Revisión documental de experiencias de actividad comunitaria en atención primaria de salud / Documental review of community health promotion experiences in primary health care

ObjetivoDescribir las actividades comunitarias (AC) publicadas o inscritas en redes de promoción de la salud en las que ha participado Atención Primaria (AP).DiseñoEstudio descriptivo, mediante revisión documental de experiencias.Fuentes de datosArtículos, actividades en redes de intercambio de experiencias on-line, comunicaciones y proyectos premiados.Selección de experienciasSe incluyeron AC en las que AP y la comunidad atendida participaban en su inicio, desarrollo y/o evaluación, sin ser acciones puntuales.Extracción de datosSe recogieron las siguiente variables: fuente, año del registro del documento, CCAA, Municipio, número y nombre de los centros de salud implicados, población diana, objetivos, participación de la comunidad, y de sectores sanitarios y no sanitarios, perspectiva teórica, y métodos de evaluación.ResultadosSe identificaron 472 actividades que cumplían criterios, con participación de 300 centros de salud de la mayoría de CCAA. El 71,8% registradas en redes on-line, y el 19,3% en artículos. Las poblaciones diana más frecuentes fueron población general (22,2%), jóvenes (18,2%) y madres y padres (10,2%). El 58,2% tenía como objetivos: capacitar a la comunidad para optar por comportamientos más saludables, transmitir información sanitaria a la población, o fomentar el autocuidado. En el 33,3% no participó ningún agente además de AP. Del resto, participaron sectores no sanitarios en el 53,8%, entidades cívicas 26,9% y administraciones 24,2%.ConclusionesLa mayoría de las AC documentadas se encuentran en redes y su presencia por CCAA es desigual. La participación de otros sectores diferentes de AP en las actividades identificadas es baja(AU)

ObjectiveDescribe the community activities (CA) published or registered in health promotion networks in which Primary Health Care (PHC) has taken part.DesignDescriptive study, by documental review of experiences. Data source: articles, activities in exchange networks, presentations and funded projects.Selected experiencesThe AC included were those where PHC and the local community were involved in its inception, development and/or evaluation, but not solitary actions with no continuity.Data extractionThe following variables were collected: Source and year of the document; region; municipality; name and number of health centres involved; target population; objectives; involvement of the community, the health and the non-health sectors; theoretical perspective and evaluation methods.ResultsA total of 472 activities were found that met criteria, involving 300 health centres in most of the autonomous regions. Of those, 71.8% were registered in networks, and 19.3% were registered in articles. The most frequent target populations were: the general population (22.2%), youth (18.2%) and parents (10.2%). More than half (58.2%) had one or more of the following objectives: to empower the community to choose healthy behaviours; transmit health information to the population, or encourage self-care. In 33.3% of the activities there were no other sectors involved besides Primary Care. Of the remainder, non-health sectors participated in 53.8%, civic bodies in 26.9%, and government administration in 24.2%.ConclusionsMost of the CA are documented in networks and their presence is uneven by region. The involvement of sectors other than PHC in the activities identified is low(AU)

Resolving ethical dilemmas in suicide prevention: the case of telephone helpline rescue policies.

The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue policies of the Samaritans and the AAS and the U.S. National Suicide Prevention Lifeline network. We contrast moralist, relativist, and libertarian ethical premises and question whether suicide can be rational. Samaritans respect a caller's right to decide to die by suicide; U.S. helplines oblige emergency intervention during an attempt even against the caller's will. We analyze the effect of emergency rescue when there is high suicide risk but an attempt has not been initiated. We examine links between values and actions, needs for empirical evidence to guide practice, and propose vigorous dialogue about values in the gray zone of moral practice.