Health, Wellness and Tourism: healthy tourists, healthy business ...

focused on the paradigm of wellness, SPAs are today a meeting point between western and
eastern views of health “The initial pioneers of the modern-day SPA concept concentrated
upon the physical aspects of wellness by providing their guest with visible results to nagging
physiological problems. (…) Over the years more and more players in the industry have
adopted holistic philosophies, and integrated Eastern and Western wellness systems into their
menus” (Haden, 2007: 1).
In the image of 21 st consumer societies, these spaces have today adopted an eminently
commercial philosophy dedicated to a clientele valuing health, the body, the environment,
social justice, personal development and sustainability. In these facilities, health continues to
be a business of an essentially liberal nature, predominantly out of medical reach and where
branding laws are sovereign. In our days, SPAs emerge as places of greater affirmation of the
ideals of self-health and of self-responsibility where individuals learn to control and monitor
their bodies by resorting to a set of specified techniques which lead precisely into a dialogue
and rediscovery of their own bodies.
Method
Sample
It is currently impossible to quantify the universe of the SPA sector in Portugal given the
absence of a legal framework regulating SPA activities: there is only a legal framework for
hot spring thermalism, and within that, for Thermal SPAs. Thus, we must begin by
establishing minimum selection criteria. Only those SPA infrastructures which significantly
render the following services were selected: health care involving recourse to water,
specifically as regards thermal bath treatments and hydrotherapy techniques and the provision
of alternative therapies. Most of the aforementioned infrastructures are integrated into hotels.
In partnership with an expert (invited) from the National Tourism Authority (Turismo de
Portugal) so as to identify the establishments which could be classified as SPAs,
approximately 60 infrastructures were identified. In addition to the aforementioned criteria,
this selection additionally considered geographical location so as to guarantee full coverage
both geographically and the actual SPA concept thus safeguarding the representation of as
many different SPA types as possible.
29 SPAs from the resulting universe agreed to participate in this study with 20 later being
validated. Taking into consideration that a significant part of the questionnaire contemplated
variables of a clinical nature, a minimum of 30 questionnaires was established as the base
requirement for the autonomous validation of an entity. The participant Day Spas, Resort
Hotel SPAs, Destinations SPAs, Medical SPAs ensured the completion of a total of 824
questionnaires by their SPA Goers between May and August of 2009.
Procedure and questionnaire design
The questionnaire was produced within the scope of a PhD project which in its first phase
carried out a review of the available literature on themes such as health, body, leisure and
tourism. The second part of this research, of an empirical nature, first contemplated analysis
of articles and messages conveyed by the major woman’s and men’s magazines in circulation
in Portugal and later, the application of the aforementioned questionnaire. The questionnaire
was produced after analysis by experts in SPA management and involved a pre-test period of
one month. The final version of the questionnaires consisted of four parts: a first section on
SPA consumption (regularity, services used, motivations, satisfaction level and factors of
choice), a second part focused on the representation and meaning of wellness and health, and
a third on health care (practices and routines) and finally a fourth aiming to define the social