Abreu Liliana, Nunes João Arriscado, Taylor Peter, Silva Susana
ISPUP-EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n˚ 135, 4050-600 Porto, PT.
i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, Porto, PT.
Int J Integr Care. 2018 Jun 5;18(2):18. doi: 10.5334/ijic.3301.
Improvements in asthma integrated care might be achieved through in-depth knowledge about how health literacy is dispersed through a group. This study intends to map out health literacy mediators (those who and how they enable self-management skills in patients with asthma.
Twenty interviews were conducted in a Primary Care Center of Porto using the McGill Illness Narrative Interview. Data were thematically analyzed as case-based and process-tracing-oriented.
Interviewees with a dense network of mediators revealed a low impact of asthma on their lives, dependence on primary care physician for instrumental support and dependence on family members to provide emotional/pragmatic support. Interviewees who relied on a restricted network of mediators (belonging to formal sources of health services and providing informational support) described episodes of crisis as disruptive and demonstrated a reactive approach to self-management skills.
The roles performed by core health mediators (health professionals, family/friends, media) in support of asthma management varied according to patients' narratives of minimization/disruption, connected to dense/restricted social networks. To clarify the boundaries of responsibility-shifting and to enrich support provided by formal sources of health services and peer education groups is needed.
通过深入了解健康素养如何在群体中传播，或许可以实现哮喘综合护理的改善。本研究旨在梳理健康素养调解人（即那些人以及他们如何在哮喘患者中促进自我管理技能）。
在波尔图的一个初级保健中心，使用麦吉尔疾病叙事访谈法进行了20次访谈。数据按照基于案例和过程追踪导向的方式进行了主题分析。
拥有密集调解人网络的受访者表示哮喘对其生活影响较小，在工具性支持方面依赖初级保健医生，在情感/实际支持方面依赖家庭成员。依赖有限调解人网络（属于健康服务的正规来源并提供信息支持）的受访者将危机事件描述为具有破坏性，并表现出对自我管理技能的被动应对方式。
核心健康调解人（健康专业人员、家人/朋友、媒体）在支持哮喘管理方面所发挥的作用，根据与密集/有限社会网络相关的患者最小化/破坏化叙事而有所不同。需要明确责任转移的界限，并丰富健康服务正规来源和同伴教育团体所提供的支持。
