Study on Community Care Needs and Influencing Factors of the Urban Elderly in Shandong Province, China

Objective: To understand community care needs of the urban elderly in Shandong Province. To analysis the influencing factors and community care needs of the urban elderly in Shandong Province. Methods: Shandong Province was divided into four levels according to the level of economic development, multi-stage stratified cluster random sampling method was used. Each city collected the old aged 60 years or older served by 5 community health service centers. A total of 3390 questionnaires were distributed, the recovery rate was 100%, it had 3363 effective questionnaires, and an effective rate was 99.20%. SPSS17.0 software was used for univariate and multivariate analysis. Results: Analysis results show that, the influencing factors of community care needs of health promotion dimension have medical time (t = 3.239, P = 0.001) and EQ-5D score (t = 9.104, P - 6.239, P - 17.276, P - 3.762, P - 8.341, P Conclusions: Community care needs of the urban elderly in Shandong Province are at a medium level and have many influencing factors, the scores of each dimension from high to low are health promotion, disease care and disease prevention. In community nursing work, we should meet the care needs of the elderly, we need to enhance elderly self-care and safety awareness and promote the physical and mental health of the elderly.

Survey and Analysis of Community Care Service in Cities and Towns from the Perspective of Internet

With the aging of the social population,community care has become another important care model between home care and institutional care.In order to fully understand the social cognition and demand of"Internet+community care",the project team conducted a questionnaire survey in accordance with the research objectives.The survey concluded that the public are still dependent on the traditional care,and do not know much about"Internet+community care",but are willing to try."Internet+community care"can not only enrich and innovate the care model,but also effectively solve the problems of limited pension resources and mismatch between supply and demand.It is conducive to promoting the realization of high-quality and efficient services for the aged.

Advances in diagnosis and management of chronic heart failure in China： reference limits of N-terminal-pro-B-type natriuretic peptide, pharmacal management, and community care

Heart failure,the final outcome of various heart diseases,has an increasingly high prevalence in China.Diagnosis,medical treatments,and community managements of heart failure are substantial clinical challenges.N-terminal-pro-B-type natriuretic peptide （NT-proBNP） is a useful biomarker for diagnostic and prognostic predictions in heart failure patients;however,the levels of reference value in normal Chinese populations are lacking.The usage of classic Western medicines has greatly improved;furthermore,the treatment pattem of the integration of Western treatments and traditional Chinese medicine （TCM） is also widely explored.Moreover,community managements of heart failure have been paid more attention and the long-term mechanism is being built.Here,we summarize the range of reference values of NT-proBNP in normal Chinese subjects,current therapies including Western treatments and especially TCM,as well as community care among people with chronic heart failure patients in China.Keywords：chronic heart failure; N-terminal-pro-B-type natriuretic peptide; pharmacology; community care

An Association Pattern of Constituent Factors of the Elder Care Community in China

With the development of the aging society in China,the contradiction between the growing old people and the shortage of the elder care community has been increasingly sharp.How to reasonably and effectively establish the elder care community becomes a problem that demanding prompt solution in China.This paper,starting from the most basic constituent factors of the elder care community,namely the concept,the configuration and the service,analyzes 6 types of the concept,redefines the type of the building configuration of the elder care community,and explains the types and levels of the service,which aims to guide the elder care community to deal with the relationship between the 3 factors with a view to providing a reference for the architectural design and standard preparation in the elder care community.

Mandibular advancement devices in the treatment of obstructive sleep apnea and snoring in community dental care: A pilot study on self-reported sleep quality

Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are proven to be efficient in treating mild to moderate sleep apnea and snoring. We examined patients who had been treated in Community Dental Care with a titrable Herbst-type MAD. The aim of the study was to evaluate the quality of sleep based on self report. Methods: A questionnaire was mailed to patients (n = 184) who had received treatment for OSA or snoring between 2007 and2010 inthe Helsinki Health Centre Oral Care Unit. The patients were referred to the clinic for primary treatment, or because another treatment modality had failed. Results: Of the respondents (n = 142, 78.4%), OSA had been diagnosed in 74%, while the MAD was applied for snoring to the remaining. Among all respondents, 78.4% had worn the MAD at least three nights per week. With the MAD in situ, sleep was felt significantly less disrupted (p < 0.001) and more restorative (p < 0.001), and snoring was markedly reduced (p < 0.001). Daytime tiredness was also markedly less frequent (p < 0.001). Conclusions: Treatment with a MAD improved perceived sleep quality and awoke alertness in mild and moderate OSA patients and in snorers. This study supports such treatment to be initiated and monitored in community dental care.

Changes and Development of Home and Community Based Elderly Care Service Policies in China

This paper analyzes the current situation of the development of home and community based elderly care service in China,points out the existing problems,and puts forward improvement measures,aiming to deepen the understanding of HCBS and promote the theoretical research and practice of community home-based elderly care service.

Construction of Xi'an ecological old-age care community in the new urbanization

The new urbanization is an important carrier of ecological civilization construction, and ecological old-age care is the concrete manifestation of the perfect combination of the two, the proper meaning of the new urbanization connotation and an inevitable trend of its development. Based on the analysis of the connotation and relationship between the new urbanization and ecological old-age care, together with the current situation and existing problems of the current nursing institutions and ecological old-age care in Xi'an area, this paper discusses the major issues that should be noticed when constructing the ecological old-age care community in Xi'an and three main construction modes.

Meta-analysis of the willingness rate of community home-based care in China

Objective:To systematically evaluate the willingness rate of the community to provide for the aged at home and analyze its influencing factors.Methods:By searching the CNKI,VIP,Wanfang,we collected literature on the willingness of the elderly in the community to provide for the aged from 2011 to 2021,extracted the data,and evaluated the quality of the included literature.Then,CMA 2.0 software was used for Meta-analysis.Results:A total of 13 articles were included in this study,and 16,402 people over 60 years old were surveyed,1782 people were willing to provide for the aged at home in the community,with a total willingness rate of 11%(95%CI:9%to 26%).The results of subgroup analysis showed that there was a statistically significant difference in the community home care willingness rate of elderly people with different gender,education levels,marital status,monthly income,living alone,the number of children,and residence(P<0.05).There was not any statistically significant difference in the willingness rate of the elderly with different ages,chronic diseases,self-care ability,and loneliness(P>0.05).Conclusion:The overall willingness rate of the elderly in the community of the elderly is relatively low in China.Gender,education level,marital status,monthly income,living alone,number of children,and residence are factors affecting the prediction of community elderly will.

Spatial Optimization and Reconstruction of Old Communities under the Background of Aging

As aging becomes increasingly serious,how to make the life of the elderly more convenient and comfortable has become one of the social problems to be solved urgently.Old residential areas are one of spaces where the elderly gather.In this paper,the prominent problems in the community space of existing old residential areas that are not conducive to the life of the elderly were analyzed,and corresponding countermeasures to transform the community space were put forward.It is hoped that public space can play its due value and make old residential areas glow with new vitality.

Assessment of Contributions of Community Tuberculosis Intervention to Tuberculosis Case Detection and Treatment Outcome in Two States in Nigeria

Background: Nigeria, one of the high burden Tuberculosis countries, has developed various intervention strategies to ensuring universal access to quality-assured tuberculosis diagnosis and treatment. However, low case detection and unsuccessful treatment outcome still remains a serious challenge in most states. Community Tuberculosis care was born against this background in 2010 as a complementing front to combat the challenges, bringing directly observed treatment short-course strategy beyond the clinic settings to the door steps of patients. This study evaluates the contributions of the intervention to Tuberculosis case detection and treatment outcomes in two states in Nigeria. Materials and Method: A retrospective study with multistage sampling technique was employed to review 23,241 presumptive Tuberculosis cases enrolled for management between 2014-2017. Chi-square (χ2) test was used for test of association between the independent variables and the main outcomes of the study, with statistical significance set at p-value of 5%. Results: The annual percentage increase for both states was 24.7%, 189.8% and 114.5% in the study group as against 5.2%, 44.6% and 65.6% in control group. Overall, 23.8% were bacteriologically positive (either AFB or Gene-Xpert MTB/Rif) and 1.4% were clinically evaluated to be positive, while 74.8% were bacteriologically negative. Of the total 5861 cases treated, successful treatment rate of the patients in the study group was 88.6% as compared to 76.1% in the control group. The relationship between the referral system from communities where the intervention program was implemented and the case detection/treatment outcome was statistically significant (OR 95% CI = 3.15, 2.95 - 3.35). Conclusion: The community level Tuberculosis intervention led to significantly better case detection and treatment outcome when compared to the conventional approach (p ≤ 0.05). Therefore, full community engagement should be advocated as a major strategy for End Tuberculosis planed by WHO since the patients are found in the community and not in the health facilities.

Corroborative Activities and Recognition Between Community Comprehensive Care Unit’s Nurses and Care Managers in Supporting Discharge of Elderly from Hospital - A Secondary Publication

Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the elderly from the hospital. Methods: A total of 300 nurses working in community comprehensive care wards and 360 care managers working in B City in A Prefecture were surveyed using an anonymous self-administered questionnaire. Results: The highest percentage of responses regarding necessary collaborative activities with multiple professions in supporting hospital discharge were the same for Ns and CMs. The items regarding practice with the highest percentages were “relationship as a team” for Ns, and “user-centered awareness” for CM. While these professionals were willing to share information about their patients’ lives after discharge, the percentage of those explaining their expertise was low. It is thought that collaborative activities focusing on these aspects would lead to more appropriate discharge support.

Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study

Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.

General medical practice in China:evaluation of urban community health care service functions based on a rough set reduction theory

Objective:This study aims to achieve an empirical evaluation on the functional performances of urban community health care services in fi ve administrative districts of Nanchang city in China.Methods:In order to increase effectiveness,data collected from fi ve administrative districts of Nanchang city were processed to exclude redundant information.Rough set reduction theory was brought in to evaluate the performances of community health care services in these districts through calculating key indices’weighed importance.Results:Comprehensive evaluation showed the score rankings from high to low as Qing-yunpu district,Xihu district,Qingshanhu district,Donghu district,and Wanli district.Conclusion:The objective performance evaluation had actually reflected the general situation(including social-economic status)of community health care services in these administrative districts of Nanchang.Attention and practical works of community health service management were needed to build a more harmonious and uniform community health care service system for residents in these districts of Nanchang.

The contribution of a non-governmental organisation’s Community Based Tuberculosis Care Programme to case finding in Myanmar:trend over time

Background:It is estimated that the standard,passive case finding(PCF)strategy for detecting cases of tuberculosis(TB)in Myanmar has not been successful:26%of cases are missing.Therefore,alternative strategies,such as active case finding(ACF)by community volunteers,have been initiated since 2011.This study aimed to assess the contribution of a Community Based TB Care Programme(CBTC)by local non-government organizations(NGOs)to TB case finding in Myanmar over 4 years.Methods:This was a descriptive study using routine,monitoring data.Original data from the NGOs were sent to a central registry within the National TB Programme and data for this study were extracted from that database.Data from all 84 project townships in five regions and three states in Myanmar were used.The project was launched in 2011.Results:Over time,the number of presumptive TB cases that were referred decreased,except in the Yangon Region,although in some areas,the numbers fluctuated.At the same time,there was a trend for the proportion of cases treated,compared to those referred,that decreased over time(P=0.051).Overall,among 84 townships,the contribution of CBTC to total case detection deceased from 6%to 4%over time(P<0.001).Conclusions:Contrary to expectations and evidence from previous studies in other countries,a concerning reduction in TB case finding by local NGO volunteer networks in several areas in Myanmar was recorded over 4 years.This suggests that measures to support the volunteer network and improve its performance are needed.They may include discussion with local NGOs human resources personnel,incentives for the volunteers,closer supervision of volunteers and improved monitoring and evaluation tools.

Health professionals’perspective on the impact of community health care reform in different regions of China

Objective:Changes in supplying community health services,degree of satisfaction,and pol-icy suggestions are presented from the perspectives of health professionals in different regions of China with the purpose of further facilitating comprehensive reform of community health services.Methods:Based on geographic location and economic level of development,eight cities were selected and 12 community health service institutions were chosen by random sampling from each city.A questionnaire survey was conducted by the health professionals.Results:With respect to working enthusiasm,reduction in antibiotic drug use,social image and trust of patients,more health professionals in middle and western China showed positive feed-backs than those in eastern China.With respect to preliminary results of the reform,performance and salary,and health care insurance policies,health professionals’satisfaction levels in middle and western China were higher than in eastern China.The health professionals in middle and western China were more concerned about equipment,infrastructure and increasing training op-portunities.The health professionals in both eastern and middle China accentuated improving the variety of essential drugs covered by health insurance,while health professionals in eastern China suggested performance-related payment reform.Conclusions:The performance of health professionals in middle and western China was improved more signifi cantly through comprehensive reform than that of health professionals in eastern China.For health professionals in middle and western China,it is essential to strengthen infrastructure and increase professional training,while health professionals in middle and eastern China would like to see an increase in the variety of essential drugs,and those in eastern China require strengthening performance-related payment reform.

Separation of Revenue and Expenditure increases first contact care in community health centers among community residents

Objective:To evaluate the impact of Separation of Revenue and Expenditure(SRE)on the first contact care in community health centers(CHCs)among community residents.Methods:Data was obtained through questionnaire survey before and after the pilot.Residents who visited CHCs within two weeks before the conduction of the surveys were included in this study.This study employed a pre-post quasi-experiment design and multiple regression models were specified based on the Andersen theoretical framework.Results:Multiple logistic regression analysis showed that the rate of first contact care in CHCs increased by 28.3%(P=0.000).Conclusions:SRE has increased the first contact care in CHCs among the community residents.

Holistic approach to health education on AIDS

Objective To identify a method for health education using the example of an educational seminar on AIDS prevention and control at Hebei Medical University in China, 1994.Methods Our goal is the theoretical formulation of a unified community approach for problem solving through the combination of the self regulative approach and the case analytical approach. “Quality improvement”, “essential quality” and “human ecosystems” provide the basic ideas for better understanding the integration of culture, science and technology within the “cultural norm”.Results The present seminar was successfully organized for Chinese medical students based on the theme of “living with AIDS”. Through this program, we identified that self regulative and case analytical approach were major issues for holistic approach to health education. We also identified that a community approach provides the scientific basis for health education in the community.Conclusions The present paper generates a healthcare paradigm for surveillance in health/medical education. Through a better understanding of community approach, we related “community care” (emphasizing self, mutual, professional and institutional care) to the “practical norm”; and “preventive epidemiology” (emphasizing the unification of quality and quantity, as well as systems and population) to the “research norm”.

Governance of Violence Risk in Patients with Severe Mental Disorders:From a Case of a Schizophrenic’s Filicide

Schizophrenia is a chronic,prolonged illness with a significant tendency to relapse and a high disease burden.Patients are often affected by psychotic symptoms and commit violent assaults that manifest as criminal acts.At the same time,such patients generally have poor medication adherence,which also makes them more likely to commit crimes.In our case,a single mother with a history of psychiatric illness strangled her 4-year-old biological son to death with a rope,put the body in a bathtub and divided it,ate some of the victim’s organs;the results of her forensic mental health identification indicated she was in a period of illness at the time of the offense and did not have the competence for criminal responsibility.Medication adherence is an important factor affecting relapse in patients with schizophrenia.Although new medications have been introduced and researchers have been improving medication adherence through many ways such as patient education and family therapy since the 1980s,the level of medication adherence is still poor,with a nonadherence rate of about 50%.This report suggests that in practice,attention should be given to improving patients’medication adherence,guardians of patients and their communities should strengthen their monitoring and care,including knowing the patients’medication adherence and monitoring them to take their medication as prescribed,together with systematic psychotherapy for patients to prevent them from relapsing and committing violent attacks.Besides,when assessing the patient’s risk of violence,the realistic factors in crime motives and the impact of guardians(family)should be taken into account to evaluate the risk of violence objectively and comprehensively.A final point is that social support for patients with mental disorders and their families should be improved.