The contribution of group work to the goals of comprehensive primary health care
The contribution of group work to the goals of comprehensive primary health care
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DOI：
10.1002/hpja.323
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发表时间：
2020-02-11
影响因子：
1.9
通讯作者：
Barton, Elsa
中科院分区：
文献类型：
--
作者：
Freeman, Toby;Baum, Fran;Barton, Elsa
小组工作，如同伴支持和促进健康，是全面初级保健的一项重要战略。然而，小组工作及其如何有助于实现综合初级卫生保健目标的研究和理论研究不足。方法在这项为期5年的研究中，我们与7家澳大利亚初级卫生保健服务机构合作，并利用服务报告、两轮工作人员访谈（2009-2010年和2013年，N = 68和55），10个社区评估讲习班（N = 65），客户调查（N = 315）和糖尿病客户病例跟踪（N = 184，加上对35名客户和5名从业者的采访）和抑郁症客户（N = 95，加上对21名客户和11名从业者的采访）。我们进行了快速的文献回顾现有的研究小组工作，并开发了一个模型，显示了一个小组工作的强化循环。我们研究了小组运行的性质，以及员工和客户感知的好处。结果好处分为四个主要主题：（a）社会支助，包括为土著服务的客户提供机会，以庆祝其文化特性，（B）提高技能和知识，（c）增加获得服务的机会;（d）结论认为集体和个人利益与全面的初级卫生保健愿景一致。然而，由新自由主义驱动的卫生政策所强调的个人主义威胁到了小组工作的提供及其潜在的集体主义利益。因此，在初级卫生保健中，小组工作有多种好处，这些好处是无法通过个人工作实现的，这突出了政策和组织支持对小组工作的重要性。
Issue addressed Group work, such as peer support and health promotion is an important strategy available to comprehensive primary health care. However, group work and how it contributes to the goals of comprehensive primary health care has been under-researched and under-theorised.Methods In this 5-year study, we partnered with seven Australian primary health care services, and drew on service reports, two rounds of staff interviews (2009-2010 and 2013, N = 68 and 55), 10 community assessment workshops (N = 65), a client survey (N = 315) and case tracking of clients with diabetes (N = 184, plus interviews with 35 clients, and five practitioners) and clients with depression (N = 95, plus interviews with 21 clients, and 11 practitioners). We conducted a rapid literature review of existing research on group work, and developed a model showing a group work reinforcing cycle. We examined the nature of the groups run, and the benefits staff and clients perceived.Results Benefits were grouped into four main themes: (a) social support, including for clients of the Aboriginal services, opportunities to celebrate their cultural identity, (b) improving skills and knowledge, (c) increasing access to services and (d) empowerment and solidarity.Conclusions The perceived collective and individual benefits aligned with a comprehensive primary health care vision. However, the individualism stressed by neoliberal-driven health policy threatened the provision of group work and its potential collectivist benefits.So What There are multiple benefits of group work in primary health care that cannot be achieved through individual work, highlighting the importance of policy and organisational support for group work.