van Dalen H, Williams A, Gudex C
Centre for Health Economics, University of York.
J Epidemiol Community Health. 1994 Jun;48(3):248-53. doi: 10.1136/jech.48.3.248.
To elicit lay concepts of health and to see whether these are related to various sociodemographic factors, as has been suggested by previous smaller studies.
A total of 196 people aged 18 and over were selected, as a representative sample of the general population, from the electoral registers of Walsall and Dudley in the West Midlands. Respondents were interviewed in their own homes in the autumn of 1989.
Open ended and structured questions were used to elicit concepts of health. The three main stages consisted of an unprompted section in which respondents were asked to describe the features of good or poor health in themselves or others; a prompted section in which they were asked to rate 37 health statements using a series of categories from "very important" to "not at all important"; and a section in which they were asked to indicate which of six groups of statements, each representing a particular concept of health, best represented their own notions of health.
Health was seen as multidimensional. Irrespective of whether respondents addressed health in self or health in others, or good or poor health, the biomedical dimension remained an important one. The manner by which concepts of health are elicited may provide some explanation as to why so many and varied concepts are alleged to be held by different subgroups of the population (notably different social classes).
The differences found in this study between models of health employed by different subgroups of the general population have not been as great as has previously been suggested in the published reports. This is encouraging for those using existing health status measurements.
如先前较小规模研究所表明的那样,引出公众对健康的概念,并观察这些概念是否与各种社会人口学因素相关。
从西米德兰兹郡沃尔索尔和达德利的选民登记册中选取了196名18岁及以上的人作为普通人群的代表性样本。1989年秋,在受访者家中对他们进行了访谈。
使用开放式和结构化问题来引出健康概念。三个主要阶段包括:一个无提示部分,要求受访者描述自己或他人健康良好或不佳的特征;一个提示部分,要求他们使用从“非常重要”到“一点也不重要”的一系列类别对37条健康陈述进行评分;以及一个部分,要求他们指出代表特定健康概念的六组陈述中哪一组最能代表他们自己的健康观念。
健康被视为多维度的。无论受访者谈论的是自身健康还是他人健康,以及健康良好或不佳,生物医学维度仍然很重要。引出健康概念的方式可能为为什么据称不同人群亚组(特别是不同社会阶层)持有如此众多和多样的概念提供一些解释。
本研究中发现的普通人群不同亚组所采用的健康模式之间的差异并不像先前发表的报告中所暗示的那么大。这对那些使用现有健康状况测量方法的人来说是令人鼓舞的。