Lombo-Caicedo Jadith Cristina, Durán-Sabogal Rosa Margarita, Palacio-Abello Juan Domingo, Lamus-Lemus Francisco
Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Tolima, Colombia.
Facultad de Medicina, Universidad de la Sabana, Bogotá, Cundinamarca, Colombia.
Front Med (Lausanne). 2025 Aug 15;12:1613937. doi: 10.3389/fmed.2025.1613937. eCollection 2025.
Decades of armed conflict in Colombia have deeply undermined public trust in the health system, particularly within rural regions. The legacy of violence has restricted healthcare delivery in these areas, concentrating services in urban centers and exacerbating geographic and social inequities. Informal caregivers in rural communities, essential yet often overlooked actors in healthcare, face significant challenges due to structural limitations and lack of institutional support.
This study evaluates a community-based intervention aimed at strengthening the competencies of informal caregivers in rural, post-conflict settings. It further positions caregivers as pivotal contributors to distributed health education models, where care practices must adapt to contextual barriers and local realities.
Developed using a Participatory Action Research (PAR) approach, the intervention engaged caregivers as co-creators. Drawing from popular education principles, it combined in-person sessions with experiential, culturally relevant materials tailored to rural environments. Ongoing remote support was provided via calls, text messages, and voice notes. The program was evaluated qualitatively through a focus group and 15 semi-structured interviews, analyzed thematically.
Findings revealed four key domains of change: (1) transformation of the caregiving role, (2) personal and technical impact on caregivers, (3) shifts in family dynamics, and (4) recognition of the course as an empowering, community-building experience. Despite barriers such as digital illiteracy, poverty, and low educational attainment, participants demonstrated increased self-efficacy and engagement.
The intervention illustrates the potential of distributed education to reduce rural health inequities. It highlights the power of academic-community partnerships in developing scalable, context-sensitive strategies that strengthen care, foster empowerment, and promote equity in underserved areas.
哥伦比亚数十年的武装冲突严重破坏了公众对卫生系统的信任,尤其是在农村地区。暴力的遗留问题限制了这些地区的医疗服务提供,使服务集中在城市中心,加剧了地理和社会不平等。农村社区的非正式护理人员是医疗保健中不可或缺但往往被忽视的角色,由于结构限制和缺乏机构支持,他们面临着重大挑战。
本研究评估了一项基于社区的干预措施,旨在增强冲突后农村地区非正式护理人员的能力。它进一步将护理人员定位为分布式健康教育模式的关键贡献者,在这种模式中,护理实践必须适应背景障碍和当地实际情况。
该干预措施采用参与式行动研究(PAR)方法开发,让护理人员作为共同创造者参与其中。借鉴大众教育原则,它将面对面培训与为农村环境量身定制的体验式、与文化相关的材料相结合。通过电话、短信和语音信息提供持续的远程支持。通过焦点小组和15次半结构化访谈对该项目进行定性评估,并进行主题分析。
研究结果揭示了四个关键的变化领域:(1)护理角色的转变;(2)对护理人员的个人和技术影响;(3)家庭动态的变化;(4)将该课程视为一种赋权和社区建设体验。尽管存在数字文盲、贫困和教育程度低等障碍,但参与者表现出更高的自我效能感和参与度。
该干预措施表明了分布式教育在减少农村卫生不平等方面的潜力。它凸显了学术-社区伙伴关系在制定可扩展、因地制宜的战略方面的力量,这些战略可加强护理、促进赋权并在服务不足地区促进公平。