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秘鲁安第斯山脉地区的心血管疾病:卡哈马卡地区的当地认知、障碍及预防慢性病的途径

Cardiovascular Disease in the Peruvian Andes: Local Perceptions, Barriers, and Paths to Preventing Chronic Diseases in the Cajamarca Region.

作者信息

Sanchez-Samaniego Giuliana, Hartinger Stella M, Tallman Paula S, Mäusezahl Daniel

机构信息

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.

University of Basel, Basel, Switzerland.

出版信息

Int J Public Health. 2021 Sep 27;66:1604117. doi: 10.3389/ijph.2021.1604117. eCollection 2021.

Abstract

Public health interventions can be improved by understanding peoples' explanatory models of disease. We explore awareness and perceptions of cardiovascular diseases (CVD) and options for preventative actions in young adults living in rural Andean communities. We used convenience sampling to select 46 men and women from communities in Cajamarca (Peru). Subjects participated in eight focus groups where they discussed their understanding and perceived causes of CVD as well as barriers and pathways to healthy lifestyles. Fresh foods, physical activity, unpleasant emotions, and healthcare access were cited as important determinants of healthy lifestyles. Barriers to healthy diets included lacking nutritional knowledge, fluctuating food prices, and limited access to foodstuffs. Women felt particularly vulnerable to CVD and identified gendered barriers to manage stress and engage in sports. Low health literacy, poor doctor-patient relationships, and long distances prevented participants from fully accessing healthcare. CVD prevention interventions should consider local knowledge of these diseases and of healthy lifestyles, and harness ongoing programmes that have successfully promoted good nutrition in children and pregnant women. In concert with public-private parterships, governments should include disease prevention interventions for the entire family.

摘要

通过了解人们对疾病的解释模型,可以改进公共卫生干预措施。我们探讨了生活在安第斯山区农村社区的年轻人对心血管疾病(CVD)的认识和看法以及预防行动的选择。我们采用便利抽样的方法,从秘鲁卡哈马卡的社区中选取了46名男性和女性。受试者参加了八个焦点小组,在小组中他们讨论了对心血管疾病的理解和感知到的病因,以及健康生活方式的障碍和途径。新鲜食物、体育活动、不愉快的情绪和医疗保健的可及性被认为是健康生活方式的重要决定因素。健康饮食的障碍包括缺乏营养知识、食品价格波动以及食品供应有限。女性认为自己尤其容易患心血管疾病,并指出了在应对压力和参与体育活动方面存在的性别障碍。健康素养低、医患关系差以及路途遥远阻碍了参与者充分获得医疗保健服务。心血管疾病预防干预措施应考虑当地对这些疾病和健康生活方式的认识,并利用那些已成功促进儿童和孕妇良好营养状况的现有项目。与公私伙伴关系协同合作,政府应为整个家庭制定疾病预防干预措施。

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