健康中国背景下发展家庭医生健康行为干预技能SWOT分析
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摘要
目的针对我国基层医疗机构家庭医生发展健康行为理论和健康干预技能的必要性、可行性进行分析,并提出相应发展策略以促进该项工作顺利开展。方法采用内容分析法整理、总结相关文献,运用SWOT战略分析法对家庭医生发展健康行为理论与技能的优势、劣势、机遇与威胁4个维度进行系统分析,充分利用内部优势,规避外部威胁。结果目前社区健康教育服务方式主要为知识单项传递,其促进个体行为转变的效率不高。现有国家政策的支持,基层医疗卫生网络体系的逐步完善,家庭医生签约制度的推进,以及居民不断提高的健康需求均为发展家庭医生健康行为干预技能的机遇;其弱势、威胁在于缺乏较完善的健康教育人才培养规划与认证标准、对健康行为干预工作的认识不足、个体行为的改变受多因素影响并具有退化可能、健康干预工作补偿机制不够完善、信息利用度低等。结论为推进健康中国战略背景下发展家庭医生健康干预技能的实施,应利用优势开展家庭医生签约服务,提高健康干预专业水平,创新干预模式,积极做好干预和评估工作,满足居民健康需求,并不断完善人才培养与认证体系,健全多渠道合理补偿机制。
Objective To analysis necessity and feasibility of developing the general practitioners teams' health intervention skills in China and promote the development strategies to do the work smoothly.Methods Using the content analysis to collect and summarize the literature related to community health education.The SWOT analysis method was adopted to analyze the strengths,weaknesses,opportunities and threats for general practitioner developing theory and skills.Results The community health education service mainly focused on the establishment of health promotion bulletin boards,the distribution of leaflets and health education prescriptions,and the broadcast of health education videos.The mode of transmission was inefficient to promote individual behavior change.The advantages of developing healthy behavior intervention skills for general practitioners under the Health China 2030 Plan included resources,organization and management,and information and data.The national policy support,the gradual improvement of primary health care network,and the increasing health needs were opportunities for implementation the work.The weakness and threats were obvious including the lack of a comprehensive health education and training planning and certification standards,the lack of understanding of health behavior intervention work and health intervention work compensation mechanism.Furthermore,individual behavior changes were affected by many factors with possibility of degradation and lower information utilization.Conclusion We should take advantage of general practitioners contracted service to improve the professional level of health interventions and evolution,to innovating intervention models and improve personnel training and certification system,enhance multi-channel compensation mechanism.
Objective To analysis necessity and feasibility of developing the general practitioners teams' health intervention skills in China and promote the development strategies to do the work smoothly.Methods Using the content analysis to collect and summarize the literature related to community health education.The SWOT analysis method was adopted to analyze the strengths,weaknesses,opportunities and threats for general practitioner developing theory and skills.Results The community health education service mainly focused on the establishment of health promotion bulletin boards,the distribution of leaflets and health education prescriptions,and the broadcast of health education videos.The mode of transmission was inefficient to promote individual behavior change.The advantages of developing healthy behavior intervention skills for general practitioners under the Health China 2030 Plan included resources,organization and management,and information and data.The national policy support,the gradual improvement of primary health care network,and the increasing health needs were opportunities for implementation the work.The weakness and threats were obvious including the lack of a comprehensive health education and training planning and certification standards,the lack of understanding of health behavior intervention work and health intervention work compensation mechanism.Furthermore,individual behavior changes were affected by many factors with possibility of degradation and lower information utilization.Conclusion We should take advantage of general practitioners contracted service to improve the professional level of health interventions and evolution,to innovating intervention models and improve personnel training and certification system,enhance multi-channel compensation mechanism.
引文
[1] 新华网.习近平:决胜全面建成小康社会夺取新时代中国特色社会主义伟大胜利——在中国共产党第十九次全国代表大会上的报告[EB/OL].[2017-05-04].http://news.xinhuanet.com/politics/19 cpcnc/2017-10/27/c_1121867529.htm.
[2] 胡永华,李立明.心血管疾病研究进展[M].北京:北京医科大学出版社,2011.
[3] 李立明,姜庆武.中国公共卫生理论与实践[M].北京:人民卫生出版社,2015.
[4] 马骁.健康教育学[M].北京:人民卫生出版社,2004:58-87.
[5] 美国运动医学学会.ACSM运动测试与运动处方指南[M].王正珍,主译.第9版.北京:北京体育大学出版社,2015:343-384.
[6] Bock BC,Marcus BH,Bernardine MP,et al.Maintenance of physical activity following an individualized motivationally tailored intervention[J].Ann Behav Med,2001(23):79-87.
[7] 卢曼曼,江启成,方桂霞.社区开展突发公共卫生事件应急健康教育的SWOT分析[J].中国农村卫生事业管理,2014,34(4):392.
[8] 邓慧君,李卫东.国内外2型糖尿病社区健康教育模式现状[J].中国健康教育,2017,33(7):641-644.
[9] 牛林艳,黄金.同伴教育在糖尿病健康教育中的应用现状[J].中华护理杂志,2014,49(1):79-82.
[10] 陈亚兰,耿劲秋,施李丽,等.依托电子健康档案开展家庭医生签约服务的探索[J].中华医学图书情报杂志,2017,26(5):9.
[11] 计光跃.基于分级诊疗制度的家庭医生信息平台理论研究[D].上海:第二军医大学,2016.
[12] 白玥,田向阳.美国健康教育师职业资格认证体系及对我国的启示[J].中国健康教育,2011,27(2):150.
[13] 国务院.中共中央国务院印发《“健康中国2030”规划纲要》[EB/OL].[2016-10-25].http://www.gov.cn/xinwen/2016-10/25/content_5124174.htm.
[14] 国家卫计委.国家卫生计生委关于印发《国家基本公共卫生服务规范(第三版)》的通知[EB/OL].[2017-03-28].http://www.nhfpc.gov.cn/jws/s3578/201703/d20 c37 e23 e1 f4 c7 db7 b8 e25 f34473 e1 b.shtml.
[15] Li X,Lu JP,Hu S,et al.The primary health-care system in China[J].Lancet,2017,390(10112):2584-2594.
[16] 中国社区卫生协会.基层医疗卫生机构健康教育服务落实情况及需求研究报告[R].北京:中国社区卫生协会,2013.
[17] 朱静芬,杨颖华,陆彧,等.上海市社区医生健康教育工作实施现状及培训需求研究[J].中国全科医学,2017,20(28):3532-3536.
[18] 国务院医改办.关于推进家庭医生签约服务的指导意见[EB/OL].[2016-06-06].http://www.nhfpc.gov.cn/tigs/s3577/201606/e3 e7 d2670 a8 b4163 b1 fe8 e409 c7887 af.shtml.
[19] 国家卫生计生委.关于做实做好2017年家庭医生签约服务工作的通知[EB/OL].[2017-05-04].http://www.nhfpc.gov.cn/jws/s3581 r/201705/ecd779 e08 d7 f4 ec4 b2 e13905 ace5 c39 d.shtml.
[20] 韩彦彬,董柏青.高血压人群健康干预常见模式的研究进展[J].中国慢性病预防与控制,2008,16(5):541.
[21] Stetson BA,Beacham AO,Frommelt SJ,et al.Exerci-se slips in high-risk situations and activity patterns in long-term exercisers:an application of the relapse prevention model[J].Ann Behav Med,2005,30(1):25-35.
[22] 田向阳,白玥.健康教育人力资源现状浅析[J].中国健康教育,2012,28(7):576-578.
[23] 王金道.关于心理治疗与咨询收费问题的几点思考[J].中国心理卫生杂志,2005,19(9):635-636.
[2] 胡永华,李立明.心血管疾病研究进展[M].北京:北京医科大学出版社,2011.
[3] 李立明,姜庆武.中国公共卫生理论与实践[M].北京:人民卫生出版社,2015.
[4] 马骁.健康教育学[M].北京:人民卫生出版社,2004:58-87.
[5] 美国运动医学学会.ACSM运动测试与运动处方指南[M].王正珍,主译.第9版.北京:北京体育大学出版社,2015:343-384.
[6] Bock BC,Marcus BH,Bernardine MP,et al.Maintenance of physical activity following an individualized motivationally tailored intervention[J].Ann Behav Med,2001(23):79-87.
[7] 卢曼曼,江启成,方桂霞.社区开展突发公共卫生事件应急健康教育的SWOT分析[J].中国农村卫生事业管理,2014,34(4):392.
[8] 邓慧君,李卫东.国内外2型糖尿病社区健康教育模式现状[J].中国健康教育,2017,33(7):641-644.
[9] 牛林艳,黄金.同伴教育在糖尿病健康教育中的应用现状[J].中华护理杂志,2014,49(1):79-82.
[10] 陈亚兰,耿劲秋,施李丽,等.依托电子健康档案开展家庭医生签约服务的探索[J].中华医学图书情报杂志,2017,26(5):9.
[11] 计光跃.基于分级诊疗制度的家庭医生信息平台理论研究[D].上海:第二军医大学,2016.
[12] 白玥,田向阳.美国健康教育师职业资格认证体系及对我国的启示[J].中国健康教育,2011,27(2):150.
[13] 国务院.中共中央国务院印发《“健康中国2030”规划纲要》[EB/OL].[2016-10-25].http://www.gov.cn/xinwen/2016-10/25/content_5124174.htm.
[14] 国家卫计委.国家卫生计生委关于印发《国家基本公共卫生服务规范(第三版)》的通知[EB/OL].[2017-03-28].http://www.nhfpc.gov.cn/jws/s3578/201703/d20 c37 e23 e1 f4 c7 db7 b8 e25 f34473 e1 b.shtml.
[15] Li X,Lu JP,Hu S,et al.The primary health-care system in China[J].Lancet,2017,390(10112):2584-2594.
[16] 中国社区卫生协会.基层医疗卫生机构健康教育服务落实情况及需求研究报告[R].北京:中国社区卫生协会,2013.
[17] 朱静芬,杨颖华,陆彧,等.上海市社区医生健康教育工作实施现状及培训需求研究[J].中国全科医学,2017,20(28):3532-3536.
[18] 国务院医改办.关于推进家庭医生签约服务的指导意见[EB/OL].[2016-06-06].http://www.nhfpc.gov.cn/tigs/s3577/201606/e3 e7 d2670 a8 b4163 b1 fe8 e409 c7887 af.shtml.
[19] 国家卫生计生委.关于做实做好2017年家庭医生签约服务工作的通知[EB/OL].[2017-05-04].http://www.nhfpc.gov.cn/jws/s3581 r/201705/ecd779 e08 d7 f4 ec4 b2 e13905 ace5 c39 d.shtml.
[20] 韩彦彬,董柏青.高血压人群健康干预常见模式的研究进展[J].中国慢性病预防与控制,2008,16(5):541.
[21] Stetson BA,Beacham AO,Frommelt SJ,et al.Exerci-se slips in high-risk situations and activity patterns in long-term exercisers:an application of the relapse prevention model[J].Ann Behav Med,2005,30(1):25-35.
[22] 田向阳,白玥.健康教育人力资源现状浅析[J].中国健康教育,2012,28(7):576-578.
[23] 王金道.关于心理治疗与咨询收费问题的几点思考[J].中国心理卫生杂志,2005,19(9):635-636.