2019-02-21
Towards a universal concept of vulnerability: Broadening the evidence from the elderly to perinatal health using a Delphi approach
Publication
Publication
Background
The concept ’vulnerability’ is prevalent in the public domain, health care, social institutions
and multidisciplinary research. Conceptual heterogeneity is present, hampering the creation
of a common evidence-base of research achievements and successful policies. Recently an
international expert group combined a specific literature review with a 2-stage Delphi procedure, arriving at a seemingly universal concept of vulnerability for the elderly with applications for research instruments. We replicated and extended this study, to generalize this
result to health in general, and perinatal health in particular.
Methods
Two independent expert panels (general health, perinatal health) repeated the Delphi-procedure, using an extended and updated literature review to derive statements on the concept and defining pathways of vulnerability. Additional views were collected on research
tools. Consensus-by-design was explicitly avoided. Data collection and processing was
independent.
Results
Both panels showed surprising convergence on the pathways of vulnerability to health/illhealth, and their interaction. The agreed conceptual model describes a dynamic relation
between health and ill-health and vulnerability. The 2 key pathways that link to vulnerability,
are complementary, but not symmetrical as biological processes of maintaining health or
obtaining better health are not reciprocal to recovery, so also not in terms of vulnerability
impacts. An individual’s degree of vulnerability is the net balance of risk effects and protective and healing factors (socially, biologically and in terms of health literacy and health care
access). These factors can for measurement purposes (according to the panels: interview for exploration, checklists for population research) be grouped into ‘material resources’, ‘taking responsibility for one’s own health’, ‘risky activities and behaviors’, and ‘social support’.
Supportive and transforming action can thus be undertaken.
Conclusion
A universal concept of vulnerability in the context of health was successfully derived after
careful replication and extension of an international Delphi study on vulnerability among the
elderly
Additional Metadata | |
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doi.org/10.1371/journal.pone.0212633, hdl.handle.net/1765/115133 | |
Organisation | Erasmus School of Health Policy & Management (ESHPM) |
de Groot, N., Bonsel, G., Birnie, E., & Valentine, N. (2019). Towards a universal concept of vulnerability: Broadening the evidence from the elderly to perinatal health using a Delphi approach. doi:10.1371/journal.pone.0212633 |