<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112017000300269</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2016.10.011</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cinco paradojas de la promoción de la salud]]></article-title>
<article-title xml:lang="en"><![CDATA[Five paradoxes in health promotion]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Dicastillo]]></surname>
<given-names><![CDATA[Olga]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Canga-Armayor]]></surname>
<given-names><![CDATA[Navidad]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mujika]]></surname>
<given-names><![CDATA[Agurtzane]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pardavila-Belio]]></surname>
<given-names><![CDATA[Miren Idoia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Belintxon]]></surname>
<given-names><![CDATA[Maider]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Serrano-Monzó]]></surname>
<given-names><![CDATA[Inmaculada]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pumar-Méndez]]></surname>
<given-names><![CDATA[María J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Navarra Facultad de Enfermería Departamento de Enfermería Comunitaria y Materno-Infantil]]></institution>
<addr-line><![CDATA[Pamplona ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<volume>31</volume>
<numero>3</numero>
<fpage>269</fpage>
<lpage>272</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112017000300269&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112017000300269&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112017000300269&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La Organización Mundial de la Salud considera que la promoción de la salud es una estrategia fundamental para aumentar la salud de la población, concibiéndola como un proceso global que permite a las personas incrementar el control sobre su salud para mejorarla. Así, la promoción de la salud no se centra únicamente en capacitar a los individuos trabajando sus conocimientos, actitudes y habilidades, sino que tiene en cuenta las esferas políticas, sociales, económicas y ambientales que influyen en la salud y el bienestar. La complejidad de aplicar estos conceptos se refleja en las cinco paradojas de la promoción de la salud que surgen entre la retórica y la puesta en práctica de sus principios. Las paradojas que se identifican y discuten en este trabajo son el paciente versus la persona, lo individual versus lo colectivo, los profesionales de la enfermedad versus los profesionales de la salud, los indicadores de enfermedad versus los indicadores de salud y la salud como gasto versus la salud como inversión. Hacer explícitas estas contradicciones puede ayudar a identificar los motivos por los que resulta tan compleja la aplicación de los conceptos relacionados con la promoción de la salud, y a plantear líneas de trabajo que faciliten su puesta en práctica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The World Health Organization states that health promotion is a key strategy to improve health, and it is conceived as a global process of enabling people to increase control over, and to improve, their health. Health promotion does not focus solely on empowering individuals dealing with their knowledge, attitudes and skills, but it also takes political, social, economic and environmental aspects influencing health and wellbeing into account. The complexity of applying these concepts is reflected in the five paradoxes in health promotion; these arise in between the rhetoric in health promotion and implementation. The detected paradoxes which are described herein involve the patient versus the person, the individual versus the group, disease professionals versus health professionals, disease indicators versus health indicators, and health as an expense versus health as an investment. Making these contradictions explicit can help determine why it is so complex to put the concepts related to health promotion into practice. It can also help to put forward aspects that need further work if health promotion is to put into practice.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Promoción de la salud]]></kwd>
<kwd lng="es"><![CDATA[Atención dirigida al paciente]]></kwd>
<kwd lng="es"><![CDATA[Determinantes sociales de la salud]]></kwd>
<kwd lng="es"><![CDATA[Educación en salud]]></kwd>
<kwd lng="es"><![CDATA[Indicadores de salud]]></kwd>
<kwd lng="es"><![CDATA[Planificación en salud]]></kwd>
<kwd lng="en"><![CDATA[Health promotion]]></kwd>
<kwd lng="en"><![CDATA[Patient-centred care]]></kwd>
<kwd lng="en"><![CDATA[Social determinants of health]]></kwd>
<kwd lng="en"><![CDATA[Health education]]></kwd>
<kwd lng="en"><![CDATA[Health indicators]]></kwd>
<kwd lng="en"><![CDATA[Health planning]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<collab>World Health Organization</collab>
<source><![CDATA[WHO Global Health Promotion]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morgan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Yoder]]></surname>
<given-names><![CDATA[LH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A concept analysis of person-centered care]]></article-title>
<source><![CDATA[J Holist Nurs]]></source>
<year>2012</year>
<volume>30</volume>
<page-range>6-15</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Little]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Everitt]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Williamson]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Preferences of patients for patient centred approach to consultation in primary care: observational study]]></article-title>
<source><![CDATA[BMJ]]></source>
<year>2001</year>
<volume>322</volume>
<page-range>468-72</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bergeson]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Dean]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A systems approach to patient-centered care]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2006</year>
<volume>296</volume>
<page-range>2848-51</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pumar-Mendez]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Mujika]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Regaira]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Stakeholders in support systems for self-care for chronic illness: the gap between expectations and reality regarding their identity, roles and relationships]]></article-title>
<source><![CDATA[Health Expect]]></source>
<year>2016</year>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Diez Roux]]></surname>
<given-names><![CDATA[AV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Residential environments and cardiovascular risk]]></article-title>
<source><![CDATA[J Urban Health]]></source>
<year>2003</year>
<volume>80</volume>
<page-range>569-89</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<collab>Comisión para Reducir las Desigualdades Sociales en Salud en España</collab>
<source><![CDATA[Análisis de situación para la elaboración de una propuesta de políticas e intervenciones para reducir las desigualdades sociales en salud en España]]></source>
<year>2010</year>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Ministerio de Sanidad y Política Social]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vela-Ríos]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez-Rasero]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Moya-Ruano]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Institucionalización de la evaluación del impacto en la salud en Andalucía]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2016</year>
<volume>30</volume>
<page-range>81-4</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Metcalfe]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Higgins]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Healthy public policy - is health impact assessment a cornerstone?]]></article-title>
<source><![CDATA[Public Health]]></source>
<year>2009</year>
<page-range>296-301</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Henry]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An asset-based approach to creating health]]></article-title>
<source><![CDATA[Nurs Times]]></source>
<year>2013</year>
<volume>109</volume>
<page-range>19-21</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Olsen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Health coaching: a concept analysis]]></article-title>
<source><![CDATA[Nurs Forum]]></source>
<year>2013</year>
<volume>49</volume>
<page-range>18-29</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="">
<collab>Ministerio de Sanidad, Servicios Sociales e Igualdad</collab>
<source><![CDATA[Estrategia de promoción de la salud y prevención en el SNS en el marco del abordaje de la cronicidad en el SNS]]></source>
<year>2014</year>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morgan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ziglio]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Revitalising the evidence base for public health: an assets model]]></article-title>
<source><![CDATA[Promot Educ]]></source>
<year>2007</year>
<numero>^s2</numero>
<issue>^s2</issue>
<supplement>2</supplement>
<page-range>17-22</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morgan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Revisiting the asset model: a clarification of ideas and terms]]></article-title>
<source><![CDATA[Glob Health Promot]]></source>
<year>2014</year>
<volume>21</volume>
<page-range>3-6</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Antonovsky]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The structure and properties of the sense of coherence scale]]></article-title>
<source><![CDATA[Soc Sci Med]]></source>
<year>1993</year>
<volume>36</volume>
<page-range>725-33</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Simo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gervas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gasto sanitario en atención primaria en España: insuficiente para ofrecer servicios atrayentes para pacientes y profesionales. Informe SESPAS 2012]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2012</year>
<volume>26</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
<page-range>36-40</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rivera]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Currais]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La inversión en salud como gasto público productivo: un análisis de su contribución al crecimiento económico]]></article-title>
<source><![CDATA[Presupuesto y Gasto Público]]></source>
<year>2005</year>
<volume>39</volume>
<page-range>103-20</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Paredes-Carbonell]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Agulló-Cantos]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Vera-Remartínez]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sentido de coherencia y activos para la salud en jóvenes internos en centros de menores]]></article-title>
<source><![CDATA[Rev Esp Sanid Penit]]></source>
<year>2013</year>
<volume>15</volume>
<page-range>87-97</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Botello]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Palacio]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metodología para el mapeo de activos de salud en una comunidad]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2013</year>
<volume>27</volume>
<page-range>180-3</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cofino]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Avino]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Benede]]></surname>
<given-names><![CDATA[CB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Promoción de la salud basada en activos: ¿cómo trabajar con esta perspectiva en intervenciones locales?]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2016</year>
</nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cofino]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Pasarin]]></surname>
<given-names><![CDATA[MI]]></given-names>
</name>
<name>
<surname><![CDATA[Segura]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[¿Cómo abordar la dimensión colectiva de la salud de las personas? Informe SESPAS 2012]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2012</year>
<volume>26</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
<page-range>88-93</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
