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解决日本农村的健康挑战:社会隔离与社区解决方案的主题分析。

Addressing health challenges in rural Japan: a thematic analysis of social isolation and community solutions.

机构信息

Community Care, Unnan City Hospital, 699-1221 96-1 Iida, Daito-Cho, Unnan, Shimane Prefecture, 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 Prim Care. 2024 Jan 13;25(1):26. doi: 10.1186/s12875-024-02266-y.

DOI:10.1186/s12875-024-02266-y
PMID:38216862
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10790262/
Abstract

BACKGROUND

The establishment of sustainable connections between medical professionals and rural citizens is pivotal for effective community healthcare. Our study focuses on understanding and resolving health problems arising from social isolation, a critical barrier to achieving this goal, especially in the context of the coronavirus disease 2019(COVID-19) pandemic's impact on community dynamics respecting social cognitive theory. This study investigates the link between social isolation and rural community healthcare. We aim to develop methods that improve interaction and collaboration between healthcare providers and rural communities, ultimately enhancing the region's healthcare system.

METHODS

Employing thematic analysis based on social cognitive theory, we conducted semi-structured interviews with 57 community workers in rural communities. This qualitative approach enabled us to delve into the nuances of social isolation and its multifaceted impact on health and community well-being.

RESULTS

Our analysis revealed four key themes: the impact of aging on social dynamics, shifts in community relationships, unique aspects of rural community networking, and the role of these networks in driving community health. Notably, we identified specific challenges, such as the erosion of intergenerational interactions and the hesitancy to seek support, exacerbated by social isolation and negatively impacting community health.

CONCLUSIONS

Our study reveals the complex factors affecting rural community sustainability, particularly social isolation influenced by privacy concerns and changing social dynamics. Emphasizing the importance of social cognitive theory, it highlights the need for adaptable healthcare systems and strong community-medical collaborations. Future research should focus on developing culturally sensitive, practical strategies for enhancing these collaborations, especially involving physicians, to address rural communities' unique challenges.

摘要

背景

在医疗专业人员和农村居民之间建立可持续的联系对于有效的社区医疗保健至关重要。我们的研究重点是理解和解决由于社会隔离而产生的健康问题,这是实现这一目标的一个关键障碍,特别是在考虑到 2019 年冠状病毒病(COVID-19)对社区动态的影响以及社会认知理论的情况下。本研究调查了社会隔离与农村社区医疗保健之间的联系。我们旨在开发改善医疗保健提供者与农村社区之间互动和协作的方法,最终增强该地区的医疗保健系统。

方法

我们根据社会认知理论采用主题分析,对农村社区的 57 名社区工作者进行了半结构化访谈。这种定性方法使我们能够深入了解社会隔离的细微差别及其对健康和社区福祉的多方面影响。

结果

我们的分析揭示了四个关键主题:老龄化对社会动态的影响、社区关系的转变、农村社区网络的独特方面以及这些网络在推动社区健康方面的作用。值得注意的是,我们确定了一些具体的挑战,例如代际互动的减少以及由于社会隔离而加剧的不愿寻求支持的情况,这些情况对社区健康产生了负面影响。

结论

我们的研究揭示了影响农村社区可持续性的复杂因素,特别是受隐私问题和不断变化的社会动态影响的社会隔离。强调社会认知理论的重要性,它突出了需要适应性强的医疗保健系统和强大的社区-医疗合作。未来的研究应侧重于制定文化上敏感的、实用的策略来增强这些合作,特别是涉及医生,以解决农村社区的独特挑战。

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Social cognitive theory-based health promotion in primary care practice: A scoping review.基于社会认知理论的初级保健实践中的健康促进:一项范围综述。
Heliyon. 2023 Mar 28;9(4):e14889. doi: 10.1016/j.heliyon.2023.e14889. eCollection 2023 Apr.
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Collaborative Care - empowering community in the development of rural primary health workforce and service delivery models.协作式护理 - 增强社区在农村基层卫生人力和服务提供模式发展方面的能力。
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'No one size fits all' - community trust-building as a strategy to reduce COVID-19-related health disparities.“一刀切”不适用——建立社区信任是减少 COVID-19 相关健康差距的策略。
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