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Updated: May 12, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
[Community diagnosis using qualitative techniques of expectations and experiences in a health area in need of social
Juan Andrés Ramos Ruiz1, Alejandro Pérez Milena, Natalia Enguix Martínez
1Medicina de Familia y Comunitaria, Centro de Salud de Orcera, Jaén, España.
Objective:
To know the views, experiences and expectations of care provided by the Andalusian Public Health System (SSPA) of users of an urban area in need of social transformation (ZNTS).
Design:
Qualitative methodology (exploratory study).
Location:
Urban basic health zone (16,000 inhabitants, 40% ZNTS).
Participants:
Purposive sampling of users of SSPA and community leaders. Homogeneity criteria: age. Heterogeneity criteria: sex, frequency, active/pensioner, level cultural/economic.
Main Interventions:
Conversational techniques recorded by videotape and moderated by a sociologist (user dicussion groups and in-depth interviews for community leaders).
Analysis:
transcription of speeches, coding, categories triangulation and final outcome.
Results:
Seven groups (43 participants, 58% ZNTS) and 6 leaders. They want continuity of care and choice of professionals, but not the medical change without information and attention's discontinuity primary care/hospital. There's bad physical accesibility by the urban environment in the ZNTS and is criticized admission services and paperwork; the programmed appointment and the electronic prescriptions are improvements but asking more hospital referrals and reviews. There's good appreciation of the professionals (primary care-closer, hospital-greater technical capacity). It needs to improve nursing education and speed of emergency assistance. There's a lack of leadership in the system organization, very fragmented. They know a range of services focusing on the demand for care; other health activities not spread to the users.
Conclusion:
The SSPA should incorporate the views and expectations of communities in social risk to a real improvement in the quality of care.
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