Challenges and strategies for sustaining youth-friendly health services - a qualitative study from the perspective of professionals at youth clinics in northern Sweden.
Challenges and strategies for sustaining youth-friendly health services - a qualitative study from the perspective of professionals at youth clinics in northern Sweden.
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DOI：
10.1186/s12978-016-0261-6
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发表时间：
2016-12-21
影响因子：
3.4
通讯作者：
Goicolea I
中科院分区：
文献类型：
--
作者：
Thomée S;Malm D;Christianson M;Hurtig AK;Wiklund M;Waenerlund AK;Goicolea I
对青年友好的保健服务-那些对不同青年亚群体而言可获得、可接受、公平、适当和有效的保健服务-有益于青年健康，但不容易实施和维持。瑞典是少数几个将方便青年的保健服务纳入公共卫生系统并长期维持的国家之一。本研究探讨了挑战和战略，在提供可持续的青年友好的保健服务，从专业人士的角度来看，在瑞典北方青年诊所工作。11个半结构化的采访，在瑞典北方的青年诊所工作的各种医疗保健专业人员进行了。这些访谈被逐字转录，并使用与世界卫生组织青年友好领域有关的专题分析进行分析。从数据分析中得出了四个主题：1）“根据青年人自己的条件满足他们-确保以青年人为中心的全面护理的关键”与服务的可接受性和适当性有关; 2）“使专业人员不断掌握青年问题专门知识的组织挑战和战略”涉及有效性领域; 3）“青年诊所为那些知道并能够接触到它们的人所利用”与可利用性和公平领域有关，和4）“在不同的地方现实中结合强有力的方向和灵活性的挑战”集中在维持青年诊所组织及其目标的斗争中在更广泛的卫生系统中。在青年诊所工作的专业人员被认为积极主动，对青年问题感兴趣，了解青年问题，诊所确保保密，并采取以青年为中心的综合办法。挑战依然存在，特别是在以下方面：确保平等地接触不同的青年亚群，改进监测程序，以及确保所有专业人员的培训和能力，无论诊所的地点和特点如何。青年诊所被认为是瑞典卫生系统无可争议的一部分，但也指出了组织方面的挑战，如缺乏明确的指示和领导、工作量繁重、地方/区域多样性和资源分配不公平。本文的在线版本（doi：10.1186/s12978-016-0261-6）包含补充材料，可供授权用户使用。
Youth-friendly health-care services — those that are accessible, acceptable, equitable, appropriate and effective for different youth subpopulations – are beneficial for youth health, but not easy to implement and sustain. Sweden is among the few countries where youth-friendly health-care services have been integrated within the public health system and sustained for a long time. This study explores the challenges and strategies in providing sustainable youth-friendly health-care services, from the perspective of professionals working in youth clinics in northern Sweden. Eleven semi-structured interviews with various health-care professionals working in youth clinics in northern Sweden were conducted. The interviews were transcribed verbatim, and analysed using thematic analysis in relation to the World Health Organization domains of youth friendliness. Four themes emerged from the analysis of the data: 1) ‘Meeting youths on their own terms – the key to ensuring a holistic and youth-centred care’ was related to the acceptability and appropriateness of the services; 2) ‘Organizational challenges and strategies in keeping professionals’ expertise on youth updated’ referred to the domain of effectiveness; 3) ‘Youth clinics are accessible for those who know and can reach them’ was related to the domains of accessibility and equity, and 4) ‘The challenge of combining strong directions and flexibility in diverse local realities’ focused on the struggle to sustain the youth clinics organization and their goals within the broader health system. Professionals working in youth clinics are perceived as motivated, interested and knowledgeable about youth, and the clinics ensure confidentiality and a youth-centred and holistic approach. Challenges remain, especially in terms of ensuring equitable access to different youth subpopulations, improving monitoring routines and ensuring training and competence for all professionals, independently of the location and characteristics of the clinic. Youth clinics are perceived as an indisputable part of the Swedish health system, but organizational challenges are also pointed out in terms of weak clear directives and leadership, heavy workload, local/regional diversity and unequitable distribution of resources. The online version of this article (doi:10.1186/s12978-016-0261-6) contains supplementary material, which is available to authorized users.