OBJECTIVE: This article presents the developments and challenges involved in integrating prevention into primary care. It is based on three leading French reports on the subject.
RESULTS: Prevention and health promotion initiatives are described as poorly organized, being based on individual and opportunistic initiatives. In particular, this is due to the difficulty of integrating a collective, long-term dimension into preventive clinical practices, even though most preventive situations require a coordinated, repeated approach that is integrated intothe care offered. At the same time, the primary care system is being structured around coordinated practice. These organizational changes are opportunities to integrate prevention into the practices of primary care professionals.
CONCLUSIONS: A great deal depends on successfully integrating prevention into the structuring and organizational evolution of the primary care system. The convergence of the operationalization of the preventive shift and the organizational transformation of the primary care system is potentially synergistic for the integration of prevention. But this development is not self-evident and must be accompanied by precise, up-to-date, and contextualized knowledge of the factors influencing the practice of prevention.
目的:本文介绍了将预防纳入初级保健的发展和挑战。它基于法国关于这一主题的三份主要报告。
结果:预防和健康促进计划被描述为组织不良,基于个人和机会主义的举措。特别是,这是由于难以整合一个集体,将长期维度纳入预防性临床实践,尽管大多数预防情况需要协调,融入所提供护理的重复方法。同时,初级保健系统是围绕协调实践而构建的。这些组织变革是将预防纳入初级保健专业人员实践的机会。
结论:在很大程度上取决于成功地将预防纳入初级保健系统的结构和组织演变。预防性转变的可操作性和初级保健系统的组织变革的融合对于预防的整合具有潜在的协同作用。但这种发展并不是不言而喻的,必须伴随着精确,最新的,以及对影响预防实践的因素的情境知识。