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Indicators for continuance of childhood gender dysphoria into adulthood: A critical interpretive synthesis of literature (2000–2020) 儿童期性别焦虑进入成年期的持续指标:文献的批判性解释性综合(2000-2020)
Pub Date : 2023-03-31 DOI: 10.32920/ihtp.v3i1.1690
Jeandré Cooke, P. Moodley
Introduction: Health professionals are unable to predict whether gender nonconforming distress or manifestations will continue after puberty. They also hold varied ideologies about gender. Information about these indicators lacks integration to benefit decision-making about how to intervene in childhood gender dysphoria. Aims: The aim of this review was to synthesize the literature on early indicators that anticipate the continuity of childhood gender dysphoria following puberty. A secondary aim, because of the ideological debates that underpin clinical decisions in transgender health care, was to critically interpret that literature. Methods: A critical interpretive synthesis was selected to integrate and offer a critical appraisal of literature (n=20). Results: A synthesizing argument was developed from four constructs: the intensity of gender dysphoric feelings, the child’s assertion of their gender identity, the stability of gender identity, and gender is a composite of multiple selves. Conclusions: The framing of experts’ arguments fed into presumed stability of gender identity. No single homogenous indicator can be postulated, but a compartmentalizing process is needed to understand the experiential world of a child’s gender nonconformity so that one concept (dysphoria about gender identity) can be teased apart from other investments of gender, body, and sexuality. Our constructs of the intensity of feelings and gender as a composite of multiple selves were found to challenge DSM-5 criteria. Understanding that multiple transitions may occur can help a child locate a gendered positioning in which they are comfortable. This could enable health practitioners offer affirmative care while remaining cautious about using medical treatments that cannot be reversed. The search for indicators itself, however, can be considered a historical moment, given the developments in the field in the 2 years after this review was conducted.
卫生专业人员无法预测性别不一致的困扰或表现是否会在青春期后继续。他们对性别也有不同的意识形态。关于这些指标的信息缺乏整合,不利于如何干预儿童性别不安的决策。目的:本综述的目的是综合有关预测青春期后儿童性别不安持续性的早期指标的文献。第二个目标是批判性地解释这些文献,因为在跨性别医疗保健的临床决策中存在着意识形态上的争论。方法:选择一种批判性的解释性综合来整合并提供对文献的批判性评价(n=20)。结果:从性别焦虑情绪的强度、儿童对其性别认同的主张、性别认同的稳定性和性别是多重自我的合成四个构面得出综合论证。结论:专家论证的框架助长了性别认同的假定稳定性。没有一个单一的同质指标可以假设,但需要一个区分的过程来理解孩子性别不一致的经验世界,这样一个概念(关于性别认同的不安)就可以从性别、身体和性的其他投资中被取笑出来。我们的情感强度和性别作为多重自我的复合结构被发现挑战了DSM-5标准。了解可能发生的多重转变可以帮助孩子找到他们感到舒适的性别定位。这可以使卫生从业人员在提供积极护理的同时,对使用无法逆转的医疗方法保持谨慎。然而,考虑到本次审查进行后两年该领域的发展,寻找指标本身可以被视为一个历史性时刻。
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引用次数: 0
A commentary on Brazilian perspectives of lessons learned during the COVID-19 pandemic 评论巴西对2019冠状病毒病大流行期间经验教训的看法
Pub Date : 2023-03-31 DOI: 10.32920/ihtp.v3i1.1707
M. Zanchetta, Stephanie Pedrotti Lucchese, Mavi Galante Mancera Molinari Blotta, Vanessa Fracazzo, Maria Odete Pereira, Cláudio da Fonseca Rodrigues Panda, Cecília Moreira Torres, Clarissa Moura De Paula
Background: While the pandemic brought many challenges and disruption to an individual’s life, it also presented individuals with the opportunity to develop coping strategies and seek changes in their lives. Brazilians experiencing that moment disclosed the uniqueness of learned lessons. Methods: A commentary written by the interviewers and transcription team of 93 interviews conducted with Brazilians living in Canada and their relatives living in Brazil, identified trends in the experiential learning acquired during the pandemic. The Bloom’s taxonomy framed the review of team’s insights about learned lessons and newest skills and organization of evidence within the domains of cognitive, affective, and psychomotor learning. Results: Overall, there was a significant number and diversity of evidence about new learning and successful strategies that the participants implemented that promoted opportunities for learning. Identified evidence was in the affective (n=26), psychomotor (n=11) and cognitive (n=8) domains. Learning occurred in the affective domain which contributed to new self-perception, expanded awareness, new life priorities, renewed humanistic thoughts, increased valorization of time, life, and interpersonal relations. Conclusions: The findings of the lessons learnt from Brazilian participants are significant and highlight the unique perspectives of the positive benefits that resulted from a negative experience due to the pandemic. The significance of this interesting set of evidence indicates that in a near future the multidisciplinary community of scientists may definitively recalibrate the research focus and further explore how individuals learn and react during a pandemic.
背景:虽然大流行病给个人的生活带来了许多挑战和干扰,但它也为个人提供了制定应对战略和寻求改变生活的机会。经历这一时刻的巴西人揭示了吸取教训的独特性。方法:采访者和转录小组对居住在加拿大的巴西人及其居住在巴西的亲属进行的93次访谈进行了评论,确定了大流行期间获得的体验式学习的趋势。Bloom的分类法框架审查了团队在认知、情感和精神运动学习领域对所学课程和最新技能的见解和证据的组织。结果:总体而言,有显著数量和多样性的证据表明,新的学习和成功的策略,参与者实施促进学习的机会。确定的证据在情感(n=26),精神运动(n=11)和认知(n=8)领域。学习发生在情感领域,它有助于新的自我认知,扩大意识,新的生活优先事项,更新人文主义思想,增加时间,生命和人际关系的价值。结论:从巴西参与者那里吸取的经验教训的结论是重要的,并突出了从流行病的负面经验中产生的积极效益的独特视角。这组有趣证据的重要性表明,在不久的将来,多学科科学家群体可能会明确地重新调整研究重点,并进一步探索个人在大流行期间如何学习和反应。
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引用次数: 0
Exploring educators’ perception of issues involving Planetary Health: A qualitative study in the Brazilian Amazon 探索教育工作者对涉及地球健康问题的看法:巴西亚马逊地区的一项定性研究
Pub Date : 2022-12-01 DOI: 10.32920/ihtp.v2i3.1680
Paula Regina Humbelino De Melo, Tatiana Souza de Camargo, Renato Abreu Lima, Thiago Ferreira Abreu, Raquel de Andrade Cardoso Santiago
Background: Planetary Health is a transdisciplinary area that needs to be part of the curriculum of students at all levels of education, starting from basic education with early childhood education. The present work aims to discuss the perceptions of basic education teachers from a riverside school on Planetary Health issues, in addition to knowing the environmental context of communities and/or riverside schools in the Brazilian State of Amazonas. Methods: The data collection was done through semi-structured interviews with rural education teachers from the south of the state of Amazonas. For the data analysis, we opted for the content analysis (Bardin, 2009) with the support of the N-Vivo software - version 1.5. Results: The results indicated the main environmental problems related to anthropogenic actions in the community and school, in which the following questions stood out: garbage disposal in the river, mineral extraction, lack of basic sanitation, and the predominance of ultra-processed foods in school meals. On the other hand, teachers pointed out the great potential of rural schools to promote the consciousness of children and adolescents on Planetary Health themes. Conclusion: Primary school teachers in rural Amazonia are in contact with a rich source for the creation of teaching materials on PH for students, in view of the importance of the inclusion of PH themes in the formative trajectory of children and adolescents in the basic education curriculum. These experiences provide knowledge about the reality of riverside schools, local traditional issues, environmental sustainability, and the changes occurring in ecosystems, especially in the Amazon.
背景:行星健康是一个跨学科领域,需要成为从基础教育到幼儿教育的各级教育学生课程的一部分。除了了解巴西亚马逊州社区和/或河畔学校的环境背景外,本工作的目的是讨论河边学校基础教育教师对地球健康问题的看法。方法:采用半结构化访谈法对亚马孙州南部农村教育教师进行数据收集。对于数据分析,我们选择在N-Vivo软件1.5版的支持下进行内容分析(Bardin, 2009)。结果:调查结果表明,社区和学校的主要环境问题与人为活动有关,其中河流垃圾处理、矿物开采、基本卫生设施缺乏、学校膳食中超加工食品占主导地位等问题较为突出。另一方面,教师们指出,农村学校在提高儿童和青少年对地球健康主题的认识方面具有巨大潜力。结论:鉴于在基础教育课程中将PH主题纳入儿童和青少年的形成轨迹的重要性,亚马逊农村地区的小学教师可以接触到丰富的资源来为学生编写PH教材。这些经历提供了关于河边学校的现实、当地传统问题、环境可持续性以及生态系统(特别是亚马逊地区)发生的变化的知识。
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引用次数: 1
Planetary health action framework: A case study 行星卫生行动框架:案例研究
Pub Date : 2022-12-01 DOI: 10.32920/ihtp.v2i3.1700
Enrique Falceto de Barros, Tatiana Souza de Camargo, Airton Tetelbom Stein, A. Abelsohn, Diogo Onofre de Souza
Planetary Health (PH) action is urgent to avoid the collapse of Earth's systems that sustain human health. PH care has been proposed as an approach to improve health equity and reduce healthcare´s ecological footprint. This paper presents the conceptual framework of patient-centered PH care as essential for PH action at the community level. We examine and reflect on one primary care clinical case through 8 lenses: 1) Actor-Network Theory, 2) Evidence-based medicine, 3) Patient-Centered Clinical Method; 4) Principles of Primary Care, 5) Proposed new primary care derivate principle of PH care, 6) the WONCA´s (World Organization of Family Doctors) core competencies tree, 7) WONCA´'s curriculum, and 8) Sustainable Development Goal 3. This case offers insights into functions of primary care that mitigate, adapt and build resilience to the challenges of climate emergency and Anthropocene. It “connects-the-dots” to propose a new identity of primary care, elaborate a blueprint for patient-centered PH care and a roadmap for PH action at the community level.
为避免维持人类健康的地球系统崩溃,采取行星健康行动迫在眉睫。PH护理已被提出作为一种改善卫生公平和减少卫生保健的生态足迹的方法。本文提出了以患者为中心的PH护理的概念框架,这对于社区层面的PH行动至关重要。本文通过行动者网络理论、循证医学理论、以患者为中心的临床方法、以患者为中心的临床方法、以患者为中心的临床方法、以患者为中心的临床方法、以患者为中心的临床方法等8个视角对1例初级保健临床病例进行了考察和反思。4)初级保健原则,5)提出新的初级保健衍生的PH护理原则,6)WONCA(世界家庭医生组织)核心能力树,7)WONCA课程,8)可持续发展目标3。本案例深入探讨了初级保健在缓解、适应和建立抵御气候紧急情况和人类世挑战的能力方面的功能。它“连接点”提出了初级保健的新身份,详细阐述了以患者为中心的PH护理蓝图和社区层面PH行动的路线图。
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引用次数: 1
Therapeutic itineraries of children with the early loss of primary teeth: A qualitative phenomenological study 儿童早期乳牙缺失的治疗方案:一项定性现象学研究
Pub Date : 2022-12-01 DOI: 10.32920/ihtp.v2i3.1661
Fernando Valentim Bitencourt, Cristiane Falcão Gaspar, Carolina Scheffler, Jonas Almeida Rodrigues, Ramona Fernanda Ceriotti Toassi
Background: Children with untreated dental caries tend to have a higher prevalence of early tooth loss, causing physical, psychosocial, and financial impacts on children and their families. The present study aims to understand the therapeutic itineraries of children with the early loss of primary teeth due to caries by analyzing the access to and integrality of care. Methods: This was a qualitative phenomenological study. Participants were caregivers, aged 18 years or older, of children up to 12 years of age who attended the University Dental Clinic of a Public University in Southern Brazil. Analysis of medical records and interviews were performed. The saturation criterion defined the sample size (n=44). Results: Public and private health services were accessed by families in the search for treatments for children's oral health conditions until they reached the University Dental Clinic. Children experiencing suffering and pain, who had had multiple extractions, and families affected financially and emotionally by the oral health condition of their children highlighted these itineraries. The resilience of these families in overcoming the challenges experienced and their continuous efforts to find solutions for the oral health care of their children were emphasized. Their relations with students and teachers at the University Dental Clinic were also discussed. Conclusion: The study showed a range of paths taken by children and their families and suggested weaknesses in ensuring the integrality of care for children in the Brazilian National Health System. Qualitative analysis of the therapeutic itineraries of children’s families presented in this study is proposed as a complementary tool for health care. This study has the potential to contribute to the evaluation of health services in the country, strengthening children's oral health.
背景:患有未经治疗的龋齿的儿童往往有较高的早期牙齿脱落率,对儿童及其家庭造成身体、社会心理和经济影响。本研究旨在通过分析护理的可及性和完整性,了解早期乳牙因蛀牙而脱落的儿童的治疗方案。方法:定性现象学研究。参与者是在巴西南部一所公立大学牙科诊所就诊的12岁以下儿童的看护者,年龄在18岁或以上。进行了病历分析和访谈。饱和度标准定义了样本量(n=44)。结果:在到达大学牙科诊所之前,家庭在寻找儿童口腔健康问题的治疗方法时使用了公共和私人保健服务。经历痛苦和痛苦、多次拔牙的儿童,以及因儿童口腔健康状况在经济上和情感上受到影响的家庭,都是这些行程的重点。他们强调了这些家庭在克服所遇到的挑战方面的复原力,以及他们不断努力寻找解决其子女口腔保健问题的办法。他们与大学牙科诊所的学生和老师的关系也被讨论。结论:该研究显示了儿童及其家庭采取的一系列途径,并提出了巴西国家卫生系统在确保儿童护理完整性方面的弱点。在本研究中提出的儿童家庭治疗行程的定性分析作为卫生保健的补充工具。这项研究有可能有助于评估该国的卫生服务,加强儿童的口腔健康。
{"title":"Therapeutic itineraries of children with the early loss of primary teeth: A qualitative phenomenological study","authors":"Fernando Valentim Bitencourt, Cristiane Falcão Gaspar, Carolina Scheffler, Jonas Almeida Rodrigues, Ramona Fernanda Ceriotti Toassi","doi":"10.32920/ihtp.v2i3.1661","DOIUrl":"https://doi.org/10.32920/ihtp.v2i3.1661","url":null,"abstract":"Background: Children with untreated dental caries tend to have a higher prevalence of early tooth loss, causing physical, psychosocial, and financial impacts on children and their families. The present study aims to understand the therapeutic itineraries of children with the early loss of primary teeth due to caries by analyzing the access to and integrality of care. Methods: This was a qualitative phenomenological study. Participants were caregivers, aged 18 years or older, of children up to 12 years of age who attended the University Dental Clinic of a Public University in Southern Brazil. Analysis of medical records and interviews were performed. The saturation criterion defined the sample size (n=44). Results: Public and private health services were accessed by families in the search for treatments for children's oral health conditions until they reached the University Dental Clinic. Children experiencing suffering and pain, who had had multiple extractions, and families affected financially and emotionally by the oral health condition of their children highlighted these itineraries. The resilience of these families in overcoming the challenges experienced and their continuous efforts to find solutions for the oral health care of their children were emphasized. Their relations with students and teachers at the University Dental Clinic were also discussed. Conclusion: The study showed a range of paths taken by children and their families and suggested weaknesses in ensuring the integrality of care for children in the Brazilian National Health System. Qualitative analysis of the therapeutic itineraries of children’s families presented in this study is proposed as a complementary tool for health care. This study has the potential to contribute to the evaluation of health services in the country, strengthening children's oral health.","PeriodicalId":231465,"journal":{"name":"International Health Trends and Perspectives","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116135689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The relationship between electronic health literacy and individual factors among adults with chronic pain: A cross-sectional study 成人慢性疼痛患者的电子健康素养与个体因素的关系:一项横断面研究
Pub Date : 2022-12-01 DOI: 10.32920/ihtp.v2i3.1671
G. Martorella, Hye‐Jin Park, G. Schluck
Introduction: Chronic pain requires individuals to develop self-management skills that rely on health literacy and, more recently, eHealth literacy. Very few studies have investigated potential predictors of eHealth literacy in chronic pain patients. Therefore, the purpose of this study is to explore potential predictors of eHealth literacy among individual characteristics and pain-related clinical factors, as a preliminary step to understanding the multi-variable relationships that could be examined in a larger study. Methods: A cross-sectional online survey was distributed to adults living in the United States with various chronic pain conditions using Amazon’s Mechanical Turk. A convenience sample of 196 participants was recruited. The independent variables of interest regarding their relationship with eHealth literacy (dependent variable) included demographics, health literacy, chronic pain severity, pain attitudes and coping skills. Chi square tests of association, and independent samples t-tests were used to examine the bivariate relationships. Results: The majority of the sample suffered from chronic pain for more than 2 years with 48% suffering from chronic back pain. Most of the sample (n=184, 93.9%) had high eHealth literacy. Significant relationships were found between eHealth literacy and the following variables: marital status, education level, and age, as well as health literacy, chronic pain interference with activities and chronic pain attitudes. These warrant further exploration in a larger study using logistic regression. Conclusions: our findings provide new information on the relationship between eHealth literacy levels, pain-related individual factors such as attitudes toward pain, and clinical outcomes, i.e., pain interference with physical and psychological function. Although further research is needed to investigate eHealth literacy predictors and mediators, these findings promote the evidence-based development and evaluation of interventions enhancing eHealth literacy skills, as well as self-management skills of chronic pain patients.
慢性疼痛需要个人发展自我管理技能,这依赖于健康素养和最近的电子健康素养。很少有研究调查了慢性疼痛患者的电子健康素养的潜在预测因素。因此,本研究的目的是探索个人特征和疼痛相关临床因素之间的电子健康素养的潜在预测因素,作为了解多变量关系的初步步骤,可以在更大规模的研究中进行检验。方法:使用亚马逊的土耳其机器人,对生活在美国的患有各种慢性疼痛的成年人进行横断面在线调查。招募了196名参与者作为方便样本。与电子健康素养(因变量)相关的自变量包括人口统计、健康素养、慢性疼痛严重程度、疼痛态度和应对技能。关联的卡方检验和独立样本t检验用于检验双变量关系。结果:大多数样本患有2年以上的慢性疼痛,其中48%患有慢性背痛。大多数样本(n=184, 93.9%)具有较高的电子健康素养。发现电子健康素养与以下变量之间存在显著关系:婚姻状况、教育水平和年龄,以及健康素养、慢性疼痛对活动的干扰和慢性疼痛态度。这些值得在使用逻辑回归的更大规模研究中进一步探索。结论:我们的研究结果为电子健康素养水平、疼痛相关的个人因素(如对疼痛的态度)和临床结果(即疼痛对身体和心理功能的干扰)之间的关系提供了新的信息。尽管需要进一步的研究来调查电子健康素养的预测因素和中介因素,但这些发现促进了基于证据的干预措施的开发和评估,以提高电子健康素养技能,以及慢性疼痛患者的自我管理技能。
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引用次数: 0
Exploring health care for transgender people in the Brazilian health system: Qualitative descriptive-interpretative study 探索巴西卫生系统中变性人的卫生保健:定性描述-解释性研究
Pub Date : 2022-12-01 DOI: 10.32920/ihtp.v2i3.1652
Mateus Aparecido De Faria, T. Paiva, Andressa Marques Cornelli, Carolina Feijó Bitencourt Voigt, C. Rocha, C. Modena
The guarantee of rights in Brazil is legitimized through its Constitution of the Republic and its national health system needs to follow a list of prerogatives that include, also, transgender people. Currently there are situations in which the expectation of rights is broken and the free exercise of life of this population is prevented. This article analyzes access to health services by trans people in the health system in Brazil. The investigation was carried out in cities in the metropolitan region of a municipality in southeastern Brazil, through qualitative, exploratory and descriptive-interpretive research. The trans population faces many difficulties in accessing the services that make up the Brazilian Health System, such as the lack of qualification of health professionals, barriers to the use of the social name and structural prejudices in society.
巴西通过《共和国宪法》使权利保障合法化,其国家卫生系统需要遵循一系列特权,其中也包括变性人。目前,在某些情况下,对权利的期望被打破,这一人口的自由生活受到阻碍。本文分析了巴西卫生系统中变性人获得卫生服务的情况。通过定性、探索性和描述性解释研究,在巴西东南部一个直辖市的大都市区进行了调查。跨性别人群在获得构成巴西卫生系统的服务方面面临许多困难,例如缺乏卫生专业人员的资格,使用社会名称的障碍以及社会中的结构性偏见。
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引用次数: 0
Rise against the machine: Creating global health for vulnerable populations through child nutrition 反抗机器:通过儿童营养为弱势群体创造全球健康
Pub Date : 2022-12-01 DOI: 10.32920/ihtp.v2i3.1719
Meryl Fury, Carrie Bruno, Ashok Nagella
There has been much talk about the connection between Global North food systems, health, and climate change. However, very little action has been taken that has made a measurable difference. The authors propose a novel view of the structure of our food system and what we can do to mitigate its impact on the environment, health, and vulnerable populations, with our children being the most vulnerable of all. Finally, a detailed outline of a viable solution is provided.
关于全球北方粮食系统、健康和气候变化之间的联系,人们讨论了很多。然而,几乎没有采取什么行动来产生可衡量的变化。作者提出了一种新的视角来看待我们的食物系统结构,以及我们可以做些什么来减轻它对环境、健康和弱势群体的影响,我们的孩子是最脆弱的。最后,给出了一个可行的解决方案的详细大纲。
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引用次数: 0
The mental well-being of children and adolescents during the COVID-19 pandemic: A systematic review of qualitative literature COVID-19大流行期间儿童和青少年的心理健康:对定性文献的系统回顾
Pub Date : 2022-12-01 DOI: 10.32920/ihtp.v2i3.1664
Kalpana Subasinghe, A. Pathiranage
COVID-19 has led to significant isolation resulting in a rise in educational inequity and mental illness among youth. A systematic literature review of qualitative studies was conducted adhering to PRISMA 2020 guidelines, to describe the mental wellbeing of children and adolescents during the COVID-19 pandemic. The protocol has been registered in the PROSPERO International Prospective Register of Systematic Reviews. Three Electronic databases were searched for original, qualitative, peer-reviewed, full text, English journal articles published from December 2019- to May 2020, conducted among children and their parents. We extracted the results that describe the psychological impact on children and their parents amidst COVID-19. Thirteen studies were included in the final review. Four major themes (1. Negative and maladaptive behavior 2. Social and psychological disruption 3. Emotion regulation 4. Value of family time) were identified through Inductive Thematic Synthesis. Although children regulate their emotions effectively, most of the children seem to experience maladaptive behaviors which may have a devastating effect on their development. Health care professionals, caregivers, school officials, and social workers should address these aspects of childcare during a pandemic and in the post-pandemic period.
2019冠状病毒病导致严重的隔离,导致教育不平等和青少年精神疾病的增加。根据PRISMA 2020指南,对定性研究进行了系统的文献综述,以描述COVID-19大流行期间儿童和青少年的心理健康状况。该议定书已在普洛斯佩罗国际前瞻性系统评价登记册中登记。在三个电子数据库中检索了2019年12月至2020年5月期间在儿童及其父母中发表的原创、定性、同行评审、全文的英文期刊文章。我们提取了描述COVID-19对儿童及其父母的心理影响的结果。13项研究被纳入最终综述。四大主题(1);消极和适应不良行为社会和心理混乱。情绪调节通过归纳主题综合来确定家庭时间的价值。虽然孩子们能有效地调节自己的情绪,但大多数孩子似乎都有适应不良的行为,这可能会对他们的发展产生破坏性的影响。卫生保健专业人员、护理人员、学校官员和社会工作者应在大流行期间和大流行后时期处理儿童保育的这些方面。
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引用次数: 0
Health promotion in primary care across Brazil: Genealogic-inspired qualitative study 巴西初级保健中的健康促进:家谱启发的定性研究
Pub Date : 2022-12-01 DOI: 10.32920/ihtp.v2i3.1660
Fernanda Carlise Mattioni, Liara Saldanha Brites, Liciane Da Silva Costa Dresch, Cristianne Maria Famer Rocha
Objective: To describe and analyze Health Promotion practices in Primary Health Care. Method: Genealogic-inspired qualitative, descriptive, and exploratory research conducted in a PHC service in Porto Alegre, Rio Grande do Sul, Brazil. Twenty-three semi-structured interviews were held with the service staff from February to May 2020. The data were qualitatively analyzed using genealogically inspired techniques, which allowed us to identify tensions, disputes, discourses, practices, and power relationships. Results: We established eight sets of Health Promotion practices: 1) Educational activities focused on behavioral/habit changes and development of personal abilities; 2) Intersectoral practices and community social networks involving other community equipment; 3) Practices that encourage community organization and participation; 4) Integrative and Complementary Health practices; 5) Practices that stimulate meeting people, sociability, art, and creativity; 6) Practices that encourage environmental and food sustainability; 7) Practices that stimulate income generation; 8) Community communication practices. Conclusion: We identified a heterogeneous field of practices to promote health established through the circulation of different types of knowledge and powers. The practices are permeated by discourses linked to neoliberal governability and practices that position themselves against such discourse. 
目的:描述和分析初级卫生保健的健康促进实践。方法:在巴西南大德州阿雷格里港的初级保健服务中进行了家谱启发的定性、描述性和探索性研究。2020年2月至5月,对服务人员进行了23次半结构化访谈。使用家谱启发的技术对数据进行定性分析,这使我们能够识别紧张,争议,话语,实践和权力关系。结果:我们建立了八套健康促进实践:1)以行为习惯改变和个人能力发展为重点的教育活动;2)涉及其他社区设备的跨部门做法和社区社会网络;3)鼓励社区组织和参与的做法;4)综合和补充保健做法;5)促进与人交往、社交、艺术和创造力的实践;6)鼓励环境和粮食可持续性的做法;7)刺激创收的做法;8)社区沟通实践。结论:我们发现了一个通过不同类型的知识和权力的流通来促进健康的异质实践领域。实践中充斥着与新自由主义治理能力相关的话语,以及将自己定位于反对这种话语的实践。
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引用次数: 0
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