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健康促进与健康生成在慢性病治疗中的作用的叙事观点:对心血管疾病护理的可行性与价值

Narrative view of the role of health promotion and salutogenesis in the treatment of chronic disease: viability and value for the care of cardiovascular conditions.

作者信息

Röhrich Christina, Giordano James, Kohls Nikola Boris

机构信息

Division Health Promotion, University of Applied Sciences and Arts, Coburg, Coburg, Germany.

Departments of Neurology and Biochemistry, and Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC, USA.

出版信息

Cardiovasc Diagn Ther. 2021 Apr;11(2):591-601. doi: 10.21037/cdt-20-610.

Abstract

Health promotion provides a complementary scientific and practical approach to medicine, which may help to create, maintain and restore wellness even in the presence of disease and illness. Salutogenesis, as key concept, focuses upon the emergence of health and thus, leads to fortifying individuals' and communities' health determinants and resources. The potential integration of health promotion and medicine can contribute to a more person-centred focus of integrative care to address and realize individuals' health potential and needs, rather than merely an emphasis upon the underlying disease, such as congenital heart diseases. We posit that it is possible-and advisable-to address lifestyle modification aspects, and to change the focus of therapeutic encounters and health care programs to be more tailored to and aligned with individual needs, demands and expectations. By adopting a health promotional approach to the individual patient as person, their subjective biography, narrative and lifeworld can serve as resources for developing more beneficial coping styles, resilience and trajectories for personal growth over the life span, despite the occurrence and durability of chronic conditions, such as long-term cardiovascular disease. Implications, important contingencies and requirements for education and training of health-care professionals are addressed, as they are key issues that may affect the successful development and engagement of health promotion programs within health care systems at-large.

摘要

健康促进为医学提供了一种补充性的科学和实践方法,即使在疾病存在的情况下,也可能有助于创造、维持和恢复健康。作为关键概念的健康生成学,关注健康的产生,从而强化个人和社区的健康决定因素及资源。健康促进与医学的潜在整合有助于以个人为中心,更关注综合护理,以挖掘和实现个人的健康潜力与需求,而不仅仅是关注潜在疾病,如先天性心脏病。我们认为,探讨生活方式改变的各个方面,并将治疗过程和医疗保健项目的重点转向更贴合个人需求、要求和期望是可行且明智的。通过对个体患者采用健康促进方法,其主观经历、故事和生活世界可成为资源,用于培养更有益的应对方式、恢复力以及贯穿一生的个人成长轨迹,尽管存在长期心血管疾病等慢性病及其持续性影响。文中还讨论了对医护专业人员进行教育和培训的意义、重要的突发事件及要求,因为这些是可能影响医疗保健系统中健康促进项目成功开展和参与的关键问题。

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