Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Centre intégré de santé et de services sociaux de la Montérégie-Centre, Longueuil, Quebec, Canada.
BMJ Open. 2020 Feb 12;10(2):e030193. doi: 10.1136/bmjopen-2019-030193.
The association between social status and health is well established, but the psychosocial factors and mechanisms underlying this association are not fully understood. This study aims to identify and describe social and psychosocial factors that may harm the health of low-income adults.
Participatory qualitative research using a problem-posing method based on Freire's pedagogy.
Community organisation in a low-income district in the metropolitan area of Montreal, in the province of Quebec, Canada.
Eight low-income adults using food bank services provided by the community organisation. Participants had to reside in the community organisation's service area, have insufficient income to cover living expenses, be aged 18 years or older, and be able to participate in group sessions.
Eight weekly group sessions (average of 2.5 hours per session) were held using problem-posing method, which included activities such as presentation of representative stories or images and role-playing. Five additional sessions were held for thematic data analysis with participants.
A main factor identified as harming the health of participants was the dissonance between perceived current circumstances and the ideal of circumstances conceived early in life. This dissonance follows a loss or a failure to achieve the ideal of circumstances and generates profound malaise. Other main factors identified were the current circumstances as a social trap and the lack of love and support from an early age.
This study identifies a new psychosocial factor, namely, the dissonance between perceived current circumstances and the ideal of circumstances conceived early in life. Larger studies should examine the influence of this factor on health.
社会地位与健康之间的关系已得到充分证实，但导致这种关系的心理社会因素和机制尚未完全阐明。本研究旨在确定和描述可能危害低收入成年人健康的社会和心理社会因素。
基于弗莱雷教育学的参与式定性研究，采用问题提出方法。
加拿大魁北克省蒙特利尔大都市区低收入地区的社区组织。
8 名使用社区组织提供的食品银行服务的低收入成年人。参与者必须居住在社区组织的服务区域内，收入不足以支付生活费用，年龄在 18 岁或以上，并且能够参加小组会议。
使用问题提出方法每周举行 8 次小组会议（每次平均 2.5 小时），其中包括介绍有代表性的故事或图像以及角色扮演等活动。与参与者进行了 5 次额外的主题数据分析会议。
一个被确定为危害参与者健康的主要因素是感知到的当前情况与早年设想的情况之间的不和谐。这种不和谐源于对理想情况的失落或未能实现，从而产生了深刻的不适。确定的其他主要因素包括当前情况是一种社会陷阱，以及早年缺乏爱和支持。
本研究确定了一个新的心理社会因素，即感知到的当前情况与早年设想的情况之间的不和谐。更大规模的研究应检验该因素对健康的影响。
