地获得专业发展的机会有限,参与者建立了外部和内部组织关系以寻求实物建议和支持。无论建议来自何处,都需要适用于与原住民和托雷斯海峡岛民偏远社区的合作。

结论

为改善农村和偏远社区的健康状况,必须加强对健康促进和预防方法的关注。初级卫生保健人员需要持续获得健康促进技能发展和专业知识,以提高他们提供全面初级卫生保健的能力。来自该领域工作人员基于实践的证据能更深入了解如何获取技能发展和建议。其中许多策略可通过组织计划和系统进行规范,这将确保维持一支熟练的健康促进工作队伍。

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