Effects of education and support groups organized by IBCLCs in early postpartum on breastfeeding.

OBJECTIVE: To examine the effectiveness of breastfeeding education and peer support groups organized by International Board Certified Lactation Consultants (IBCLCs) during the first week (T1) and the fifth to sixth week postpartum (T2), in terms of breastfeeding self-efficacy and exclusive breastfeeding rate. DESIGN: A quasi-experimental design. SETTING: A maternity ward of a medical center in northern Taiwan. PARTICIPANTS: 214 postpartum women. INTERVENTION: The control group (n = 122) received standard care, while the intervention group (n = 92) received standard care and attended a support group at T1 and T2. MEASUREMENTS: Outcome measures were assessed through self-administered questionnaires: Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) and exclusive breastfeeding rate. Demographic and obstetric data were collected from participants and from their medical records. A general estimating equation, t-tests, and chi-square tests were adopted to examine hypotheses. FINDINGS: Before examining the hypotheses, homogeneous tests confirmed the equality between the groups at T1. There were significant differences in breastfeeding self-efficacy (B = 0.21, p < 0.01) between the two groups from T1 to T2. The breastfeeding self-efficacy of participants in the intervention group was significantly higher than those in the control group (t = 3.26, p = 0.01) at T2. The exclusive breastfeeding rate (61%) in the intervention group at T2 was significantly higher than the rate (39%) in the control group (chi-square=11.28, p = 0.001). KEY CONCLUSIONS: Attending IBCLC-organized breastfeeding education and support groups during early postpartum hospitalization may increase mothers' breastfeeding self-efficacy and exclusive breastfeeding rate.

Construcción de espacios grupales terapéuticos en el ámbito de la internación: relato de experiencia en una unidad de mediana estancia de la ciudad autónoma de Buenos Aires / Construction of therapeutic group spaces in the field of hospitalization: experience report in a medium-stay unit of the city autonomous of Buenos Aires

Este relato de experiencia describe el desarrollo de un dispositivo grupal de socialización en el abordaje de pacientes complejos en rehabilitación a partir del año 2016 en una Unidad de Mediana Estancia (UME) del Hospital Italiano de Buenos Aires. Se partió de reconocer la posibilidad de trabajar en el marco de la psicología social de Pichon-Rivière adaptando la técnica del grupo operativo para ámbitos hospitalarios que generan alto nivel de estrés, desfuncionalización y disrupción de la vida cotidiana. En este relato describimos la conformación, en esta UME, de grupos operativos terapéuticos de pacientes con deterioro físico, cognitivo o en cuidados paliativos. La metodología para el análisis de esta experiencia se basó en el registro prospectivo narrativo de cada encuentro grupal. Presentamos una reflexión teórica sobre las adaptaciones al encuadre y a la planificación de cada actividad grupal, para lograr continuidad y pertenencia grupal, en los grupos operativos desarrollados en este tipo de contexto hospitalario. (AU)

This experience report describes the development of a socialization group device in the approach of complex patients in rehabilitation from 2016 on a Medium-Stay Unit (MSU) of the Hospital Italiano de Buenos Aires. It started by recognizing the possibility of working within the social psychology framework of Pichon-Rivière by adapting the technique of the operative group for hospital environments with high level of stress, defunctionalization and disruption of daily life. In this report we describe the conformation in this MSU of therapeutic operative groups of patients with physical, cognitive or palliative care impairment. The methodology for the analysis was based on the prospective narrative record of each group meeting. We present a theoretical reflection on the adaptations to the framing and the planning of each group activity. This allowed us to achieve continuity and group belonging in the operative groups developed in this hospital context. (AU)

Evaluation of families of crack users in relation to support groups.

OBJECTIVE: to evaluate the perception of the relatives of crack users in relation to the support groups offered to this population in a Psychosocial Care Center for Alcohol and Drugs in the South of Brazil. METHOD: the fourth-generation theoretical framework was used for evaluation, having as methodological device the hermeneutical-dialectic circle. Data collection occurred through 500 hours of observations and interviews with 12 relatives of crack users, and the comparative constant method was used in the analysis, generating the "family group" unit of meaning. RESULTS: this group was regarded by the family members as a space for guidance on the management of users in their home environment. They reported the need for a basic structure to conduct the groups, greater duration of the meetings, confidentiality of information and diversity of timetables. FINAL CONSIDERATIONS: investment in education and training of nursing professionals focused on group care is suggested to the education institutions.

¿Cuál es la relación entre el síndrome de burnout, el sentido de la vida y el proyecto de vida laboral en los médicos residentes?: una perspectiva logoterapéutica / What is the relationship between burnout syndrome, the meaning of life and the project of working life in resident physicians ?: a logotherapeutic perspective

Introducción: el síndrome de burnout (BO) suele afectar a médicos residentes, debido al estrés laboral crónico. Desde un marco logoterapéutico, la pérdida de un sentido de la vida (SV) es el denominador más común de todas las formas de perturbación emocional, y el BO podría enmarcarse dentro de un proyecto de vida laboral (PVL) con enrolamiento enajenante. El objetivo principal del trabajo es evaluar la relación entre el BO, el SV y el PVL, en los programas de residencia del Hospital Italiano de Buenos Aires. Población y métodos: se evaluaron residentes de 6 programas de residencia del Hospital Italiano de Buenos Aires, a través de un cuestionario. El BO se midió con el "Maslach Burnout Inventory" (MBI). El SV se midió con el "Purpose in Life Test" (PIL Test). El PVL se midió con la Escala de PVL de la Dra. Isabel Pérez Jáuregui. Resultados: participaron 104 residentes. El 28,8% de los evaluados mostraron BO, el 18,3% falta de SV y el 30,8% un PVL inauténtico con sobreadaptación. Tanto la falta de SV como el PVL inauténtico con sobreadaptación se asociaron en forma estadísticamente significativa con BO (p < 0,01), y la presencia de cualquiera de estas alteraciones aumentó en casi 18 veces (odds ratio [OR] crudo) la probabilidad de presentar el síndrome. Los OR ajustados de falta de SV (6,28) y PVL inauténtico (9,57) para la presencia de BO continuaron siendo estadísticamente significativos. Por último, en esta investigación pudimos determinar que las subescalas del MBI agotamiento y despersonalización se correlacionaron negativamente con el PIL Test (r=-0,41 y r=-0,53, respectivamente) y la Escala de PVL (r=-0,45 y r=-0,42, respectivamente), mientras que la subescala de realización se correlacionó positivamente en forma significativa con estas dos últimas (r=0,63 y r=0,61, respectivamente). Conclusiones: se encontró una relación estadísticamente significativa entre BO, falta de SV y PVL inauténtico, en la residencia. (AU)

Introduction: The Burnout Syndrome (BO) usually affects medical residents because they are exposed to chronic labour stress. From a logotherapeutic view, the loss of meaning and purpose in life (ML) is the common denominator of all types of emotional distress, and the BO could belong to an altered labour life project (LLP) with overadaptation. The objective of this study was to evaluate the relationship between the BO, the ML, and the LLP, in residency programs at a university hospital. Population and methods: residents from six programs at Hospital Italiano de Buenos Aires were evaluated. The BO was measured with the Maslach Burnout Inventory (MBI). The ML was measured with the Purpose in Life Test (Pil Test). The LLP was measured with the LLP Scale created by Doctor Isabel Pérez Jáuregui. Results: one hundred and four residents participated. Out of the evaluated residentes, 28.8% showed BO. The loss of ML was observed in 18.3%, and an altered LLP with overadaptation affected the 30.8% of the sample. Loss of ML and altered LLP with overadaptation were associated in a statistically significant way with BO (p<0.01), and the presence of any of this alterations increased the odds ratio almost 18 times to suffer BO. The adjusted odds ratio of loss of ML (6.28) and altered LLP (9.57) to suffer BO, were also statistically significant. Finally, a negative correlation was observed between exhaustion and despersonalization (MBI) and the Pil Test (r=-0.41 and r=-0.53, respectively) and the LLP Scale (r=-0.45 and r=-0.42, respectively), while a positive significant correlation was observed between the personal accomplishment (MBI) and the Pil Test and LLP Scale (r=0.63 and r=0.61, respectively). Conclusions: in the residency, we found a statistically significant relationship between BO, loss of ML and altered LLP. (AU)

Grupos terapêuticos comunitários: uma proposta de empoderamento dos usuários na atenção básica / Community therapeutic groups: a proposal for empowering users in basic care

A partir da reflexão sobre esse tema, é possível compreender a proposta de criação de grupos comunitários terapêuticos como uma ferramenta de empoderamento dos usuários dos serviços de saúde na Atenção Básica, a partir do desenvolvimento da autogestão e valorização de saberes e práticas originais da comunidade, respeitando a sua territorialidade. Por ser uma tecnologia acessível e que envolve as características dos profissionais envolvidos no cuidado, acredita-se que é necessário o investimento pessoal desses para que se tornem facilitadores de algum processo grupal. Cabe lembrar, que a formação grupal dentro dos serviços de saúde pode ter efeitos para além do "terapêutico", refletem os efeitos na vida e rotina social dos seus integrantes e a depender dos objetivos de cada grupo, pode ser um reforço a aliança cidadã desses usuários

Japan's healthcare policy for the elderly through the concepts of self-help (Ji-jo), mutual aid (Go-jo), social solidarity care (Kyo-jo), and governmental care (Ko-jo).

Elderly care is an emerging global issue threatening both developed and developing countries. The elderly in Japan increased to 26.7% of the population in 2015, and Japan is classified as a super-aged society. In this article, we introduce the financial aspects of the medical care and welfare services policy for the elderly in Japan. Japan's universal health insurance coverage system has been in place since 1961. Long-term care includes welfare services, which were separated from the medical care insurance scheme in 2000 when Japan was already recognized as an aging society. Since then, the percentage of the population over 65 has increased dramatically, with the productive-age population on the decrease. The Japanese government, therefore, is seeking to implement "The Community-based Integrated Care System" with the aim of building comprehensive up-to-the-end-of-life support services in each community. The system has four proposed elements: self-help (Ji-jo), mutual aid (Go-jo), social solidarity care (Kyo-jo), and government care (Ko-jo). From the financial perspective, as the government struggles against the financial burdens of an aging population, they are considering self-help and mutual aid. Based on Japan's present situation, both elements could lead to positive results. The Japanese government must also entrust the responsibility for implementing preventive support to municipalities through strongly required regional autonomy. As Japan has resolved this new challenge through several discussions over a long period of time, other aging countries could learn from the Japanese experience of solving barriers to healthcare policy for the elderly.

Face-to-face vs. online peer support groups for prostate cancer: A cross-sectional comparison study.

BACKGROUND: As social media are evolving rapidly online support groups (OSG) are becoming increasingly important for patients. Therefore, the aim of our study was to compare the users of traditional face-to-face support groups and OSG. PATIENTS AND METHODS: We performed a cross-sectional comparison study of all regional face-to-face support groups and the largest OSG in Germany. By applying validated instruments, the survey covered sociodemographic and disease-related information, decision-making habits, psychological aspects, and quality of life. RESULTS: We analyzed the complete data of 955 patients visiting face-to-face support groups and 686 patients using OSG. Patients using OSG were 6 years younger (65.3 vs. 71.5 years; p < 0.001), had higher education levels (47 vs. 21%; p < 0.001), and had higher income. Patients using OSG reported a higher share of metastatic disease (17 vs. 12%; p < 0.001). Patients using OSG reported greater distress. There were no significant differences in anxiety, depression, and global quality of life. In the face-to-face support groups, patient ratings were better for exchanging information, gaining recognition, and caring for others. Patients using OSG demanded a more active role in the treatment decision-making process (58 vs. 33%; p < 0.001) and changed their initial treatment decision more frequently (29 vs. 25%; p < 0.001). CONCLUSIONS: Both modalities of peer support received very positive ratings by their users and have significant impact on treatment decision-making. IMPLICATIONS FOR CANCER SURVIVORS: Older patients might benefit more from the continuous social support in face-to-face support groups. OSG offer low-threshold advice for acute problems to younger and better educated patients with high distress. TRIAL REGISTRATION: www.germanctr.de , number DRKS00005086.

Influencia de los lazos sociales en la salud de las personas / Influence of social ties on people's health

Se denomina apoyo social (AS) a la información y/o ayuda que recibe o percibe recibir una persona, con repercusión conductual y emocional. El AS estructural se refiere a los aspectos objetivos y/o cuantitativos de la red social, mientras que el funcional hace hincapié en los efectos que generan en un sujeto la conservación de su relaciones sociales. Se denomina AS objetivo a los recursos, las provisiones y las transacciones reales a los que las personas pueden recurrir. El AS percibido integra aspectos subjetivos de apoyo social y se centra en lo que percibe la persona en cuestión respecto de la ayuda con la que cree contar, existiendo creciente evidencia de su importancia pronóstica a través de caminos causales conductuales, psicológicos y fisiológicos. (AU)

Social support (AS) includes information and/or help received or perceived by a person, with behavioral and emotional conse-quences. Structural AS refers to objective and/or quantitative aspects of the social network, while functional AS emphasizes the effects generated by the preservation of social relations.Objective AS means resources, provisions and actual transactions to which people can turn. Perceived AS integrates subjective aspects of social support and focuses on what the person in question feels with respect to the help he or she believes they have; and there is growing evidence of its prognostic importance through behavioral psychological and physiological causal paths. (AU)

Evaluation of families of crack users in relation to support groups / Evaluación de las familias de usuarios de crack en el grupo de apoyo / Avaliação das famílias de usuários de crack sobre grupo de apoio

ABSTRACT Objective: to evaluate the perception of the relatives of crack users in relation to the support groups offered to this population in a Psychosocial Care Center for Alcohol and Drugs in the South of Brazil. Method: the fourth-generation theoretical framework was used for evaluation, having as methodological device the hermeneutical-dialectic circle. Data collection occurred through 500 hours of observations and interviews with 12 relatives of crack users, and the comparative constant method was used in the analysis, generating the "family group" unit of meaning. Results: this group was regarded by the family members as a space for guidance on the management of users in their home environment. They reported the need for a basic structure to conduct the groups, greater duration of the meetings, confidentiality of information and diversity of timetables. Final considerations: investment in education and training of nursing professionals focused on group care is suggested to the education institutions.

RESUMEN Objetivo: evaluar la percepción de los familiares de usuarios de crack sobre grupos de apoyo ofertados a ese núcleo de cuidado en un CAPS (Centro de Atención Psicosocial) Alcohol y Drogas del sur de Brasil. Método: se utilizó el referencial teórico de la evaluación de cuarta generación, teniendo como dispositivo metodológico el círculo hermenéutico-dialéctico. La recolección de datos ocurrió a través de 500 horas de observaciones y entrevistas con 12 familiares de usuarios de crack, y en el análisis se utilizó el método comparativo constante, que generó la unidad de significado "grupo de familia". Resultados: ese grupo fue evaluado por los familiares como un espacio que instrumentaliza para el manejo del usuario en domicilio. Evaluaron la necesidad de estructura básica para la realización de los grupos, de mayor duración de los encuentros, de sigilo de las informaciones y de diversidad de horarios. Consideraciones finales: se sugiere a las instituciones de enseñanza inversiones en la formación y en la calificación de profesionales de enfermería dirigidos a la atención en grupo.

RESUMO Objetivo: avaliar a percepção dos familiares de usuários de crack sobre grupos de apoio ofertados a esse núcleo de cuidado em um Caps Álcool e Drogas do sul do Brasil. Método: utilizou-se o referencial teórico da avaliação de quarta geração, tendo como dispositivo metodológico o círculo hermenêutico-dialético. A coleta de dados ocorreu através de 500 horas de observações e entrevistas com 12 familiares de usuários de crack, e na análise foi utilizado o método comparativo constante, que gerou a unidade de significado "grupo de família". Resultados: esse grupo foi avaliado pelos familiares como um espaço que instrumentaliza para o manejo do o usuário em domicílio. Avaliaram a necessidade de estrutura básica para a realização dos grupos, de maior duração dos encontros, de sigilo das informações e de diversidade de horários. Considerações finais: sugere-se às instituições de ensino investimentos na formação e na qualificação de profissionais da enfermagem voltados para o atendimento em grupo.

Eliciting and receiving online support: using computer-aided content analysis to examine the dynamics of online social support.

BACKGROUND: Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites. OBJECTIVE: The first goal was to propose and test a model of the dynamic process through which participants in online support communities elicit and provide emotional and informational support. The second was to demonstrate the value of computer coding of conversational data using machine learning techniques (1) by replicating results derived from human-coded data about how people elicit support and (2) by answering questions that are intractable with small samples of human-coded data, namely how exposure to different types of social support predicts continued participation in online support communities. The third was to provide a detailed description of these machine learning techniques to enable other researchers to perform large-scale data analysis in these communities. METHODS: Communication among approximately 90,000 registered users of an online cancer support community was analyzed. The corpus comprised 1,562,459 messages organized into 68,158 discussion threads. Amazon Mechanical Turk workers coded (1) 1000 thread-starting messages on 5 attributes (positive and negative emotional self-disclosure, positive and negative informational self-disclosure, questions) and (2) 1000 replies on emotional and informational support. Their judgments were used to train machine learning models that automatically estimated the amount of these 7 attributes in the messages. Across attributes, the average Pearson correlation between human-based judgments and computer-based judgments was .65. RESULTS: Part 1 used human-coded data to investigate relationships between (1) 4 kinds of self-disclosure and question asking in thread-starting posts and (2) the amount of emotional and informational support in the first reply. Self-disclosure about negative emotions (beta=.24, P<.001), negative events (beta=.25, P<.001), and positive events (beta=.10, P=.02) increased emotional support. However, asking questions depressed emotional support (beta=-.21, P<.001). In contrast, asking questions increased informational support (beta=.38, P<.001), whereas positive informational self-disclosure depressed it (beta=-.09, P=.003). Self-disclosure led to the perception of emotional needs, which elicited emotional support, whereas asking questions led to the perception of informational needs, which elicited informational support. Part 2 used machine-coded data to replicate these results. Part 3 analyzed the machine-coded data and showed that exposure to more emotional support predicted staying in the group longer 33% (hazard ratio=0.67, P<.001), whereas exposure to more informational support predicted leaving the group sooner (hazard ratio=1.05, P<.001). CONCLUSIONS: Self-disclosure is effective in eliciting emotional support, whereas question asking is effective in eliciting informational support. Moreover, perceptions that people desire particular kinds of support influence the support they receive. Finally, the type of support people receive affects the likelihood of their staying in or leaving the group. These results demonstrate the utility of machine learning methods for investigating the dynamics of social support exchange in online support communities.

[Influence of psychological therapy on duration of survival in patients with metastatic cancer]. / Wplyw terapii psychologicznej na przedluzanie czasu przezycia u osób z zaawansowana choroba nowotworowa.

The work of A. J. Cunningham has created new perspectives for extension of survival through psychological intervention in patients with advanced cancer. Therapeutic techniques exploiting unique subjective psychic and social experiences may be particularly helpful at the time when life of the patient is threatened by an incurable disease. Psychological therapy should be based on an individual plan for living with cancer. Novel qualitative research and therapeutic methods need to be developed.

[An activating state and active citizen groups in the German health care system]. / Aktivierender Staat und aktive Bürgergesellschaft im deutschen Gesundheitswesen.

This paper discusses the question, to what extent concepts of an enabling state are realised in the German health policy and wether they meet active citizens with corresponding competencies. The analysis is based on a review of the literature referring to the promotion and development of the self-help movement and citizen participation in the German health care system. The results show, that since 1999 the following enabling health policy measures were adopted: the promotion of independent patient advisory services and shared decision-making, the enactment of participation rules in the rehabilitation system and the compulsory subsidy for self-help groups, self-help organisations and clearing houses for self-help. The active engagement of the citizens both as co-producers of health on the individual level and as participants in processes of communication and decision-making on the system level is still restricted to a small part of the population. An enabling health policy and a broad citizen participation are still in the beginning, but they have the potential to strengthen each other and to realise synergetic effects. Even though some corresponding institutions were already established and attitudes of the health care professionals start to alter, the question wether the health policy will change from a welfare producing state to an enabling state cannot be answered completely yet.

The effect of a psychosocial group intervention on loneliness and social support for Japanese women with primary breast cancer.

PURPOSE/OBJECTIVES: To examine the effects of a psychosocial group intervention on loneliness and social support in Japanese women with breast cancer. DESIGN: Secondary analysis of a randomized, controlled trial. SETTING: A breast cancer outpatient area of a National Cancer Center hospital in Japan. SAMPLE: 50 women who were less than 65 years old, were diagnosed with primary breast cancer, and had undergone surgery within 4-18 months of the start of the study. METHODS: Data were collected as part of a trial of an intervention. The investigators conducted a six-week group intervention consisting of health education, coping skills training, stress management, and psychological support. Subjects completed the revised University of California, Los Angeles, Loneliness Scale and a social support questionnaire at baseline, six weeks, and six months. MAIN RESEARCH VARIABLES: Loneliness, number of confidants, satisfaction with confidants, and satisfaction with mutual aid. FINDINGS: Fifty (33%) of the 151 invited patients participated and were randomized to either experimental (n = 25) or control (n = 25) groups, and 23 (92%) in each group completed the study. The experimental group had significantly lower scores than the control group for loneliness and significantly higher scores for the number of confidants, satisfaction with confidants, and satisfaction with mutual aid over the six-month study period. CONCLUSIONS: This intervention is beneficial for Japanese patients with breast cancer experiencing loneliness and inadequate social support. IMPLICATIONS FOR NURSING: The program can be used as an effective support for Japanese patients with cancer to manage their psychosocial concerns associated with illness.

Atividades em grupo: uma alternativa para inclusao social na terceira idade / Activities in group: a choice for social inclusion in the old age

O presente artigo tem por objetivo contribuir para o trabalho de profissionais preocupados em ajudar idosos a ajustarem-se a sua nova condicao, a lidarem melhor com suas limitacoes e possibilidades, mantendo-se ativos e participantes no exercicio de sua cidadania. Sera enfocada a importancia de atividades em grupo para a terceira idade numa grande metropole, tomando como parametro a cidade de Sao Paulo, na qual os autores vem desenvolvendo seu trabalho. A discussao tem como ponto de partida observacoes e reflexoes a respeito da evolucao historica dos grupos de idosos e consideracoes a partir da experiencia com diferentes atividades realizadas em grupo de terceira idade em instituicoes publicas e particulares

Educational group support for patients with gynaecological cancer and their families.

Prior to the start of a psychosocial project for patients with gynaecological cancer and their families, a questionnaire was mailed to evaluate their potential interest in an educational and supportive group. Another aim was to rank the most important issues. Group I consisted of patients with a newly diagnosed cancer and group II comprised patients who had been in clinical remission for 2-5 years; 173 questionnaires were sent. The response rate was 80%. The rates of interest in the proposed group sessions were 63% and 65% from patients and relatives in group I, and 52% and 36% from those in group II (P < 0.05). Younger individuals, couples and people with a higher formal education were generally more interested in participating (P < 0.05). The highest-ranked issues (mean 3.9-3.7 on a four-point scale) were cancer and cancer treatment, living with a cancer diagnosis, side-effects of treatment, cancer pain and psychological reactions to cancer. Among patients in group I, the interest in questions related to sexual activity was moderate (mean 2.8); the corresponding figure was significantly higher in group II (P < 0.05). Interest in supportive and educational groups was significantly higher than in comparable studies. Since relaxation programmes and issues concerning problems with relationships have been generally regarded as the most crucial topics in supportive programmes, the preference for specifically cancer-related issues was surprising. The study underlines the importance of specifically ascertaining which issues an intended group considers to be important.

[Status of health policy and possible support to self-help groups]. / Gesundheitspolitischer Stellenwert und Unterstützungsmöglichkeiten von Selbsthilfegruppen.

Self-help groups strengthen an individual's sense of autonomy and self-determination, and help to recover from diseases and other health-related problems. Participants mutually support each other within the group to promote a healthier approach to socio-psychological issues; they also conduct activities outside the group, especially counselling services for peers dealing with similar problems. In recent years, the number of groups throughout Germany rosen to approximately 60,000. The groups are mainly supported by self-help clearinghouses which have sprung up in many regions of western and eastern Germany over the last few years. This paper provides an overview of the development of self-help groups as well as the current state of support and funding in this area. Furthermore, it describes in detail the work performed by clearinghouses and the possibilities for cooperation with these new "liaison institutions".

[Promoting self-help by a public health office--the example of the Unna district]. / Selbsthilfeförderung durch ein Gesundheitsamt--Beispiel Kreis Unna.

In the district of Unna support of self-help movement has been enjoying high priority for many years, giving a new orientation to the public health service towards a modern and more customer-friendly public service. Since January 1990 a self-help clearinghouse has been established by the section of health promotion supervised by the public health office. By now, three centres have been opened. The scheme of organisation, staffing and facilities, contents and working procedure, results and experiences are presented. It is quite obvious that support of the self-help movement should be one of the major tasks of public health service in the years to come.