University of Twente Student Theses


Positive health in Dutch public health services possibilities for integration of the concept positive health in work-related activities of professionals at the Dutch Public Health Services (GGD)

Berkenbosch, T.S. (2016) Positive health in Dutch public health services possibilities for integration of the concept positive health in work-related activities of professionals at the Dutch Public Health Services (GGD).

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Abstract:Introduction: At the moment the health system in the Netherlands is dominated by a biomedical, body and disease oriented approach. In order to meet the challenges in healthcare a transformation towards a broader-oriented system is necessary. In recent years a new, more holistic approach, has been introduced. This approach: Positive Health, is focussing on the ability to adapt to, and self-managing of social, physical and emotional challenges. Because this concept is embraced by several Public Health Services, a change for the employees towards Positive Health is necessary. This study focuses on the employees’ willingness to change and possibilities and difficulties for integration of the concept Positive Health in the Public Health service’ daily work-routine. Methodology: This explorative research uses a mixed method design. To study the employees’ willingness to change, the possibilities and difficulties regarding Positive Health in the work-related sphere both quantitative and qualitative methods are used. To measure the willingness to change and to what extent the employees themselves think how they are working towards the concept an online questionnaire was used. To explore how the concept is reflected in the activities and what possibilities and difficulties the employees encounter with the integration of the concept, focus-group interviews and semi-structured interviews were carried out. The guidance of the interviews is based on the concept Positive health. Every sub-department of the department Public Health, of the Public Health Service Twente was interviewed, including the head of the department and a secretary. For the data analysis the design of parallel triangulation strategy is used. The quantitative data is analysed with the program SPSS and the qualitative data with the program ATLAS.ti. Results: The analysis was carried out on 36 respondents. In general the employees are willing to change to the concept of Positive Health, but the aspects of 1) effects on their work activities, 2) the provision of information and 3) the control the employees have towards the change were rated more negative. The sub-departments inspection & hygiene and public mental healthcare rated more aspects negative than the other sub-departments. The extent to which the employees think they are working towards the six dimensions was rated in average from 4.2 to 4.9, on a nine points Likert scale. The sub-departments inspection & hygiene and forensics rated the concept Positive Health lower on average in average the concept Positive Health lower. The sub-department tuberculosis rated the concept Positive Health higher on average. Related to the dimensions bodily function and mental functions & perception the most work activities were mentioned, the least for quality of life and daily functioning. The sub-department sexual health identified the most and most different work activities. Motivational Interviewing, broaden organizational-wide approach, looking beyond your main tasks and a greater collaboration were mentioned possibilities for a better integration of the concept in their work activities. Difficulties mentioned most by the employees are: not every aspect is a task for the employees, some employees only have indirect influence to the client, the language-barrier in certain cases and definitions within and of the concept of what Positive Health is, is considered to be vague. Discussion: This explorative mixed method research focuses on the views of employees of the Public Health Service Twente regarding the concept Positive Health in their work activities, and is the first study on Positive Health in the department of Public Health. Using this design much data is collected. When interpreting the quantitative results, selection bias has to be taken into account, because the number of respondents of some sub-departments was very low. Two interview types were used, that have been taken into account with the interpretation of the qualitative results. Respondents mentioned in the quantitative research are willing to change towards the concept Positive Health, but rated some aspects negatively. Despite of the identification of work activities and possibilities by the sub-departments several difficulties were also mentioned. Meetings about the continuation between employees is necessary for further integration of the concepts, the term Positive Health with corresponding aspects has to be evaluated and Motivational Interviewing seems like the best feasible working method for Positive Health.
Item Type:Essay (Master)
GGD, Enschede, Netherlands
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Health Sciences MSc (66851)
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