"If we only got a chance.” Barriers to and possibilities for a more health-promoting health service

Abstract

With the overall objective to develop future strategies for a more health-promoting health service in Sweden, the aim of this paper was to describe how health personnel view barriers and possibilities for having a health-promoting role in practice. Seven focus group discussions were carried out with a total of 34 informants from both hospital and primary health care settings in Sweden. The informants represented seven professional groups; counselors, occupational therapists, assistant nurses, midwives, nurses, physicians, and physiotherapists. The data were analyzed using qualitative content analysis. The analysis resulted in one major theme "If we only got a chance". The theme captures the health professionals' positive view about, and their willingness to, develop a health-promoting and/or preventive role, while at the same time feeling limited by existing values, structures, and resources. The four categories, "organizational commitment to a paradigm shift", "recognition of staff as health-promoting instruments", "a balance between resources and tasks", and "freedom of action" capture what is needed for implementing and increasing health promotion and preventive efforts in the health services. The study indicates that an organizational setting that support health promotion is still to be developed. There is a need for a more explicit leadership with a clear direction towards the goal of "a more health-promoting health service" and with enough resources for achieving this goal.