Senior citizens have become a major part of the clientele of general practitioners and home care nurses due to a major demographic transition in most western countries. How do the health concepts in professional practice reflect these trends? Research has largely investigated the health concepts of lay people. This study is focused on the representations of health in old age held by two groups of professionals— general practitioners and nurses—both working in home care with elderly people in two German cities. The results show how health professionals use an extended concept of health, which focuses on the life situation of the old person, on autonomy, self-determination or independence and on how the elderly manage disease and physical restrictions.
Get full access to this article
View all access options for this article.
References
1.
Abel, T., Bucher, S., Duetz, M., Niemann, S. & Walter, E. (2002). Gesundheitsrelevante Lebensstile und soziale Differenzierung: Zur Weiterentwicklung eines empirischen Konzepts in der Public Health Forschung. In U. Flick (Ed.), Innovation durch New Public Health(pp. 113–136). Göttingen: Hogrefe .
2.
Advisory Council for the Concerted Action in Health Care. (2001). Appropriateness and efficiency: Vol. 1: The foundation of aims, prevention, user orientation and participation report 2000/2001. Bonn: Advisory Council for the Concerted Action in Health Care .
3.
Anda, R. F., Remington, P. L., Sienko, D. G., & Davis, R. M. (1987). Are physicians advising smokers to quit? The patient’s perspective . Journal of the American Medical Association, 257(14), 1916–1919 .
4.
Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. San Francisco, CA: Jossey-Bass .
5.
Arnold, M., Helou, A., & Schwartz, F. W. (2000). Pl‰doyer für eine Neuorientierung der medizinischen Pr‰vention und Rehabilitation. In M. Arnold, M. Litsch, & F. W. Schwartz (Eds.), Der Krankenhaus-Report 99(pp. 11–20). Stuttgart: Schattauer.
6.
Baltes, P. B., & Mayer, K. U. (Eds.) (1999). The Berlin Aging Study. Aging from 70 to 100. New York: Cambridge University Press .
7.
Bunker, J. P., Frazier, H. S., & Mosteller, F. (1995). The role of medical care in determining health. Creating an inventory of benefits. In B. J. Amick III, S. Levine, A. R. Tarlov, & D. C. Walsh (Eds.), Society and health(pp. 305–341). New York: Oxford University Press .
8.
Deutscher Bundestag. (1998). Demographischer Wandel. Zweiter Zwischenbericht der EnquÍte-Kommission ‘Demographischer Wandel’. Herausforderungen unserer ‰lter werdenden Gesellschaft an den Einzelnen und die Politik. Referat ÷ffentlichkeitsarbeit. Bonn: Universit‰tsdruckerei.
9.
Filner, B., & Williams, T. F. (1979). Health promotion for the elderly: Reducing functional dependency. In the US Department of Health, Education, and Welfare, Public Health Service publication, Healthy people(pp. 365–379). Washington, DC: US Government Printing Office .
10.
Flick, U. (Ed.) (1998a). Psychology of the social. Cambridge, MA: Cambridge University Press .
11.
Flick, U. (1998b). The social construction of individual and public health: Contributions of social representations theory to a social science of health . Social Science Information, 37(4), 639–662 .
12.
Flick, U. (Ed.). (1998c). Wann fühlen wir uns gesund? Subjektive Vorstellungen von Gesundheit und Krankheit(When do we feel healthy? Subjective representations of health and illness). Weinheim & Munich: Juventa .
13.
Flick, U. (2000a). Qualitative inquiries into social representations of health . Journal of Health Psychology, 5, 309–318 .
14.
Flick, U. (2000b). Episodic interviewing. In M. Bauer & G. Gaskell (Eds.), Qualitative researching with text, image and sound: A handbook(pp. 75–92). London: Sage Publications .
15.
Flick, U. (Ed.) (2002a). Innovation durch New Public Health(Innovation through New Public Health). Göttingen: Hogrefe .
16.
Flick, U. (2002b). An introduction to qualitative research, 2nd edn. London/Thousand Oaks, CA/Dehli: Sage Publications .
17.
Flick, U., Fischer, C., Walter, U., & Schwartz, F. W. (2002). Social representations of health held by health professionals: The case of general practitioners and home care nurses . Social Science Information, 41, 581–602 .
18.
Fontana, S. A., Baumann, L. C., Helberg, C., & Love, R. R. (1997). The delivery of preventive services in primary care practices according to chronic disease status . American Journal Public Health, 87, 1190–1196 .
19.
Guggenmoos-Holzmann, I., Bloomfield, K., Brenner, H., & Flick, U. (Eds.) (1995). Quality of life and health: Concepts, methods and applications. Berlin: Blackwell Science .
20.
Güther, B. (1998). Morbidit‰t und Krankheitskosten von Alten . Gesundheitswesen, 60, 39–46 .
21.
Herzlich, C. (1973). Health and illness. A social psychological analysis. London: Academic Press .
22.
Kennie, D. (1984). Health maintenance of the elderly . Journal of the American Geriatrics Society, 32, 316–323 .
23.
Knesebeck, O. von dem, Janßen, C., & Lüschen, G. (1999). Alter und die Inanspruchnahme ambulanter ‰rztlicher Versorgung—ein Ost-West-vergleich . Public Health Forum, 25, 5-5 .
24.
Kruse, A. (2002). Gesund altern. Stand der Pr‰vention und Entwicklung erg‰nzender Pr‰ventionsstrategien.Available at www.bmgesundheit.de/ downloadsthemen/sonstiges/gesundaltern.pdf
25.
Marks, D. F., Murray, M., Evans, B., & Willig, C. (2000). Health psychology: Theory, research and practice. London/Thousand Oaks, CA/Dehli: Sage Publications .
26.
Moscovici, S. (2000). Social representations:Explorations in social psychology. Cambridge: Polity .
27.
Muhr, T. (1997). ATLAS.ti. Qualitative data analysis, management, model building(Manual for the software). Scolari: Sage .
28.
Robert Koch-Institut in Zusammenarbeit mit dem Statistischen Bundesamt (2002). Gesundheit im Alter.Berlin: Verlag Robert Koch-Institut.
29.
Schach, E., Schwartz, F. W., & Kerek-Bodden, H. E. (Eds.). (1989). Die EvaS-Studie: Eine Erhebung über die ambulante medizinische Versorgung in der Bundesrepublik Deutschland.Köln: Deutscher ƒrzte-Verlag.
30.
Singer, B. H., & Manton, K. G. (1998). The effects of health changes on projections of health service needs for the elderly population of the United States . Proc. National Academy of Sciences, USA, 95, 15618–15622 .
Walter, U., Flick, U., & Schwartz, F. W. (2000). Gesundheits—und Alterskonzepte von ƒrzten und Pflegekr‰ften in der ambulanten Versorgung ‰lterer Menschen. Projektantrag. Berlin/Hannover: Ms.
33.
Walter, U., & Schwartz, F. W. (2002). Altern: Beitr‰ge der Deutschen Public Health Forschung. In U. Flick (Ed.), Innovation durch New Public Health(pp. 179–192). Göttingen: Hogrefe.
34.
World Health Organization. (1948). Constitution. Geneva: World Health Organization .
35.
World Health Organization. (1986). Office of Research, Promotion and Development. Research on ageing: Report of a subcommittee of the ACHR. Geneva: World Health Organization .
36.
World Health Organization. (1998). The world health report. Life in the 21st century: A vision for all. Geneva: World Health Organization .
37.
World Health Organization. (2002). Active ageing: A policy framework. Geneva: World Health Organization .
