[The outlook for Spanish primary care starting with a bibliometric analysis of its scientific production (1971-1994)]. / Perspectiva de la atención primaria española a partir del análisis bibliométrico de su producción científica (1971-1994).

OBJECTIVE: To establish the relative weight of the various kinds of primary health care (PHC) research collected in the IME (Spanish medical index), In order to determine their possible relationships with Spain's PHC model. DESIGN: Bibliometric analysis. PARTICIPANTS: PHC documents (1971-1994) from the IME data base (CD-ROM), subdivided by years, journals, themes and Autonomous Communities (AC). RESULTS: 3,015 studies were published, with a first phase (1970s) of under 10 documents per year, a second (1980s) with a big increase and a third (1990s) of stagnation. Of the 117 journals containing studies, Atención Primaria gave a home to almost 58% (60% after 1984). CONCLUSIONS: PHC research production has stagnated recently, though the journal Atención Primaria has maintained its undisputed leadership position. The clinical model predominant in Spanish medicine is generally followed.

[Rational structures in health education models: basics and systematization]. / Estructuras de racionalidad en educación para la salud: fundamentos y sistematización.

The different Health Education (HE) models appeared in the scientific literature are analyzed, trying to eliminate the confusion produced by its great diversity, applying a general and systematic point of view. Due to the relevance of that topic in the activities of Health Promotion in Primary Health Care it is urgent a deep reappraisal due the heterogeneity of scientific papers dealing with that topic. The curriculum, as the confluence of thought and action in Health Education, is the basic concept thanks to which it is possible to integrate both scientific logic, the biological one and that pertaining to the social sciences. Of particular importance have been the different paradigms that have emerged in the field of HE from the beginning of the present century: a first generation with a "normative" point of view, a second one orientated from positivistic bases, and a third generation adopting an hermeneutic and critic nature. This third generation of paradigms in HE has taken distances from the behaviouristic and cognitive perspectives being more critical and participative. The principal scientific contributors in the field of HE, internationals as well as spaniards are studied and classified. The main conclusions obtained from this Health Education paradigm controversy are referred to both aspects: 1) planning, programming and evaluating activities, and 2) models, qualitative and quantitative methodologies. Emphasis is given to the need of including Community Participation in all phases of the process in critic methodologies of HE. It is postulated the critic paradigm as the only one able to integrate the rest of the scientific approaches in Health Education.

[Social attitude towards health participation]. / Actitud Social ante la participación en salud.

BACKGROUND: The community health participation is an important issue for all health systems based on a Primary Health Care, which emphasizes prevention and promotion, as a complement to assistance. In this survey, the social attitude towards health participation is studied, taking into account the different research paradigms on Social Sciences, the models of health behaviours, the meaning of participation and the meaning of the own attitudes. METHODS: A Likert scale of 18 items, which constitutes a part of a general health survey of 128 variables, is elaborated and validated. It is complemented with a personal interview to 1371 persons in a random sample from four health areas. RESULTS: The data obtained show that there are neither statistical significant differences among areas in relation with having or not a Health Council, nor between men and women. The attitudes towards participation are more favourable among young people, bachelors and persons from a high socioeconomic status, hig degree studies, white collar professions, and the persons going to the doctor with the lowest frequency, show a positive tendency. The factorial analysis identifies three dimensions: a) Self-care, b) political and c) community health agent. The discriminant analysis shows that variables (age, civil, status, socioeconomic level, studies...) classify correctly 74% of cases. CONCLUSIONS: The personal profile, showing a health participative attitude, is consistent, in most variables, with that published by previous reports.

[Health instruction in adult education as instrument for community participation. Analysis of an experiment in La Nora (Murcia)]. / La formación sanitaria en la educación de adultos como instrumento para la participación comunitaria. Análisis de una experiencia en La Nora (Murcia).

AIM: The main aim of this work is to demonstrate the possibility of establishing stable contacts between the PC study and citizens' groups, in order to promote Health Education. The experience of Adult Education in a Health Centre, initiated by its Consejo de Salud (Health Council), was analysed. DESIGN: The study's methodology is of Participatory Research based on an earlier descriptive analysis, which had followed the educational input. PLACE: It takes place in a PCC and is a Community-based activity. PARTICIPANTS: The PC study, Adult Education teachers, the Social Health Department of the Faculty of Medicine and 136 adult students from nine villages in the rural area of La Nora (Murcia), took part in the study. ACTIVITIES: Essentially to develop a programme of Health Instruction within Adult Education, in order to encourage Community Participation. RESULTS: They focus on checking the effect of the programme on all the groups concerned and analysing the characteristics of the adult student body. CONCLUSIONS: The most important have been the generally positive feelings about the experiment and thus the possibility of tackling new ones. It was important that the study had been the fruit of a programme of Community Participation, with the Health Centre as the point of reference.