[Sense of coherence and health assets in a youth center for minors]. / Sentido de coherencia y activos para la salud en jóvenes internos en centros de menores

OBJECTIVES: To determine the Sense of Coherence (SOC) amongst young people at 2 Youth Detention Centres in Valencia, the views of professionals on SOC and how young people identify health assets. MATERIALS AND METHODS: 45 young people answered the SOC-13 test. Categorical variables were expressed as absolute and relative frequencies, while the quantitative ones were expressed via means with confidence intervals (CI) at 95%. We designed and conducted a group interview with 5 teenage inmates and an open-ended questionnaire for six professionals. We performed an analysis based on content and categories. RESULTS: Mean SOC score is 54.4 (95% CI 53.9 to 59.8). Regarding the size of the test, manageability, 17.6 (95% CI 16.5 to 18.8); comprehensibility, 19.6 (95% CI: 18.1, 21.1) and meaningfulness, 17,1 (95% CI: 16.0 to 18.2). Young people identify internal assets such as "sport" and "being positive" and external assets such as "persons (family and friends)" and "spaces related to physical activity". Professionals believe that SOC places value on aspects that are relevant to the life of the centre and that young people obtain a moderate score. DISCUSSION: The SOC level obtained is moderate and similar to other populations. The results show limitations linked to acquisition of the sample, but also indicate scope for further research on SOC, and on the differences between youth cultures, SOC and identified health assets. Assets could be given further impetus by young people themselves with support from professionals, family and the community environment.

Sentido de coherencia y activos para la salud en jóvenes internos en centros de menores / Sense of coherence and health assets in a youth center for minors

OBJETIVOS: Determinar el Sentido de Coherencia (SOC) en jóvenes de 2 Centros de Menores (CM) de la Comunidad Valenciana, conocer la opinión de sus profesionales sobre SOC y que estos jóvenes identifiquen activos para su salud. MATERIAL Y MÉTODO: 45 jóvenes autocumplimentaron el test SOC-13. Las variables categóricas se expresaron como frecuencias absolutas y relativas; las cuantitativas, mediante medias con intervalos de confianza (IC) al 95%. Se diseñó y realizó una entrevista grupal a 5 adolescentes internos y un cuestionario de preguntas abiertas a 6 profesionales. Se realizó análisis de contenido temático y por categorías. RESULTADOS: La media de puntuación de SOC es 54,4 (IC 95%: 53,9 a 59,8). Respecto a las dimensiones del test, manejabilidad: 17,6 (IC 95%: 16,5 a 18,8); comprensibilidad: 19,6 (IC 95%: 18,1 a 21,1); y significatividad: 17,1 (IC 95%: 16,0 a 18,2). Los jóvenes identifican activos internos como "hacer deporte" y "ser positivos"; y externos como "personas (familia y amigos)" y "espacios relacionados con la actividad física". Los profesionales opinan que SOC valora aspectos relevantes para la vida del centro y que los jóvenes obtendrán una puntuación moderada. DISCUSIÓN: El nivel de SOC obtenido es moderado y similar a otras poblaciones. Los resultados presentan limitaciones relacionadas con la obtención de la muestra, pero invitan a seguir investigando sobre SOC y diferencias socioculturales de jóvenes; y SOC y activos identificados. Los activos podrían dinamizarse por los propios jóvenes con el apoyo de profesionales y del entorno familiar y comunitario (AU)

OBJECTIVES: To determine the Sense of Coherence (SOC) amongst young people at 2 Youth Detention Centres in Valencia, the views of professionals on SOC and how young people identify health assets. MATERIALS AND METHODS: 45 young people answered the SOC-13 test. Categorical variables were expressed as absolute and relative frequencies, while the quantitative ones were expressed via means with confidence intervals (CI) at 95%. We designed and conducted a group interview with 5 teenage inmates and an open-ended questionnaire for six professionals. We performed an analysis based on content and categories. RESULTS: Mean SOC score is 54.4 (95% CI 53.9 to 59.8). Regarding the size of the test, manageability, 17.6 (95% CI 16.5 to 18.8); comprehensibility, 19.6 (95% CI: 18.1, 21.1) and meaningfulness, 17,1 (95% CI: 16.0 to 18.2). Young people identify internal assets such as "sport" and "being positive" and external assets such as "persons (family and friends)" and "spaces related to physical activity". Professionals believe that SOC places value on aspects that are relevant to the life of the centre and that young people obtain a moderate score. DISCUSSION: The SOC level obtained is moderate and similar to other populations. The results show limitations linked to acquisition of the sample, but also indicate scope for further research on SOC, and on the differences between youth cultures, SOC and identified health assets. Assets could be given further impetus by young people themselves with support from professionals, family and the community environment (AU)

[Patients and quality of primary health care services. Survey of practitioners at the Bahía de Cádiz and La Janda health centers]. / Los pacientes y la calidad de los servicios de atención primaria de salud. Opinión de los profesionales de los centros de salud de la Bahía de Cádiz y La Janda.

AIM: To report the opinions of practitioners at health centers on dimensions of quality that affect user satisfaction. DESIGN: Cross-sectional study of focus groups (FG). SETTING: Bahía de Cádiz and La Janda health centers in southwestern Spain. PARTICIPANTS: We studied 4 FG whose participants were staff members of the two health centers: FG1, physicians; FG2, user satisfaction service staff; FG3, social workers; FG4, nurses. The groups were based on the different functions of staff at the two centers. METHOD: The analysis was based on variables in the SERCAL model (an adaptation of the SERVQUAL model for the Spanish health care system) of opinions regarding service quality: access, comfort (tangibles), personalized service (courtesy), competence, and loyalty. The data were analyzed with version N-Vivo of the NUDIST program. RESULTS: All dimensions of the theoretical model were identified by practitioners as constructs of users' perceptions of service quality. Users' and practitioners' views contrasted with and complemented each other to generate a model that could be validated. Access, personalized service and problem-solving (responsiveness) were key variables. CONCLUSIONS: Practitioners' opinions provided information of use in improving the quality model. Differences in opinion between users and practitioners merit further study based on an understanding of these groups' values and interests, and on the care provision context. Practitioners identified access, personalized service and problem-solving as features that influenced users' opinions of the quality of the health center.

Los pacientes y la calidad de los servicios de atención primaria de salud. Opinión de los profesionales de los centros de salud de la Bahía de Cádiz y La Janda / Patients and quality of primary health care services. Survey of practitioners at the Bahía de Cádiz and La Janda health centers

Objetivo. Conocer la opinión de los profesionales de los centros de salud (CS) sobre las dimensiones de la calidad que afectan a la satisfacción de los usuarios. Diseño. Estudio transversal mediante grupos focales (GF).Emplazamiento. CS de la Bahía de Cádiz y La Janda (BCJ).Participantes. Se realizaron cuatro GF con personal de los CS. GF1: médicos; GF2: servicios de atención al usuario; GF3: trabajadores sociales; GF4: enfermeras. La selección de los segmentos se realizó según las funciones desempeñadas en el CS. Método. El análisis se hizo según variables del modelo SERCAL de opinión sobre la calidad del servicio: accesible, confortable, personalizado, garantía y fidelidad. Se utilizó el programa NUDIST, versión N-Vivo. Resultados. Todas las dimensiones del modelo teórico han sido identificadas por los profesionales como constructoras de la percepción que el usuario tiene de la calidad del servicio. Las visiones de usuarios y profesionales se contraponen y se complementan, generando un modelo susceptible de validación. El acceso, el trato y la solución del problema son variables clave. Conclusiones. La opinión de los profesionales proporciona información para mejorar el modelo de calidad predefinido. Es necesario estudiar las diferencias en la opinión entre usuarios y profesionales según los valores e intereses de estos colectivos y el contexto de la atención. Los profesionales identifican la accesibilidad, el trato y la solución del problema como características que influyen en la opinión que tiene el usuario sobre la calidad del CS (AU)

[Review of published works on Spanish youth health promotion]. / Revisión de los trabajos publicados sobre promoción de la salud en jóvenes españoles.

The objective of this study is to review the health promotion interventions on spanish youths published in Spanish in the 1995-2000 period and to describe them in accordance with the scope within which they have been carried out, the topics addressed, the methodology, the evaluation design used and the results obtained. Two hundred and fourteen intervention were identified. Illegal drugs were the topic on which the largest number of interventions were focused (29.8%), followed by alcohol (15.9%), the risk-related sexual behaviours (14.6%) and leisure time (12.6%). The activities carried out most often were: participation-based educational methods (30.7%), explanatory education methods (11.5%) and the preparation of educational materials (11%). In 80.8% of the cases, some evaluation of the health promotion activities was found. The type of evaluation employed most often was the process evaluation (73.7%), and the medium-long term results evaluation being those employed the least (2.2%). The evaluation methodologies used most often were questionnaires (28.2%). A combination of qualitative and quantitative methods was employed in 13.2% of the cases. The four interventions in which the medium-long term impact was gauged had the purpose of preventing and reducing cigarette smoking and/or drinking and or marijuana smoking, all of these initiatives achieving a reduction in cigarette smoking. In conclusion, it seems necessary to improve the design of the evaluations of the health promotion initiatives addressed to young people in Spain and to increase the dissemination of the same by way of their publication.

[Health education in schools for adults: by a teacher or health education lecture?]. / Educación para la salud en escuelas de adultos: Por medio del profesor o mediante charla de educación sanitaria?

OBJECTIVE: To compare the results of two ways of teaching the rational use of medicines to students of centres of permanent education of adults (CPEA): one taught by the normal teachers (after training by health personnel) and one through a lecture given by the health staff. DESIGN: Intervention study without randomised distribution and with a control group. SETTING: Five CPEA in an urban centre. PARTICIPANTS: 385 students and 15 CPEA teachers. INTERVENTIONS: Three groups: a) "teachers" group: consisting of students who received education on medicines in the class-room through their teachers, who had been previously trained by health personnel; b) "lecture" group: students who had received a health education lecture on medicines given by health staff; c) non-intervention group. All three groups were administered a questionnaire before and after the intervention. Both questionnaires were paired. MEASUREMENTS AND MAIN RESULTS: 248 people completed the first questionnaire and 149 the second. Significant gains in knowledge were only found in the teachers intervention group (p < 0.01; 7.8% increase in score). Dividing the students into terciles made these gains significantly greater (11.7%) in the students of the teachers group who in the first questionnaire had intermediate scores than in the students in the other groups who had intermediate scores. CONCLUSIONS: Intervention with teachers seems more effective than either a health education lecture or no intervention, especially in the improvement in knowledge of students who already had beforehand intermediate knowledge.

Educación para la salud en escuelas de adultos: ¿por medio del profesor o mediante charla de educación sanitaria? / Health education in schools for adults: through the teacher or a health education lecture?

Objetivo. Comparar los resultados de dos modalidades de enseñanza sobre uso racional de medicamentos en alumnos de centros de educación permanente de adultos (CEPA): la realizada a través del profesorado (formado previamente por los sanitarios) o mediante charla de educación impartida por el personal sanitario. Diseño. Estudio de intervención sin distribución aleatoria, con grupo control. Emplazamiento. Cinco CEPA de un núcleo urbano. Participantes. Trescientos ochenta y cinco alumnos y 15 profesores de CEPA. Intervenciones. Tres grupos: a)grupo 'profesores', constituido por alumnos que recibieron educación sobre medicamentos en el aula, mediante sus profesores, los cuales habían sido formados previamente por los sanitarios; b)grupo 'charla': alumnos que recibieron una charla de educación sanitaria sobre medicamentos impartida por los sanitarios, y c)grupo no intervención. En los 3 grupos se realizó encuesta previa y posterior a la intervención. Ambas encuestas fueron apareadas. Mediciones y resultados principales. Doscientos cuarenta y ocho sujetos completaron la primera encuesta y 149 la segunda. Sólo se encontraron ganancias significativas de conocimiento en el grupo de intervención con profesores (p < 0,01; 7,8 por ciento de ganancia de puntos relativa). Si dividíamos a los alumnos en terciles, estas ganancias eran superiores (11,7 por ciento) significativamente en los alumnos del grupo 'profesores' con puntuaciones previas intermedias en la primera encuesta, en comparación con los alumnos de puntuación intermedia de los otros grupos. Conclusiones. La intervención mediante 'profesores' parece mostrarse más efectiva que la realizada mediante 'charla de educación sanitaria' o la 'no intervención', y se diferencia de éstas en la mejoría de conocimientos en los alumnos con conocimientos previos intermedios (AU)

[Qualitative techniques for public health research and the development of health care services: more than just another technique]. / Técnicas cualitativas para la investigación en salud pública y gestión de servicios de salud: algo más que otro tipo de técnicas.

Regarding the debate on the existence of two current focuses on health science research (qualitative and quantitative), the paper states the need for complementing the techniques which contribute to a better knowledge of populations and communities, and the need for offering effective solutions to different problems. The article analyses the usefulness of qualitative methods, describes the techniques and procedures more frequently used to guarantee the validity and reliability of research findings and ends bringing up the need for using qualitative and quantitative approaches. This way of working together or learning from each other will enrich research and interventions on public heath and health management fields. Qualitative methods are useful for sound understanding of a given issue that is being investigated or evaluated taking into account the point of view of the participants under research. Key techniques, listed from the most structured to the less structured are among others: structured interview, Delphi, nominal group, case study, semistructured interview, focal group, brainstorming, discussion group, in depth interview, life story and participant observation.