La factibilidad del consejo preventivo sobre accidentes de tráfico en atención primaria.

Student thesis: Doctoral thesis


1. Introduction: Traffic accidents (TA) are a health significant problem due to the mortality, morbility and disabilities they cause. There are three major risk groups: population between 15-24 years old motorbike users, population between 18-24 car drivers, and pedestrians in urban zone older than 65 years. In the frame of the preventive activities, and as a basic work element of Primary Health Care (PHC) Professionals, we could find the health education on lifestyles or behaviors that directly affect the Health Status. Health Education is essential and it is Health Practitioners´ responsibility to give advice in road safety. 2. Objectives and hypotheses: The aims of this work are: 1. To assess the level of knowledge and attitudes of PHC Professionals about TA preventive advice relating to: epidemiology (incidence and prevalence), frequent injuries produced by TA, use of active and passive safety measures to be recommend to the general population, alcohol consumption, drugs consumption and other potentially dangerous substances for driving as well as illnesses affecting driving abilities. 2. To explore the feasibility of AP preventive advice about road safety on: responsibility of every (HP) (general practitioners, pediatricians, and nurses), facilitator elements and barrier elements. The hypotheses are as follows: 1. The level of TA prevention knowledge is not enough to make a preventive advice. 2. PHC Professionals knowledge as well as their attitude towards road safety are different depending on age, sex, familiar core, profession (doctor or nurse), experience in emergency services, and personal experience in TA. 3. PHC professionals consider the preventive advice non factible due to lack of time. 3. Method Design: this work has been done with the combination of quantitative and qualitative methodologies. The quantitative study is descri ptive transversal and the qualitative one by focal group's technique. Both studies took place from October 2000 to March 2001.Setting: Primary Attention Centers in the City of Barcelona. Study subjects: Doctors (General Practitioners and Pediatricians) and Nurses in Barcelona. Measure tools: self survey on preventive road safety advice knowledge and attitudes, and analyses of focal groups. Variables: according to working tools they would be: age, sex, civil state, number of children, profession, work center, knowledge level on preventive advice, responsibility grade, facilitator and barrier elements (time, incentives, motivation, and level of self confidence). 4. Results Quantitative study: Rate of response to the questionnaire of 54.8 % (187/341). Answered by 74.6% women and 25.4% men, average age of 41.3 years old (SD 8.3), ranging 23-64 years old (CI 95%: 40.1-42.5) years. They were taking an average of 11.6 working years (SD 7.6), ranging 1-43 years of practice [CI 95 %: 10.5-11.7]. They declare to have personal or relative experience related to some TA 59,9 % [CI 95 % 52.9-66.9]. The main variable (score of the whole test) showed an average of 11.3 (CI 95 % 10.9-11.7). The total score of the test was connected to age in an inverse and statistically significant way (r = -0.344; r2 = 0.118; p < 0.001) and years of experience (r = -0.194; r2 = 0.038; p = 0.009). The overcoming skills test were connected to the profession of the Doctor (OR 3.7; CI95 % 1.5-9), age group up to 45 years (OR 3.1; CI95 % 1.3-7.6) and being driver (OR 2.9; CI95 % 1.04-8.3). Qualitative study Four grouped interviews were carried out (focal groups), three segmenting according to type of Health Professional and the fourth one with participation of all professionals. TA are perceived as a serious problem, but not a main priority. It has been identified a significant lack of coordination of efforts to reduce the TA from diverse areas. The level of awareness of the HP towards the TA is changeable depending on having been employed with an Emergency Services dealing directly with TA or those having children on their own The main barriers for the viability of its application are: lack of time, training, information about the efficiency of the preventive actions, lack of resources and of motivation related to the ignorance of the efficiency of these advices. The highlighted elements that might ease the application of this program are as follows: to have information about efficiency applied actions, help handbooks, supporting material in surgeries, awareness of PHC professionals before the beginning of the program application, and coordination of efforts with other areas to reinforce the efficiency of this program. 5. Conclusions 1. PHC professionals have a intermediate level of knowledge, which need formative activities. 2. HP consider important the preventive advice in TA, but not as a priority activity. 3. The main barriers to apply the preventive advice detected by PA professionals are: lack of time, absence of material resources (educational and supporting), shortage of training, and low motivation. 4. The elements that would ease the preventive advice in TA are: Information on intervention efficiency, supporting material in surgeries, awareness campaigns, and increase in time for this function. 5. Health Professionals believe is necessary that the Health Authority as well as Scientific Societies are aware of the importance of activities carried out between HP and other involved groups.
Date of Award16 Jan 2006
Original languageUndefined/Unknown
SupervisorRafael Azagra Ledesma (Director) & Javier Mundet Tuduri (Director)

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