The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service(CHS) under the gatekee...The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service(CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor‐patient relationships, information and support, organization of care, and accessibility(P 〈 0.001). One or more factors such as gender and self‐perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy.展开更多
This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are present...This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.展开更多
The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of Natio...The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.展开更多
In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical...In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available con-cerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based rec-ommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.展开更多
In China, the implementation of community health service shows that the prevention is an essential and important part of our national health system and is helpful to decrease the medical expenditure gradually. Accord...In China, the implementation of community health service shows that the prevention is an essential and important part of our national health system and is helpful to decrease the medical expenditure gradually. According to the data from Health Statistic Information Center of Ministry of Health in China, we calculated that the total health expenditure of China would be decreased 8000.0 million yuan only in 2001, among which, 1188.3 million, 1953.9 million and 4833.0 million yuan were respectively saved for the government budget, the society and resident if implementing the policy of community health service powerfully. And every outpatient can save 15.46 yuan per time. By the quantitative analysis on the economic contribution of community health service, it can be proved that a great economic benefit could be gotten from the implementation of community health service.展开更多
The purpose of this study is to use the model of service quality concepts to evaluate the service qualities of"community health centers"in order to find out the service quality gaps and thus reinforce the co...The purpose of this study is to use the model of service quality concepts to evaluate the service qualities of"community health centers"in order to find out the service quality gaps and thus reinforce the competitive edge.This study took Datong District Health Centre in Taipei city as the research object and performed a questionnaire survey with internal and external customers.In terms of internal customers(service staff),50 employees participated and a total number of 50 effective questionnaires were returned.In terms of external customers,convenience sampling was adopted to collect the questionnaires,679 answered questionnaires were returned,effective copies being 667.The research tool was the questionnaire that was designed mainly on the basis of SERVQUAL(the scale of service quality determinants)and with reference to the practical data of service process during its implementation at subject service departments.The findings included the conclusions such as"there exists significant effect between service quality and customer satisfaction","the biggest difference among service qualities is service performance gap(GAP3),showing that there is still a room for improvement regarding the service provided at the health centre"and"different demographic variables have significant effects on customer satisfactions,e.g.higher age groups,lower education level and jobless people have lower satisfaction on the service received".The research result can be provided to relevant organisations as a reference for improvement.展开更多
With the aging of the population and the change of family structure, the physical and mental health of the elderly has become the focus of attention at home and abroad. The traditional mental health service in our cou...With the aging of the population and the change of family structure, the physical and mental health of the elderly has become the focus of attention at home and abroad. The traditional mental health service in our country is narrow and the form is single, which can not meet the needs of the elderly. This paper based on the analysis of characteristics of community, community mental health services with respect to the unique advantages of Chinese traditional psychological service mode in the maintenance of the mental health of the elderly, with a unique entry point to analyze the problems of psychological services in community elderly, puts forward a sound proposal, summed up the community mental health service is suitable to China's national conditions, the practical significance of the road,展开更多
The health status of the floating elderly population and the need of community management services are complex and important problems.Owing to the change of living environment and the insecure medical care,the mobile ...The health status of the floating elderly population and the need of community management services are complex and important problems.Owing to the change of living environment and the insecure medical care,the mobile elderly people have more health and psy-chological problems compared to the rest of the elderly population.Therefore,the community should take a variety of measures to meet their needs and help them to better adapt to the new living environment,and maintain their physical and mental health.This paper aims to summarize recent studies on the physical and emotional health problems of mobile elderly people and related community management service needs.展开更多
This study proposes to discuss the experience lived by Pró-Saúde and PET-Saúde team of FACISA/ UFRN together with the Municipal Health Department of Santa Cruz/RN from a critical-reflexive perspective a...This study proposes to discuss the experience lived by Pró-Saúde and PET-Saúde team of FACISA/ UFRN together with the Municipal Health Department of Santa Cruz/RN from a critical-reflexive perspective about the interaction between education, service and community as well as advances in approach and the strengthening between the school and Primary Health Care. This is an exploratory study with an experience report approach of the Pró-Saúde and PET-Saúde team from 2012 to 2014. The integration of these programs in experimental scenarios of the Unified Health System and the strengthening of the proposed training of human resources capable of the current healthcare system were observed. Thus, contributions in health in undergraduate courses and practices of health services are important, since the approach to the reality of the population and their social needs contribute to the vocational training quality.展开更多
Objective:This study aimed to describe the social determinants of health influencing obesity for the aged in a community context and based on the perspectives of various stakeholders.Methods:This was qualitative conte...Objective:This study aimed to describe the social determinants of health influencing obesity for the aged in a community context and based on the perspectives of various stakeholders.Methods:This was qualitative content analysis study using data from the focus group,individual in-depth interview,and observation.The study population was domiciled in Pakpoon Village,Mung Dis-trict,Nakhon Si Thammarat Province,a tight-knit settlement typical of most retirement communities.Data were collected through two focus group discussions,direct observation,and in-depth interviews with 19 participants.Respondents represented key community groups:local nurses and public health officers,elderly residents,family caregivers(family members),and village health volunteers.Results:The participants shared similar perspectives about the social determinants of health influencing obesity in the aged,which spanned three themes.These were:1)neighborhood food environment(easy access to unhealthy food,no choice to recruit healthy food);2)social networks influencing obesity(family affects food choices and prohibitions on exercise;belief,and socially imposed body image per-ceptions contributing to obesity in the aged);and 3)knowledge,attitudes,and beliefs behind lifestyle choices that cause obesity in the elderly(lack of awareness,personal attitudes,job and familial duties as barriers to engaging in physical activities;over-consumption behaviors lead to obesity in older people).Conclusion:These three themes were the root causes of obesity in the elderly in Pakpoon’s retirement community.This finding suggests that policymakers and nurses can create healthy environments,both to treat and prevent obesity,by raising awareness in younger generations,providing aging the provision of healthy food choices for older adults,encouraging health care professionals to share knowledge,and by modifying the attitudes and beliefs of both caregivers and older adults.展开更多
Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from t...Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.展开更多
Objectives: This study aimed to describe work and activities of community networks focusing on the improvement of the quality of life (QOL) of older people in Thailand.The understanding of the work can help enhancing ...Objectives: This study aimed to describe work and activities of community networks focusing on the improvement of the quality of life (QOL) of older people in Thailand.The understanding of the work can help enhancing the community development and strengthening of local communities and their networks.Methods: Qualitative methods including in-depth interview,observation,and focus group discussion were employed to the study.64 participants participated to the study and were recruited from 4 key actors within the community.Content analysis was used to analyze the obtained data.This study was conducted in 6 local administrative organizations (LAOs) which selected from the outstanding areas of the project.Each LAO represents one sub-district of the regions of Thailand namely;(1) the upper north,(2) the lower north,(3)the upper eastern,(4) the lower eastern,(5) the central and (6) the south.Results: The findings of this study were categorized into three main themes: (1) Social capital including people in the community,social groups,and organizations,(2) Mutual help/collaboration activities composed of six sets of activities related to social capitals working on the improvement of QOL of older people,and (3) Impacts of the mutual help/collaboration activities on older people and local communities who help to improve of QOL of older people.Conclusion: The findings are important features for the community development.These themes should be recommended for community nurses,health related groups and organizations for the improvement of QOL of older people in the community.展开更多
Objective:This study aimed at exploring the attempters'perception of community social services included any barriers to seeking help and services.Method:The participants were patients with self-harming behavior ag...Objective:This study aimed at exploring the attempters'perception of community social services included any barriers to seeking help and services.Method:The participants were patients with self-harming behavior aged 15 years or above.A set of guiding questions were designed to explore the general barriers and accessibility to community social services.A voice recording was made,which was later converted into a text transcript and then preceded for content analysis with co-occurrence and similarity matrix interpretation.Two males and nine females with a history of self-harm aged between 24 and 58 years were recruited for the interviews.Result:The participants had diverse experiences and backgrounds,and attitudes toward community social services.However,there was a shared perception of the need to enhance community social services.There were four main themes and 12 sub themes identified.The main theme included the service availability,service accessibility,affordability and acceptability.For details,participants were unaware of the available types of care/social services in the community,and were unaware about the nearby social services.They also suggested extending service hours and focused services should be offered to help people with different backgrounds and needs.Actually,those with experience of service utilization had both positive and negative perspectives and they gave suggestions for service delivery,mainly extending service hours and offering focused services such as for gambling control and financial planning.In view of interaction with service providers,counseling skills and trust were highly appreciated by the participants.Conclusion:The results identified common circumstances of falling into financial hardship(gambling)and social fragmentation(divorce,poor family relationships,and poor marital relationships),which also suggested to enhance services on center location,service arrangement,and skill of caregivers.展开更多
Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and st...Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and still have,the same relationship with madness.It is only with the affirmation of the Modern State,and of Capitalism,that the idea of“normality”indispensable to be able to conceive diversity as something dangerously distant and different from the norm takes over.In our post-modern society,people with mental illness in Italy can resort to specialists and social-health services.But the heterogeneous answers given after the approval of law 180 appear to be increasingly diversified.In this research,much attention will be paid to how the social and health services,located in different areas of Italy(Messina,Rome,Trento)face the current growing risk of social,housing and economic isolation of these fragile subjects.The aim of the research is to explore the possibility of a new relationship between the social-health service and the local community.On the one hand,research investigates what the contribution of the services could be.On the other what the spaces of protagonism and participation of the community could be in inclusion process account.In order to better understand the differences between these two dimensions,a qualitative research approach was chosen through the conduct of in-depth interviews.In this way it was possible to investigate:(1)the partial representations characteristic of the single individual,family members,operators and stackholders in general;(2)the services around the topic dealt with is articulated.From the first results of the research it emerges that the territory can no longer be considered as an abstract entity,but becomes the social space within which the construction of a new community welfare can and must take place.展开更多
The outbreak of Covid-19 affects China’s health delivery system, and the current status of primary health services after the Covid-19 pandemic is not yet clear. To further explore the current status of demands of fam...The outbreak of Covid-19 affects China’s health delivery system, and the current status of primary health services after the Covid-19 pandemic is not yet clear. To further explore the current status of demands of family health services, we conducted a cross-sectional survey, in the community of Haidian District, Beijing. Chi-square test analysis and multivariate logistic regression models were used to identify factors influencing residents’ demands for family healthcare services. Results show that population of married (OR = 3.108), living with parents (OR = 2.171), degree of Junior high school and above (OR = 7.250) and high school (OR = 7.670), Annual income: 0 - 56,000 (OR = 3.680) and 72,001 - 88,000 (OR = 1.690) have significant demands for family health care. The approach to building primary health services in Haidian District is worth promoting, but it is also important to pay attention to the health inequalities that can occur when patients are moved down to the grassroots level. .展开更多
Objective:To investigate the health service demands and to analyze influencing factors among elderly people based on a community survey in Guilin,China.Methods:A random sampling was used to investigate 366 elderly peo...Objective:To investigate the health service demands and to analyze influencing factors among elderly people based on a community survey in Guilin,China.Methods:A random sampling was used to investigate 366 elderly people in a community using a Health-Care-Needs questionnaire,which was designed by The Western Nursing Alliance research team in China.This survey was used to understand the basic situation,financial condition,health condition,self-care abilities,pension plan,and care services demands of the elderly residing at home.Additionally,this article analyzed the influencing factors contributing to the obtained results.Results:The top 3 nursing needs were security needs(1.61±0.45 points),health education needs(1.54±0.57 points),and respect and self-development needs(1.13±0.64 points).Logistic multifactor regression analysis showed that gender,monthly income,lack of exercise,activities of daily living(ADL)scores,methods of medical payment,and pension plan were independent factors affecting elderly nursing needs.Conclusions:The home-based health services supply for elders did not meet their needs.Therefore,a comprehensive approach considering multifactors such as gender,income,exercise,self-care ability,medical expense payments,and supporting preferences should be considered to address the complex needs of health care.展开更多
Objective This study aimed to explore the perceptions of good death of the older adults living in Bang Nang Li Sub-District,Amphawa District,Samut Songkhram Province,Thailand.Method The data of the study was collected...Objective This study aimed to explore the perceptions of good death of the older adults living in Bang Nang Li Sub-District,Amphawa District,Samut Songkhram Province,Thailand.Method The data of the study was collected using in-depth interviews between October 2019 to January 2020.The data collected a total of 14 older adults who had firsthand experience in caring for terminally ill patients were recruited for the study.Content analysis was employed to analyze qualitative data.Results The results of this study revealed the perceptions of good death which were categorized into three main themes and eight sub-themes,including 1)death without suffering(not suffering from life support devices,dying with care);2)natural death(death with the end of life expectancy,death with illness or ailments);and 3)death without the worries(preparation for death,spiritual and belief practice toward preparation for death,family and property management before death,death among family members and at their familiar place).Conclusion The findings of this research provided the insight to clarify the understanding of the perceptions on a good death of older adults.The findings can be used to support the practice and management of nursing education and health care providers who have to be involved in palliative care for terminally ill older adults.展开更多
Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects shou...Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects should be included in health self assessment, especially in developed world. In the developing world, however, very few studies have examined self health assessment. The aim of this study was to identify particular aspects and associations in self health assessment and differences between subgroups in Ulaanbaatar, Mongolia. The area sampling approach and Kish tables were used for selecting respondents. Total 500 respondents were surveyed by paper-based questionnaires. Spearman’s analysis and multiple logistic regression analysis were used to show relations between variables. Sociodemographic status, such as age and gender, proved to be important in self health assessment. Other factors affecting self health assessment included the number of family members, daily life and lifestyles, social environment, community motivation, and utilization of health services. Women, the elderly, or people with less-than- normal access to information suffer from poor self-assessed health. People who are socially inactive and who have poor living conditions are less likely to use health care services and are likely to assess their health as “poor.” In order to reduce the poor self-assessed health status it is important to address disparities in socioeconomic factors, such as age, gender, employment, and residential area. In addition, more attention should be paid to community and health services, as well as to health promotion and empowerment activities, including income-generation activities. Further research is also needed, however, for better understanding of about the local people and their health-related issues.展开更多
International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational ...International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.展开更多
This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the me...This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.展开更多
基金supported by the National Natural Science Foundation of China.(NSFC,71373090,‘Study on the gatekeeper policy of CHS’)
文摘The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service(CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor‐patient relationships, information and support, organization of care, and accessibility(P 〈 0.001). One or more factors such as gender and self‐perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy.
文摘This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.
基金The Baseline Survey of "The National Urban Community Health Service System Building Project" was funded by Ministry Of Health of China
文摘The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.
基金supported by agrant from"The National Urban Community Health Service System Building Project"of the Ministry of Health of China(No.)
文摘In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available con-cerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based rec-ommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.
文摘In China, the implementation of community health service shows that the prevention is an essential and important part of our national health system and is helpful to decrease the medical expenditure gradually. According to the data from Health Statistic Information Center of Ministry of Health in China, we calculated that the total health expenditure of China would be decreased 8000.0 million yuan only in 2001, among which, 1188.3 million, 1953.9 million and 4833.0 million yuan were respectively saved for the government budget, the society and resident if implementing the policy of community health service powerfully. And every outpatient can save 15.46 yuan per time. By the quantitative analysis on the economic contribution of community health service, it can be proved that a great economic benefit could be gotten from the implementation of community health service.
文摘The purpose of this study is to use the model of service quality concepts to evaluate the service qualities of"community health centers"in order to find out the service quality gaps and thus reinforce the competitive edge.This study took Datong District Health Centre in Taipei city as the research object and performed a questionnaire survey with internal and external customers.In terms of internal customers(service staff),50 employees participated and a total number of 50 effective questionnaires were returned.In terms of external customers,convenience sampling was adopted to collect the questionnaires,679 answered questionnaires were returned,effective copies being 667.The research tool was the questionnaire that was designed mainly on the basis of SERVQUAL(the scale of service quality determinants)and with reference to the practical data of service process during its implementation at subject service departments.The findings included the conclusions such as"there exists significant effect between service quality and customer satisfaction","the biggest difference among service qualities is service performance gap(GAP3),showing that there is still a room for improvement regarding the service provided at the health centre"and"different demographic variables have significant effects on customer satisfactions,e.g.higher age groups,lower education level and jobless people have lower satisfaction on the service received".The research result can be provided to relevant organisations as a reference for improvement.
文摘With the aging of the population and the change of family structure, the physical and mental health of the elderly has become the focus of attention at home and abroad. The traditional mental health service in our country is narrow and the form is single, which can not meet the needs of the elderly. This paper based on the analysis of characteristics of community, community mental health services with respect to the unique advantages of Chinese traditional psychological service mode in the maintenance of the mental health of the elderly, with a unique entry point to analyze the problems of psychological services in community elderly, puts forward a sound proposal, summed up the community mental health service is suitable to China's national conditions, the practical significance of the road,
文摘The health status of the floating elderly population and the need of community management services are complex and important problems.Owing to the change of living environment and the insecure medical care,the mobile elderly people have more health and psy-chological problems compared to the rest of the elderly population.Therefore,the community should take a variety of measures to meet their needs and help them to better adapt to the new living environment,and maintain their physical and mental health.This paper aims to summarize recent studies on the physical and emotional health problems of mobile elderly people and related community management service needs.
文摘This study proposes to discuss the experience lived by Pró-Saúde and PET-Saúde team of FACISA/ UFRN together with the Municipal Health Department of Santa Cruz/RN from a critical-reflexive perspective about the interaction between education, service and community as well as advances in approach and the strengthening between the school and Primary Health Care. This is an exploratory study with an experience report approach of the Pró-Saúde and PET-Saúde team from 2012 to 2014. The integration of these programs in experimental scenarios of the Unified Health System and the strengthening of the proposed training of human resources capable of the current healthcare system were observed. Thus, contributions in health in undergraduate courses and practices of health services are important, since the approach to the reality of the population and their social needs contribute to the vocational training quality.
文摘Objective:This study aimed to describe the social determinants of health influencing obesity for the aged in a community context and based on the perspectives of various stakeholders.Methods:This was qualitative content analysis study using data from the focus group,individual in-depth interview,and observation.The study population was domiciled in Pakpoon Village,Mung Dis-trict,Nakhon Si Thammarat Province,a tight-knit settlement typical of most retirement communities.Data were collected through two focus group discussions,direct observation,and in-depth interviews with 19 participants.Respondents represented key community groups:local nurses and public health officers,elderly residents,family caregivers(family members),and village health volunteers.Results:The participants shared similar perspectives about the social determinants of health influencing obesity in the aged,which spanned three themes.These were:1)neighborhood food environment(easy access to unhealthy food,no choice to recruit healthy food);2)social networks influencing obesity(family affects food choices and prohibitions on exercise;belief,and socially imposed body image per-ceptions contributing to obesity in the aged);and 3)knowledge,attitudes,and beliefs behind lifestyle choices that cause obesity in the elderly(lack of awareness,personal attitudes,job and familial duties as barriers to engaging in physical activities;over-consumption behaviors lead to obesity in older people).Conclusion:These three themes were the root causes of obesity in the elderly in Pakpoon’s retirement community.This finding suggests that policymakers and nurses can create healthy environments,both to treat and prevent obesity,by raising awareness in younger generations,providing aging the provision of healthy food choices for older adults,encouraging health care professionals to share knowledge,and by modifying the attitudes and beliefs of both caregivers and older adults.
基金This work was supported by the Ministry of Health and Sports,Republic of the Union of Myanmar(MOHS IR Grant 2019,Research ID No.501).
文摘Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.
基金The Center of Research and Development in Community Health System,Faculty of Nursing,at Khon Kaen University,Thailand provided supporting for the research grant (Ref:61-00-001)
文摘Objectives: This study aimed to describe work and activities of community networks focusing on the improvement of the quality of life (QOL) of older people in Thailand.The understanding of the work can help enhancing the community development and strengthening of local communities and their networks.Methods: Qualitative methods including in-depth interview,observation,and focus group discussion were employed to the study.64 participants participated to the study and were recruited from 4 key actors within the community.Content analysis was used to analyze the obtained data.This study was conducted in 6 local administrative organizations (LAOs) which selected from the outstanding areas of the project.Each LAO represents one sub-district of the regions of Thailand namely;(1) the upper north,(2) the lower north,(3)the upper eastern,(4) the lower eastern,(5) the central and (6) the south.Results: The findings of this study were categorized into three main themes: (1) Social capital including people in the community,social groups,and organizations,(2) Mutual help/collaboration activities composed of six sets of activities related to social capitals working on the improvement of QOL of older people,and (3) Impacts of the mutual help/collaboration activities on older people and local communities who help to improve of QOL of older people.Conclusion: The findings are important features for the community development.These themes should be recommended for community nurses,health related groups and organizations for the improvement of QOL of older people in the community.
基金The study was supported by Kowloon West Cluster Clinical Research ethic committee,HK
文摘Objective:This study aimed at exploring the attempters'perception of community social services included any barriers to seeking help and services.Method:The participants were patients with self-harming behavior aged 15 years or above.A set of guiding questions were designed to explore the general barriers and accessibility to community social services.A voice recording was made,which was later converted into a text transcript and then preceded for content analysis with co-occurrence and similarity matrix interpretation.Two males and nine females with a history of self-harm aged between 24 and 58 years were recruited for the interviews.Result:The participants had diverse experiences and backgrounds,and attitudes toward community social services.However,there was a shared perception of the need to enhance community social services.There were four main themes and 12 sub themes identified.The main theme included the service availability,service accessibility,affordability and acceptability.For details,participants were unaware of the available types of care/social services in the community,and were unaware about the nearby social services.They also suggested extending service hours and focused services should be offered to help people with different backgrounds and needs.Actually,those with experience of service utilization had both positive and negative perspectives and they gave suggestions for service delivery,mainly extending service hours and offering focused services such as for gambling control and financial planning.In view of interaction with service providers,counseling skills and trust were highly appreciated by the participants.Conclusion:The results identified common circumstances of falling into financial hardship(gambling)and social fragmentation(divorce,poor family relationships,and poor marital relationships),which also suggested to enhance services on center location,service arrangement,and skill of caregivers.
文摘Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and still have,the same relationship with madness.It is only with the affirmation of the Modern State,and of Capitalism,that the idea of“normality”indispensable to be able to conceive diversity as something dangerously distant and different from the norm takes over.In our post-modern society,people with mental illness in Italy can resort to specialists and social-health services.But the heterogeneous answers given after the approval of law 180 appear to be increasingly diversified.In this research,much attention will be paid to how the social and health services,located in different areas of Italy(Messina,Rome,Trento)face the current growing risk of social,housing and economic isolation of these fragile subjects.The aim of the research is to explore the possibility of a new relationship between the social-health service and the local community.On the one hand,research investigates what the contribution of the services could be.On the other what the spaces of protagonism and participation of the community could be in inclusion process account.In order to better understand the differences between these two dimensions,a qualitative research approach was chosen through the conduct of in-depth interviews.In this way it was possible to investigate:(1)the partial representations characteristic of the single individual,family members,operators and stackholders in general;(2)the services around the topic dealt with is articulated.From the first results of the research it emerges that the territory can no longer be considered as an abstract entity,but becomes the social space within which the construction of a new community welfare can and must take place.
文摘The outbreak of Covid-19 affects China’s health delivery system, and the current status of primary health services after the Covid-19 pandemic is not yet clear. To further explore the current status of demands of family health services, we conducted a cross-sectional survey, in the community of Haidian District, Beijing. Chi-square test analysis and multivariate logistic regression models were used to identify factors influencing residents’ demands for family healthcare services. Results show that population of married (OR = 3.108), living with parents (OR = 2.171), degree of Junior high school and above (OR = 7.250) and high school (OR = 7.670), Annual income: 0 - 56,000 (OR = 3.680) and 72,001 - 88,000 (OR = 1.690) have significant demands for family health care. The approach to building primary health services in Haidian District is worth promoting, but it is also important to pay attention to the health inequalities that can occur when patients are moved down to the grassroots level. .
基金supported by The Scientific Research Project of Guangxi Health and Family Planning Commission Foundation of China(No.Z20180913)。
文摘Objective:To investigate the health service demands and to analyze influencing factors among elderly people based on a community survey in Guilin,China.Methods:A random sampling was used to investigate 366 elderly people in a community using a Health-Care-Needs questionnaire,which was designed by The Western Nursing Alliance research team in China.This survey was used to understand the basic situation,financial condition,health condition,self-care abilities,pension plan,and care services demands of the elderly residing at home.Additionally,this article analyzed the influencing factors contributing to the obtained results.Results:The top 3 nursing needs were security needs(1.61±0.45 points),health education needs(1.54±0.57 points),and respect and self-development needs(1.13±0.64 points).Logistic multifactor regression analysis showed that gender,monthly income,lack of exercise,activities of daily living(ADL)scores,methods of medical payment,and pension plan were independent factors affecting elderly nursing needs.Conclusions:The home-based health services supply for elders did not meet their needs.Therefore,a comprehensive approach considering multifactors such as gender,income,exercise,self-care ability,medical expense payments,and supporting preferences should be considered to address the complex needs of health care.
基金The research grant for a potential lecturer was supported by Suan Sunadha Rajabhat Thailand.
文摘Objective This study aimed to explore the perceptions of good death of the older adults living in Bang Nang Li Sub-District,Amphawa District,Samut Songkhram Province,Thailand.Method The data of the study was collected using in-depth interviews between October 2019 to January 2020.The data collected a total of 14 older adults who had firsthand experience in caring for terminally ill patients were recruited for the study.Content analysis was employed to analyze qualitative data.Results The results of this study revealed the perceptions of good death which were categorized into three main themes and eight sub-themes,including 1)death without suffering(not suffering from life support devices,dying with care);2)natural death(death with the end of life expectancy,death with illness or ailments);and 3)death without the worries(preparation for death,spiritual and belief practice toward preparation for death,family and property management before death,death among family members and at their familiar place).Conclusion The findings of this research provided the insight to clarify the understanding of the perceptions on a good death of older adults.The findings can be used to support the practice and management of nursing education and health care providers who have to be involved in palliative care for terminally ill older adults.
文摘Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects should be included in health self assessment, especially in developed world. In the developing world, however, very few studies have examined self health assessment. The aim of this study was to identify particular aspects and associations in self health assessment and differences between subgroups in Ulaanbaatar, Mongolia. The area sampling approach and Kish tables were used for selecting respondents. Total 500 respondents were surveyed by paper-based questionnaires. Spearman’s analysis and multiple logistic regression analysis were used to show relations between variables. Sociodemographic status, such as age and gender, proved to be important in self health assessment. Other factors affecting self health assessment included the number of family members, daily life and lifestyles, social environment, community motivation, and utilization of health services. Women, the elderly, or people with less-than- normal access to information suffer from poor self-assessed health. People who are socially inactive and who have poor living conditions are less likely to use health care services and are likely to assess their health as “poor.” In order to reduce the poor self-assessed health status it is important to address disparities in socioeconomic factors, such as age, gender, employment, and residential area. In addition, more attention should be paid to community and health services, as well as to health promotion and empowerment activities, including income-generation activities. Further research is also needed, however, for better understanding of about the local people and their health-related issues.
文摘International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.
文摘This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.