Occupational therapists as contributors to health promotion

Objective: This study was undertaken to explore the views of occupational therapists concerning their competences in health promotion, and their perceptions of how they apply these competences in their daily work. The study also elicited their views on the contributions that occupational therapists could make to health promotion if given the opportunity. Methods: Data were collected in five focus-group discussions with 24 occupational therapists. These discussions were tape recorded and transcribed verbatim; data were analysed using qualitative content analysis. Results: The main findings are that the informants took an individualized salutogenic approach in their work and rarely engaged in health promotion on a systemic or societal level. They believed that their patients and collaborating partners, as well as public officials, remained unaware of their competences in health promotion. Conclusions: The findings of this study could enrich the discussion among occupational therapists on how they could make a more significant contribution to health promotion on a broader level

Developing lay health worker policy in South Africa: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Over the past half decade South Africa has been developing, implementing and redeveloping its Lay Health Worker (LHW) policies. Research during this period has highlighted challenges with LHW programme implementation. These challenges have included an increased burden of care for female LHWs. The aim of this study was to explore contemporary LHW policy development processes and the extent to which issues of gender are taken up within this process.</p> <p>Methods</p> <p>The study adopted a qualitative approach to exploring policy development from the perspective of policy actors. Eleven policy actors (policy makers and policy commentators) were interviewed individually. Data from the interviews were analysed thematically.</p> <p>Results</p> <p>Considerations of LHW working conditions drove policy redevelopment. From the interviews it seems that gender as an issue never reached the policy making agenda. Although there was strong recognition that the working conditions of LHWs needed to be improved, poor working conditions were not necessarily seen as a gender concern. Our data suggests that in the process of defining the problem which the redeveloped policy had to address, gender was not included. There was no group or body who brought the issue of gender to the attention of policy developers. As such the issue of gender never entered the policy debates. These debates focused on whether it was appropriate to have LHWs, what LHW programme model should be adopted and whether or not LHWs should be incorporated into the formal health system.</p> <p>Conclusion</p> <p>LHW policy redevelopment focused on resolving issues of LHW working conditions through an active process involving many actors and strong debates. Within this process the issue of gender had no champion and never reached the LHW policy agenda. Future research may consider how to incorporate the voices of ordinary women into the policy making process.</p

Nordiska högskolan för Folkhälsovetenskap (NHV) ett nordiskt utbildnings- och Kunskapscentrum för Folkhälsovetenskap

Nordiska högskolan för folkhälsovetenskap (NHV), en institution på universitetsnivå som lyder under Nordiska ministerrådet, har en lång erfarenhet av utbildning och kunskapsspridning av folkhälsovetenskap. I den här artikeln presenteras NHV:s uppdrag och inriktning med fokus på forskning, forskarutbildning samt dess specifika roll som ett Nordiskt Kunskapscentrum för Health Promotion.Unique knowledge is collected at the Nordic school of public health (NHV) regarding public health in the five Nordic countries. Students as well as teachers/researchers are recruited from all the Nordic countries. There are ongoing efforts made to strengthen research activities between the Nordic countries, especially within the fields of health promotion and the Nordic Research Academy in Mental Health. The establishment of the Knowledge Center for health promotion provides unique possibilities to further deepen this work. A pilot study recently performed within the Nordic research network for health promotion shows that fields that should be given priority to be studied from a health promotion perspective are the health of children and elderly, different aspects of inequality in health, methods used to evaluate studies and projects and cooperation between researchers, practitioners, politicians and journalists. It is also important to compare Nordic health promotive work with what such a work is done in Europe and globally

Occupational therapists as contributors to health promotion

Objective: This study was undertaken to explore the views of occupational therapists concerning their competences in health promotion, and their perceptions of how they apply these competences in their daily work. The study also elicited their views on the contributions that occupational therapists could make to health promotion if given the opportunity. Methods: Data were collected in five focus-group discussions with 24 occupational therapists. These discussions were tape recorded and transcribed verbatim; data were analysed using qualitative content analysis. Results: The main findings are that the informants took an individualized salutogenic approach in their work and rarely engaged in health promotion on a systemic or societal level. They believed that their patients and collaborating partners, as well as public officials, remained unaware of their competences in health promotion. Conclusions: The findings of this study could enrich the discussion among occupational therapists on how they could make a more significant contribution to health promotion on a broader level

Situational factors in focus group studies: a systematic review

The aim of this study was to see how contextual factors are expressed, used, and analyzed in data collected in focus group discussions (FGDs). The study includes an assessment of how the methodological reporting of contextual factors might influence and improve the trustworthiness of articles. Articles reporting workplace health, stress, and coping among health professionals were identified in a systematic review and used in the analysis. By using Vicsek’s framework of situational factors for analysis of focus group results as a starting point, we found that contextual factors were most frequently described in the method sections and less frequently in the results and discussion sections. Vicsek’s framework for the analysis of focus group results covers six contextual and methodological dimensions: interactional factors, personal characteristics of the participants, the moderator, the environment, time factors, and the content of FGDs. We found that the framework does not include a consideration of psychological safety, ethical issues, or organizational information. To deepen the analysis of focus group results, we argue that contextual factors should be analyzed as methodological dimensions and be considered as a sensitizing concept. Credibility, confirmability, dependability, and transferability can be strengthened by using, reporting, and discussing contextual factors in detail. The study contributes to elucidating how reporting of contextual data may enrich the analysis of focus group results and strengthen the trustworthiness. Future research should focus on clear reporting of contextual factors as well as further develop Vicsek’s model to enhance reporting accuracy and transferability

Factores situacionales en estudios de grupos focales: una revisión sistemática

El objetivo del estudio que presentan estas páginas fue determinar cómo se expresan, utilizan y analizan los factores contextuales en los datos recolectados a partir de las discusiones en grupos focales. El estudio incluyó una evaluación de cómo la presentación metodológica de los factores contextuales puede influir y mejorar la fiabilidad de los artículos. Se hizo una revisión sistemática para identificar los artículos que informaran –entre los profesionales del área de la salud– sobre su nivel de estrés, salud y mecanismos para sobrellevar situaciones difíciles en su lugar de trabajo, los cuales fueron utilizados en el análisis. Como punto de partida se empleó el marco de Vicsek de factores situacionales para el análisis de resultados de grupos focales y así se halló que en tales artículos los factores contextuales eran descritos con mayor frecuencia en la sección del método y con menos frecuencia en las secciones “Resultados” y “Discusión”. El marco de Vicsek para el análisis de resultados de grupos focales abarca seis dimensiones contextuales y metodológicas: los factores interaccionales, las características personales de los participantes, el moderador, el ambiente, los factores de tiempo y el contenido de las discusiones. Sin embargo, se evidenció que el marco no incluye una consideración sobre la seguridad psicológica, las cuestiones éticas o la información institucional. Para profundizar en el análisis de los resultados de grupos focales, se argumenta que los factores contextuales deben ser analizados como dimensiones metodológicas y ser considerados como un concepto de sensibilización. La credibilidad, la posibilidad de confirmación, la fiabilidad y la capacidad de transferencia se pueden fortalecer al emplear, reportar y discutir los factores contextuales en detalle. El estudio contribuye a esclarecer la forma en que la presentación de informes sobre datos contextuales puede enriquecer el análisis de los resultados de grupos focales y fortalecer su nivel de confiabilidad. Investigaciones futuras deben centrarse en presentar informes claros de los factores contextuales, así como continuar desarrollando el modelo de Vicsek para mejorar la precisión y la transferencia de información.Nota:Originalmente publicado en Originalmente publicado en International Journal of Qualitative Methods (2013), 12, 338-358. Copyright 2013: Orvik, Larun, Berland y Ringsberg. Traducido al español por Carolina Carter para Paradigmas con permiso de los titulares de los derechos de autor

Health care professionals’ perceptions of health promotion with preschool children

Background: The growing burden of non-communicable diseases (NCDs) all over the world calls for a change in peoples’ lifestyles. One way to prevent NCDs is to work with health promotion. The burden of communicable diseases (CDs), however, is still high and resources are limited. Studies suggest that promotion of health should start early in life and in cooperation between preschool teachers and parents. Also health care workers should be included in such work. The aim of the present study was to explore health care professionals’ experiences and their reflections on health promotion in relation to children’s health in two different Western Cape settings, South Africa. Methods: Data was collected in two focus group discussions (FGDs) with twelve health care professionals from health clinics situated in two different settings; one upper-middle income urban suburb and one peri-urban township. Data was analysed with latent content analysis. Results: The findings are presented in four categories and twelve subcategories. The focus group (FG) participants had a holistic view on health and they talked about children’s health from a health promotion perspective where they saw children’s health as affected by an interplay between family, societal and structural factors. Further they saw several possibilities and expressed ideas about how to work from a health promotion perspective. They had a positive attitude to working intersectorally and interdisciplinary and believed that they could contribute to such a work. However, the cooperation with doctors and social service must be improved in order to succeed. Conclusions: The organizers of the health care sector should see to that health professionals have the possibility to work according to health promotion principles. Also the health care workers themselves must engage more actively in the work by considering the attitudes of the staff, the parents and grandparents and develop cultural awareness and sensibility

Provider experiences of the implementation of a new tuberculosis treatment programme: A qualitative study using the normalisation process model

Abstract Background Tuberculosis (TB) is a major contributor to the global burden of disease. In many settings, including South Africa, treatment outcomes remain poor. In contrast, many antiretroviral treatment (ART) programmes are achieving high levels of adherence and good outcomes. The ART programme model for maintaining treatment adherence may therefore hold promise for TB treatment. Changing treatment models, however, requires an assessment of how staff receive the new model, as they are responsible for programme implementation. Using the normalization process model as an analytic framework, this paper aims to explore staff perceptions of a new TB treatment programme modelled on the ART treatment programme. Methods A qualitative approach was used. Interviews and focus group discussions were conducted with clinic staff from five intervention clinics. Data were analysed initially using qualitative content analysis. The resulting categories were then organised under the constructs of the normalization process model. Results Staff recounted a number of challenges with implementing the programme. Interviews and focus group discussions identified factors relating to the main categories of the normalization process model. The key issues hindering the normalisation of the programme within clinics related to the interactional workability, relational integration and skill-set workability constructs of the model. These included hierarchical relationships, teamwork, training needs and insufficient internalisation by staff of the empowerment approach included in the programme. Logistical and management issues also impacted negatively on the normalization of the programme at the clinics. Conclusion The normalization process model assisted in categorising the challenges experienced during implementation of the intervention. The results suggest that issues remain that need to be resolved before the programme is implemented more widely. Considerable work is needed in order to embed the intervention in routine clinic practice.</p