Reorientation to more health promotion in health services – a study of barriers and possibilities from the perspective of health professionals

Figures & data

Table 1 Number of respondents in various categories

	Counselor	Dietician	Midwife	Nurse	Occup. therapist	Physician	Physiotherapist	Psychologist	Total
Sexa
Men	6	1	0	34	4	113	28	14	200
Women	73	18	78	203	81	130	112	55	750
Years in professionb
0–8	16	7	17	67	16	92	32	29	276
9–17	6	6	23	61	44	57	61	15	273
18–28	28	5	19	57	19	55	28	15	226
29–42	27	1	19	47	5	35	16	10	160
Workplace
Hospital	56	11	50	182	147	191	78	58	673
PHCC	14	7	24	50	35	49	59	5	243
Other	9	1	1	5	3	4	3	6	35
Field of work
Research
No	9	11	71	212	76	143	124	54	761
Yes	70	8	7	25	9	101	16	15	190
Teaching
No	70	10	63	198	78	151	130	53	744
Yes	9	9	15	39	7	92	20	16	207
Total	79	19	78	237	85	244	140	69	951

Notes:

a Physicians one missing value;

b Missing values (n = 16).

Table 2 Attitudes towards more health-promotion in health services, % agree

	Health services play a major role in long-term health development		Health promotion and disease prevention are the responsibility of the entire health service		Health promotion and disease prevention are primarily the responsibility of primary health care		Health services should make prevention the priority rather than treatments		Health orientation as a strategy, is necessary to provide more effective health care
	% agree	P	% agree	P	% agree	P	% agree	P	% agree	P
Sex		0.281		<0.001		0.019		0.377		<0.001
Men	95		86		65		48		84
Women	97		95		54		52		94
Workplacea		0.478		0.502		0.979		<0.001		0.608
Hospital	96		93		56		45		90
Primary health care center	97		94		56		69		97
Profession		0.030		<0.001		0.430		<0.001		<0.001
Counselor	98		96		45		40		95
Dietician	93		100		59		79		100
Midwife	98		98		58		68		95
Nurse	97		96		55		54		95
Occup. therapist	98		96		55		57		92
Physician	93		85		61		38		82
Physiotherapist	98		93		56		63		98
Psychologist	97		96		56		59		95
Years in profession		0.287		0.622		0.834		0.803		0.878
0–8	96		92		57		53		91
9–17	96		94		55		49		91
18–28	96		92		54		53		93
29–42	99		95		60		49		92
Field of work
Research		0.432		0.404		0.959		0.122		0.120
No	96		93		56		53		93
Yes	97		92		56		45		89
Teaching		0.716		0.001		0.693		0.474		0.006
No	96		95		57		52		93
Yes	97		87		55		48		87
Total	96		93		56		51		92

Note:

a Workplace “other” was excluded from the analysis due to low number.

Figure 1 Reported willingness to focus more on health promotion and disease prevention, by sex, workplace, and profession (P < 0.001).

Figure 2 Barriers for health promotion in practice, presented in decreasing order of frequency.

Figure 3 Percentages of respondents reporting heavy workload as a barrier for health promotion in practice, by profession and workplace (hospital and primary health care center) (P < 0.001).

Table 3 Barriers for health promotion in practice, among those reporting willingness to focus more on health promotion and disease prevention

	Limited competence		Heavy workload		Lack of managerial support		No one listens to my ideas		My competence is not asked for/used		Low decision-latitude		Unclear objectives		Lack of guide lines		Low priority from the management		Lack of reward-system		Lack of co-operation		Other
	%	P	%	P	%	P	%	P	%	P	%	P	%	P	%	P	%	P	%	P	%	P	%	P
Sex		0.606		0.437		0.675		0.308		0.779		0.843		0.789		0.476		0.186		0.886		0.141		0.505
Men	13		74		15		8		25		17		38		42		39		23		30		12
Women	16		68		13		5		22		18		40		48		30		22		20		10
Workplacea		0.127		<0.001		0.318		0.134		0.224		0.038		0.858		0.047		0.872		0.432		0.583		0.330
Hospital	18		62		12		6		21		21		40		51		31		24		22		11
PHCC	11		87		16		3		27		11		39		38		30		19		20		8
Profession		0.022		0.002		0.394		0.976		<0.001		0.733		0.110		0.546		0.201		0.405		0.697		0.627
Counselor	14		76		28		4		22		22		49		49		41		31		22		10
Dietician	0		79		21		0		57		14		57		57		43		21		21		21
Midwife	12		76		20		5		29		20		29		48		24		32		17		5
Nurse	16		64		12		5		20		16		43		46		27		21		20		10
Occup. therapist	7		74		13		6		53		13		32		39		32		19		32		10
Physician	23		84		11		6		18		22		30		46		37		26		21		9
Physiother	5		63		16		4		37		16		38		60		38		20		27		12
Psychologist	4		55		8		7		17		14		49		41		38		10		25		20
Years in profession		<0.001		0.711		0.439		0.191		0.100		0.754		0.414		0.659		0.782		0.850		0.278		0.146
0–8	30		72		9		2		19		15		37		47		32		22		20		9
9–17	8		67		12		8		32		21		42		48		30		21		27		17
18–28	10		72		15		7		20		16		44		52		28		26		24		8
29–42	7		63		19		5		17		20		29		40		37		21		12		4
Field of work
Research		0.106		0.648		0.753		0.278		0.267		0.758		0.742		0.401		0.327		0.373		0.692		0.388
No	17		70		13		4		22		18		40		46		30		23		21		10
Yes	10		67		14		8		29		16		38		52		36		18		24		13
Teaching		0.267		0.279		0.219		0.417		0.255		0.063		0.537		0.383		<0.001		0.286		0.804		0.989
No	17		68		12		5		22		20		40		48		27		21		21		10
Yes	11		75		18		7		29		10		36		42		49		27		23		10
Total	16		70		13		5		23		18		40		47		31		22		22		10

Note:

a Workplace “other” was excluded from the analysis due to low number.