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农村老年人求医行为可持续性的健康对话:扎根理论方法。

Rural health dialogue for the sustainability of help-seeking behaviors among older patients: grounded theory approach.

机构信息

Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, 699-1221, Japan.

Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo, Shimane Prefecture, 693-8501, Japan.

出版信息

BMC Geriatr. 2023 Oct 18;23(1):674. doi: 10.1186/s12877-023-04401-3.

Abstract

BACKGROUND

Help-seeking behaviors (HSBs) are essential for disease prevention and health promotion. Dialogues with peers and medical professionals can improve HSBs, both qualitatively and quantitatively. Rural communities lacking healthcare resources require effective HSBs for healthcare sustainability. The current study aimed to investigate the effect of health dialogues between medical professionals and rural citizens on their HSBs.

METHODS

All procedures complied with the Declaration of Helsinki and its subsequent amendments. The Unnan City Hospital Clinical Ethics Committee approved the study protocol (No. 20,220,002). A grounded theory approach was employed for the health dialogue participants in rural communities. Health dialogues with family physicians were conducted once a month at rural community centers. The dialogues and focus group interviews were recorded and coded to investigate changes in participants' perceptions and behaviors regarding HSBs.

RESULTS

Twenty-one dialogues were conducted in two rural community centers, with a total of 112 participants. The average age of the participants was 70.2 years (standard deviation = 5.4), with 24% being males. Analysis of the grounded theory approach revealed four themes, namely joy-driven dialogue driving the realization of HSBs, reflection on personal HSBs through learning from others, revising HSBs based on rural social resources, and familiarity with physicians, hence motivating safe and secure HSBs.

CONCLUSIONS

Mitigation of barriers between citizens and medical professionals and improvement of psychological safety in communities can drive effective HSBs in rural communities.

摘要

背景

寻求帮助行为(HSB)对于疾病预防和健康促进至关重要。与同龄人及医疗专业人员的对话可以提高 HSB 的质量和数量。缺乏医疗资源的农村社区需要有效的 HSB 来实现医疗保健的可持续性。本研究旨在调查医疗专业人员与农村居民之间的健康对话对他们 HSB 的影响。

方法

所有程序均符合《赫尔辛基宣言》及其后修正案的规定。船桥市医院临床伦理委员会批准了研究方案(编号 20,220,002)。采用扎根理论方法对农村社区的健康对话参与者进行研究。每月在农村社区中心与家庭医生进行一次健康对话。记录和编码对话和焦点小组访谈,以调查参与者对 HSB 的看法和行为的变化。

结果

在两个农村社区中心进行了 21 次对话,共有 112 名参与者。参与者的平均年龄为 70.2 岁(标准差=5.4),其中 24%为男性。对扎根理论方法的分析揭示了四个主题,即快乐驱动的对话推动 HSB 的实现、通过向他人学习反思个人 HSB、根据农村社会资源修改 HSB 以及熟悉医生,从而激发安全可靠的 HSB。

结论

减轻公民与医疗专业人员之间的障碍以及提高社区的心理安全感可以推动农村社区有效的 HSB。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b517/10585832/a9b5b1b3d979/12877_2023_4401_Fig1_HTML.jpg

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