When providers and community leaders define health priorities: the results of a Delphi survey in the canton of Geneva
When providers and community leaders define health priorities: the results of a Delphi survey in the canton of Geneva
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DOI：
10.1016/s0277-9536(99)00457-8
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发表时间：
2000-08-01
影响因子：
5.4
通讯作者：
Rougemont, A
中科院分区：
文献类型：
--
作者：
Schopper, D;Ammon, C;Rougemont, A
德尔菲法被用来确定瑞士一个州的卫生优先事项。收集了作为卫生专业人员或作为普通民众代表的各有关群体的意见，以确定被认为最重要的健康决定因素和健康问题，澄清作出这些选择的理由，并建议采取干预措施，以改善已确定的优先领域的状况。五个小组，包括卫生专业人员以及没有直接参与卫生工作的社区团体的选定领导人，有机会回答两轮调查表。在各小组之间以及在第一轮和第二轮之间，关于健康决定因素和应优先考虑的问题的意见高度一致。确定的优先事项主要是身体问题（心血管疾病、呼吸道和乳腺癌、艾滋病、交通事故造成的伤害、慢性背痛）、心理社会障碍（抑郁症、自杀、家庭暴力、压力）和药物滥用问题（酒精和烟草）。选择失业和社会孤立是因为它们对健康的影响。在医疗技术或研究领域提出的干预措施很少。这可能部分是因为在日内瓦，高质量的保健服务随处可见，而预防方案在过去没有得到足够的重视。通过确定的优先事项和拟议的活动，出现了一种新的健康观，它更加重视心理社会问题和社会环境。在这方面，促进健康被视为至关重要，因为认识到只有考虑到社会和文化背景，才能持续改变个人行为。总之，调查结果表明，德尔菲法是一种有用的工具，可在各种行为者之间就卫生优先事项和相应活动达成共识。(C)2000爱思唯尔科技有限公司版权所有。
The Delphi method was used to determine the health priorities in one Swiss canton. The opinion of various groups concerned, either as health professionals or as representatives of the general population, was gathered to identify the health determinants and health problems perceived as most important, to clarify the reasons for these choices, and to recommend interventions to be undertaken in order to improve the situation in the identified priority areas. Five panels, including health professionals as well as selected leaders of community groups with no direct involvement in health, were given the opportunity to reply to two rounds of questionnaires. There was a high convergence of opinion on health determinants and problems to be given priority between panels and between the first and second round. priorities identified are mainly physical problems (cardiovascular disease, respiratory and breast cancer, AIDS, injuries due to road accidents, chronic back pain), psychosocial disorders (depression, suicide, violence in the family, stress), and problems of substance abuse (alcohol and tobacco). Unemployment and social isolation were chosen because of their perceived impact on health. Very few interventions were proposed in the medical technical or research areas. This may be due partly to the fact that good quality care is widely available and accessible in Geneva, whereas preventive programmes have not received enough attention in the past. Through the identified priorities and the proposed activities, a new vision of health emerges which gives more importance to psychosocial problems and the social environment. In this context, health promotion is seen as essential, acknowledging that sustained change in individual behaviours can only occur if the social and cultural context is taken into consideration. In conclusion, the results of this survey show that the Delphi method is a useful tool to reach consensus on health priorities and corresponding activities among a variety of actors. (C) 2000 Elsevier Science Ltd. All rights reserved.