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Job Satisfaction and Mental Health among Physicians in Primary Health Care Centers in Kuwait
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作者 Rihab Al-Wotayan Mahmoud Annaka Maqsood Nazar 《Health》 2019年第6期692-710,共19页
Objectives: To measure the level of job satisfaction among primary health care physicians Ministry of Health (MOH) Primary Healthcare Center (PHC) physicians, to evaluate the physicians’ mental health, and to assess ... Objectives: To measure the level of job satisfaction among primary health care physicians Ministry of Health (MOH) Primary Healthcare Center (PHC) physicians, to evaluate the physicians’ mental health, and to assess their associated factors. Study Setting: Kuwait Ministry of Health, Primary Care Centers. Study Design: Cross-sectional study. Data Collection: The study was conducted from July to September, 2017. Of 746 questionnaires distributed to all PHC physicians in the MOH, 417 questionnaires were completed. Information was collected on socio-demographic characteristics, work and health-related factors, job satisfaction (using the Warr-Cook-Wall job satisfaction scale), and mental health (using General Health Questionnaire). Principal Findings: Of participants, 40.8% were male, and 24.9% were Kuwaitis. Median overall job satisfaction was 71.4%. There were significant differences in overall job satisfaction with the physician rank (p = 0.008) and governorate (p = 0.05). The GPs were moderately satisfied with work surroundings;work freedom;recognition;degree of responsibility;salary;opportunity to use abilities;attention given to suggestions;relationship with hospital physicians, colleagues, and fellow workers;relations between management and workers;working hours;and the amount of variety in their job, but more satisfied with their immediate supervisors. Conclusions: Job satisfaction of PHC physicians is critical for the improvement of health systems. This study showed that GPs (General Practitioners) were more satisfied overall than previously reported studies done in Kuwait. They were moderately satisfied with their salary and the amount of variety in work. 展开更多
关键词 PHYSICIANS JOB SATISFACTION Primary health care centerS KUWAIT
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Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia
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作者 Sabah Mohammed Asiri Sultan Yahia Alfifii +6 位作者 Tagreed Khairan Al-Rashidi Sager Misfer Alqahtani Faiz Abdulrahman Alshafa Fayez Mari Alamri Amal Mohammed Asiri Fatima Mohammed Ali Almagadi Thuraya Mohammed Asiri 《International Journal of Clinical Medicine》 CAS 2024年第2期31-54,共24页
Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for... Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices. 展开更多
关键词 ASSESSMENT Breast Cancer Prevention Practices Women Attending health care centers Abha City
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U. S. Academic Medical Centers Under the Managed Health Care Environment 被引量:1
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作者 KRISTINA GUO (School of Policy and Managment, Florida International University,North Miami, FL 33181, U. S. A.) 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 1999年第2期81-87,共7页
This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of ... This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being. 展开更多
关键词 Academic Medical centers Cost Control health Policy Humans Managed care Programs Organizational Innovation United States
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Factors Influencing Patient-Centered Care in the Primary Health Care Settings: The Impact of the Pandemic Crisis and Nurses’ Experience
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作者 Adepeju Lateef Euphemia Mbali Mhlongo 《Open Journal of Nursing》 2022年第3期220-233,共14页
Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthc... Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness. 展开更多
关键词 healthcare Service NURSING Quality care Improvement Work Environment Patient-centered care And Primary health care
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Challenges for Nurses in Providing Patient-Centered Care in Rural Primary Health Care Clinics in Nigeria
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作者 Adepeju Lateef Euphemia M. Mhlongo 《Open Journal of Nursing》 2021年第9期772-793,共22页
Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in P... Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in Primary Health Care (PHC), and have recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with challenges in achieving the desired results in the PHC system. Thus, the study aimed to explore the factors that influence PCC utilization in the PHC facilities in Nigeria. A qualitative exploratory-descriptive design was used for this study. Data collection was conducted with the nurses from PHC facilities through individual interviews. Data saturation was achieved with 35 participants from 30 PHC facilities in Osun State, Nigeria, using a purposive sampling technique. All interviews were audio-recorded, later transcribed verbatim, and analyzed using the thematic analysis approach. NVivo 12 software was used for data management. The results from this study were categorized into two factors: Organizational factors and individual factors. Six themes that emerged from the study include inadequate management support, insufficient opportunities for further training, work overload and time constraints, health personnel readiness to use PCC, dearth enthusiasm for change, and poor nurses’ Accountability. The study shows that nurses encountered diverse challenges in providing patient-centered care. To improve the quality of healthcare delivery in the PHC facilities, there is a need to reinforce adequate management support, education, continued training, and the internal motivation of nurses to achieve transformative health outcomes in the community. 展开更多
关键词 Patient-centered care CHALLENGES Nurses Primary health care healthcare Service
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Place of Otorhinolaryngological (ENT) Diseases in a 2<i>nd</i>Level Health Center: Case of the of Commune V (CSRéf CV) Reference Health Center of the District of Bamako
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作者 Djibril Samaké Youssouf Sidibé +15 位作者 Sinaly Thiocary Fatogoma Issa Koné Youma Mamadou Maï ga Fatoumata Konaté Yatemelou Dara Kadidiatou Singaré Abdoul Wahab Haidara Adama Dembele Djeneba Sacko Mamadou Traoré Boubacar Sanogo Samba Karim Timbo Mohamed Amadou Kéï ta Alhousseini Ag Mohamed 《International Journal of Otolaryngology and Head & Neck Surgery》 2019年第3期91-97,共7页
Objective: Provide the place of ENT diseases at the Reference Health Center of the Commune V of Bamako. Materials and Method: A cross-sectional study using ENT medical assessment was carried out from January 2017 to D... Objective: Provide the place of ENT diseases at the Reference Health Center of the Commune V of Bamako. Materials and Method: A cross-sectional study using ENT medical assessment was carried out from January 2017 to December 2017 at the Reference Health Center of Commune V of Bamako’s District. Results: 1911 patients were included and that number represented 15.46% of all non-obstetrics medical consultations in the health center. The sex ratio was 0.83 for women (54.7%). The average age was 22 years old. Otologic diseases were 66.4% of the cases followed by nasal sinus cases (16.6%). Infectious and inflammatory diseases were 74.1% and were the main diagnosed diseases. The difficulties were mainly from technical platform. Conclusion: The diversity of these pathologies required a strong development or reinforcement of human and material resources capacities in of these structures for proximity care management. 展开更多
关键词 ENT Disease care REFERENCE health center
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基于SERVQUAL模型的基层医疗卫生服务质量评价研究 被引量:1
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作者 李旭 赖思宏 +3 位作者 陈静纯 黄群芳 林晓玲 周驰 《中国卫生事业管理》 北大核心 2024年第3期274-279,共6页
目的:在县域医共体的建设背景下,评价社区卫生服务中心服务质量及影响因素,提出基层医疗卫生服务质量改善对策。方法:运用SERVQUAL模型,从社区卫生服务中心服务质量的有形性、可靠性、响应性、信任性、移情性方面,形成问卷条目;通过多... 目的:在县域医共体的建设背景下,评价社区卫生服务中心服务质量及影响因素,提出基层医疗卫生服务质量改善对策。方法:运用SERVQUAL模型,从社区卫生服务中心服务质量的有形性、可靠性、响应性、信任性、移情性方面,形成问卷条目;通过多因素二分类logistic回归探索筛查服务质量差距的影响因素;借助IPA象限图呈现居民对社区卫生服务中心的SERVQUAL模型各维度服务质量重要性的分布情况。结果:问卷各项条目的服务质量差距均为负值,服务保证性和移情性维度的服务质量差距得分最高,分别为-0.47±0.59分和-0.47±0.65分;服务有形性维度的服务质量差距得分最低,为-0.40±0.55分。年龄、收入情况和慢病年限是服务质量差距的影响因素。结论:当前基层医疗卫生服务质量与居民的期望之间存在一定差距,基层医疗卫生服务机构应重视对低年龄、高收入和慢病病程较长的居民的服务需求。 展开更多
关键词 县域医共体 SERVQUAL模型 社区卫生服务中心 基层医疗卫生服务
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People-Centered Care: Concept Analysis
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作者 Aya Nitamizu Noyuri Yamaji Erika Ota 《Health》 CAS 2022年第11期1130-1142,共13页
Purpose: This study aims to clarify the definition, attributes, antecedents, and consequences of the concept of people-centered care (PCC). Method: Rogers and Knafl’s evolutionary method was used to analyze the conce... Purpose: This study aims to clarify the definition, attributes, antecedents, and consequences of the concept of people-centered care (PCC). Method: Rogers and Knafl’s evolutionary method was used to analyze the concept of People-centered care. The cords such as “Attributes,” “Antecedent,” and “Consequences” were extracted on the coding sheet. The extracted contents of each of the “Attributes,” “Antecedent,” and “Consequences” from the created coding sheets were summarized as codes, and similar codes were categorized. Result: We included 33 studies in the analysis. As a result of the analysis, we identified four attributes (the subject is people, approaches to improving and enhancing health issues, relationships as a basis for partnership building, and behavioral attitudes for building partnerships), four antecedents (changes in social conditions, increasing people’s ownership of their health, health issues in modern society, and care in a variety of settings), and three consequences (achieving goals set by the people themselves, self-transformations of both people and healthcare providers, and social transformations). Discussion: Based on the analysis results, PCC was defined as “an initiative in which people step forward and partner with health care providers to improve and enhance health issues in individuals and communities.” In various social and individual changes, the realization of PCC is expected to result in the achievement of goals set by the people themselves together with health care providers and the transformation of individuals and society. 展开更多
关键词 People-centered care Community Members health care Providers PARTNERSHIP Concept Analysis
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Nurse Mentor Training Program to Improve Quality of Maternal and Newborn Care at Primary Health Centres: Process Evaluation
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作者 Maryann Washington Krishnamurthy Jayanna +8 位作者 Swarnarekha Bhat Annamma Thomas Suman Rao Gayathiri Perumal Troy Cunningham Janet Bradley Lisa Avery Elisabeth Fischer Prem K. Mony 《Open Journal of Nursing》 2016年第6期458-469,共12页
Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form th... Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems. 展开更多
关键词 Nurse Mentors Skilled Birth Attendance Training Program Basic Newborn care Maternal care Primary health centers Quality Improvement INDIA
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Quality assessment of the practice of focused antenatal care (FANC) in rural and urban primary health centres in Ekiti State
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作者 Ikeoluwapo O. Ajayi Damilola C. Osakinle Eunice O. Osakinle 《Open Journal of Obstetrics and Gynecology》 2013年第3期319-326,共8页
Objective: To ascertain that standard antenatal care (Focused antenatal care) is being received at the Primary Health Care level in urban and rural areas of Ekiti State and to determine the facilitating factors and ch... Objective: To ascertain that standard antenatal care (Focused antenatal care) is being received at the Primary Health Care level in urban and rural areas of Ekiti State and to determine the facilitating factors and challenges to the practice of FANC in urban and rural areas. Design: Cross sectional. Setting: Primary Health Centers Participants: Pregnant women and Heads of health facilities. Methods: Two hundred respondents each from urban and rural areas primary health centres were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the antenatal care exit interview form of the Safe Motherhood Needs Assessment package. In-depth Interviews were conducted with the heads of selected facilities. Data was analysed using descriptive statistics and Chi square test and content analysis for indepth interview. Results: More respondents 58 (29.3%) from the urban areas had the minimum contents compared to 41 (20.7%) of the rural respondents (p < 0.05) and 178 (90.8%) of the urban were taught a range of health education topics compared to 177 (88.5%) (p = 0.45). Urban respondents were about 1.6 times more likely to receive the minimum contents than rural respondents. In-depth interview results explicated the facilitating factors and challenges to focused antenatal care in the study areas. Conclusion: The findings of this study is consistent with other studies establishing the fact that better health service is available to urban residents than rural residents;however, this study has succeeded in comparing the documented standard of antenatal care with what was being practiced in the selected PHCs of the state. The basic contents of focused antenatal care in Ekiti state were received by a small proportion of the respondents, suggesting that focused antenatal care had not fully translated into quality service;one major challenge to the delivery of standard antenatal care was inadequate number of skilled health workers especially in the rural areas. The gap between quality and utilisation of antenatal in urban and rural areas is gradually being closed up;this success should be improved upon and maintained. 展开更多
关键词 FOCUSED ANTENATAL care URBAN and RURAL Differences Ekiti STATE PRIMARY health centers (PHCs)
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中医馆健康信息平台应用现状与思考
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作者 张磊 于林勇 +2 位作者 国华 李淳 张兴平 《中国中医药图书情报杂志》 2024年第4期43-46,共4页
本文基于中医馆健康信息平台应用现场调研和问卷调研结果,发现中医馆健康信息平台推广应用过程中存在后续经费投入不足、与医院信息系统对接困难等一系列问题。笔者基于调研结果,就如何更好地推广应用中医馆健康信息平台提出相关建议,... 本文基于中医馆健康信息平台应用现场调研和问卷调研结果,发现中医馆健康信息平台推广应用过程中存在后续经费投入不足、与医院信息系统对接困难等一系列问题。笔者基于调研结果,就如何更好地推广应用中医馆健康信息平台提出相关建议,以期更有效地提升基层中医馆信息化水平和诊疗能力。 展开更多
关键词 中医馆健康信息平台 基层医疗卫生机构中医诊疗区(中医馆) 中医药数据中心 信息化
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基于PCAT的签约服务模式下社区儿童健康服务质量研究
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作者 王晰 殷涛 +2 位作者 杨慧敏 王皓翔 尹德卢 《中国全科医学》 CAS 北大核心 2024年第28期3510-3514,共5页
背景基层医疗卫生机构以其综合、连续、协调、便捷和经济的特点,扮演着儿童常见病、多发病诊疗、计划免疫以及儿童健康管理的重要角色,为儿童健康服务奠定坚实基础。开展家庭医生签约管理下的儿童保健服务,对于提升儿童健康服务质量至... 背景基层医疗卫生机构以其综合、连续、协调、便捷和经济的特点,扮演着儿童常见病、多发病诊疗、计划免疫以及儿童健康管理的重要角色,为儿童健康服务奠定坚实基础。开展家庭医生签约管理下的儿童保健服务,对于提升儿童健康服务质量至关重要。然而,我国基层机构在儿童健康服务能力方面存在地区差异,因此,准确评价基层儿童健康服务质量,有助于及时发现问题,推动基层儿童健康服务向更高水平发展。目的了解签约儿童家长对社区儿童健康服务质量的评价情况,分析质量问题,提出优化策略,为进一步提升社区儿童健康服务质量、推进儿童签约服务高质量发展提供决策参考。方法以成都市某区为案例地区,2022年采用方便抽样,抽取该区3家社区卫生服务中心为样本机构,采用初级卫生保健服务质量评价工具(PCAT)中文版,对样本机构签约儿童家长进行社区儿童健康服务质量在线问卷调查。结果共完成3631名签约儿童家长调查。样本机构社区儿童健康服务质量PCAT中文版总得分为(58.72±13.43)分。社区儿童健康服务质量PCAT得分相对较高的维度为“持续性”“社区首诊(服务可及性和服务使用)”以及“服务综合性(服务提供)”,而“以家庭为中心”“综合性(可用服务)”和“协调性(转诊)”等维度得分相对较低。不同户籍、文化程度、平均年收入、有无熟悉的医护人员和过去1年在该中心就诊次数的调查对象PCAT中文版总得分比较,差异有统计学意义(P<0.05);多元线性回归分析结果显示,调查对象的户籍所在地,母亲的文化程度、家庭平均月收入、有无熟悉的医护人员和过去1年在该中心就诊次数均是PCAT总得分的影响因素(P<0.05)。结论案例地区签约服务模式下社区儿童健康服务质量水平有较大提升空间,应重点加强社区儿童健康服务综合性(可用服务)和服务协调性(转诊),推动以儿童及家庭为中心理念落实,关注非本地户籍儿童健康服务工作。 展开更多
关键词 儿童保健服务 签约服务 社区卫生中心 初级卫生保健服务质量评价工具
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化州市乡镇卫生院急救与生命支持类医疗设备管理现状
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作者 方灿亮 刘舒娅 +4 位作者 杨军 文艺 周元淼 薛允莲 刘贵浩 《现代医院》 2024年第10期1522-1526,共5页
目的了解化州市乡镇卫生院急救与生命支持类医疗设备管理现状,为基层医疗机构提升急救服务水平提供参考依据。方法采用便利抽样的方法,对化州市24所乡镇卫生院的医师、护士、医技人员、公卫人员、行政及后勤人员进行问卷调查,主要包括... 目的了解化州市乡镇卫生院急救与生命支持类医疗设备管理现状,为基层医疗机构提升急救服务水平提供参考依据。方法采用便利抽样的方法,对化州市24所乡镇卫生院的医师、护士、医技人员、公卫人员、行政及后勤人员进行问卷调查,主要包括急救与生命支持类医疗设备的采购配置、更新升级、使用操作、维护保养、应急处理、管理制度、质量评估监测和培训七方面的内容。结果化州市乡镇卫生院对急救、生命支持类设备培训较为充足(65.2%),化州北部和化州中部乡镇卫生院在设备培训、设备故障停机应急处理流程、定期开展设备故障停机应急处理演练、满足临床救治工作需要、管理制度完善、定期设备维护和检查、定期质量评估和监测等方面均优于化州城区和化州南部乡镇卫生院;因子分析结果显示,化州城区乡镇卫生院设备老化与质量问题较为突出,化州北部乡镇卫生院急需生命维持与治疗设备的问题较为突出。结论化州市乡镇卫生院急救与生命支持类医疗设备管理水平存在区域差异,建议通过提升乡镇卫生院人员综合素质、优化工作人员“有效培训”、完善年度管理计划以提升管理品质等措施进一步提升基层急救服务能力。 展开更多
关键词 乡镇卫生院 急救 生命支持 医疗设备
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构建优质高效的整合型卫生健康体系 被引量:1
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作者 梁万年 《中国全科医学》 CAS 北大核心 2024年第19期2301-2304,共4页
建设中国特色优质高效的、以人为本的整合型卫生健康服务体系,是落实健康中国战略的重要抓手,是推动卫生健康事业高质量发展的必然要求。本文指出,以人为本的整合型卫生健康服务体系必须是以健康为中心,急慢分诊、上下联动、防治结合,... 建设中国特色优质高效的、以人为本的整合型卫生健康服务体系,是落实健康中国战略的重要抓手,是推动卫生健康事业高质量发展的必然要求。本文指出,以人为本的整合型卫生健康服务体系必须是以健康为中心,急慢分诊、上下联动、防治结合,公立医疗卫生机构和社会力量办医协同发展。构建以人为本的整合型卫生健康服务体系,要实现服务体系、服务理念、服务决策、医患关系、服务模式、支付机制、监管考核7个方面的转变,关键在于推动医疗卫生体系和公共卫生服务体系的强化、延伸和融合。本文强调了管理体制改革与充分利用信息化手段的重要性,并指出以人为本的整合型卫生健康服务体系的本质目的是尽力满足老百姓全方位的健康需求,建立合理有序的就医格局,最终使健康中国建设有强大的卫生健康系统做支撑。 展开更多
关键词 卫生服务管理 以人为本的整合型卫生服务 跨部门合作 社区卫生服务 卫生保健评价机制 家庭医疗保健服务
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城市社区安宁疗护病房服务困境及对策分析——以H社区卫生服务中心安宁疗护病房为例
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作者 龙庆珍 马允亮 刘帅 《医学与哲学》 北大核心 2024年第19期36-40,共5页
在共生理论视域下,以上海市闵行区H社区卫生服务中心为例,探讨当前城市社区安宁疗护病房服务过程中的难点,从共生单元、共生模式和共生环境三方面分析困境及对策,总结出分工协作格局待优化、信息共享交互迟滞等问题。针对困境,提出明确... 在共生理论视域下,以上海市闵行区H社区卫生服务中心为例,探讨当前城市社区安宁疗护病房服务过程中的难点,从共生单元、共生模式和共生环境三方面分析困境及对策,总结出分工协作格局待优化、信息共享交互迟滞等问题。针对困境,提出明确功能定位及各单元责任,加强信息交互;基于医联体建设,优化组织机制;构建一体化互惠服务模式;加大扶持力度;积极宣传引导,提升人文关怀意识等对策;以期进一步推动城市社区安宁疗护病房服务的可持续发展。 展开更多
关键词 安宁疗护 共生理论 社区卫生服务中心 卫生政策
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某医联体内奈玛特韦片/利托那韦片药学监护实践效果
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作者 邱瑶 徐嵘 +8 位作者 赵新才 江静舟 刘翎 戴旸 姚顺 杨琦 瞿隆 张剑萍 郭澄 《中国药业》 CAS 2024年第12期28-32,共5页
目的促进临床新型冠状病毒感染小分子药物(简称新冠小分子药物)的合理使用。方法以上海交通大学医学院附属第六人民医院及上海市徐汇区康健街道、凌云街道、田林街道社区卫生服务中心组建医疗联合体(简称医联体),构建新冠小分子药物药... 目的促进临床新型冠状病毒感染小分子药物(简称新冠小分子药物)的合理使用。方法以上海交通大学医学院附属第六人民医院及上海市徐汇区康健街道、凌云街道、田林街道社区卫生服务中心组建医疗联合体(简称医联体),构建新冠小分子药物药学监护模式,包括社区药师培训、开展药学监护及三级医院药师指导评价等环节。收集3个社区卫生服务中心2023年1月至2月使用奈玛特韦片/利托那韦片(NMV/RTV)新冠病毒感染门诊患者的资料,分析患者的用药情况,以及药物相关问题(DRP)的发生情况。结果共纳入79例患者,其中78例(98.73%)年龄≥60岁;合并疾病(3.04±1.71)种,主要为心血管疾病(64例次、81.01%),糖尿病(35例次、44.30%),高脂血症(16例次、20.25%);使用药品(6.00±3.66)种;使用中成药36例(45.57%)。社区药师共完成150次随访,发现并干预87件DRP,其中NMV/RTV 77件,主要为药物相互作用(70件),涉及药物类型排前3的分别为钙离子通道阻滞剂(31件、44.29%),抗焦虑药(12件、17.14%),羟甲基戊二酰辅酶A还原酶抑制剂(11件、15.71%)。根据出现的DRP,医联体药师提出了减量服用、暂停给药、密切监测相关指标(如疗效、药品不良反应、血压、血栓风险)等用药建议。结论社区新冠病毒感染老年患者占比较高,用药复杂,NMV/RTV使用过程中存在较多DRP。基于医联体的新冠小分子药物药学监护模式可帮助社区药师规范化开展药学监护工作,及时发现并干预DRP,有利于促进医联体内药学服务同质化,为后续新冠小分子药物的用药管理提供依据。 展开更多
关键词 新型冠状病毒感染 小分子药物 奈玛特韦片/利托那韦片 医疗联合体 药学监护 三级医院 社区卫生服务中心
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中心群组化孕期保健模式联合循证护理对高龄孕妇剖宫产率、妊娠结局及母乳喂养情况的影响
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作者 黄伟妍 李文君 夏斌 《海南医学》 CAS 2024年第12期1809-1813,共5页
目的探讨中心群组化孕期保健模式联合循证护理对高龄孕妇剖宫产率、妊娠结局及母乳喂养情况的影响。方法选择2021年12月至2023年8月东莞市人民医院产科收治的90例高龄孕妇作为研究对象,按照随机数字分配法分为观察组和对照组各45例。对... 目的探讨中心群组化孕期保健模式联合循证护理对高龄孕妇剖宫产率、妊娠结局及母乳喂养情况的影响。方法选择2021年12月至2023年8月东莞市人民医院产科收治的90例高龄孕妇作为研究对象,按照随机数字分配法分为观察组和对照组各45例。对照组孕妇接受传统孕期保健模式,观察组孕妇给予中心群组化孕期保健模式联合循证护理,孕期保健及护理从孕妇入组开始直至孕妇分娩。自制调查问卷调查两组孕妇的孕期相关知识了解程度,所有孕妇于孕32周前完成第一次问卷调查,包括孕期活动、产前检查、孕期饮食三个维度;所有孕妇于孕35周前完成第二次问卷调查,包括胎儿保健和分娩知识两个维度。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)分别于孕妇入组时、分娩后2 h评价两组孕妇的负面情绪。比较两组孕妇的第一产程、第二产程、第三产程及总产程时间以及分娩方式、产后出血量、新生儿Apgar评分和母乳喂养技能量表(LATCHES)评分。结果观察组孕妇的孕期活动、产前检查、孕期饮食、胎儿保健和分娩知识得分分别为(18.86±1.19)分、(18.21±1.03)分、(18.06±0.94)分、(19.11±1.13)分、(18.23±0.98)分,明显高于对照组的(17.51±0.86)分、(17.34±0.91)分、(17.02±0.75)分、(17.89±0.85)分、(17.42±0.81)分,差异均有统计学意义(P<0.05);观察组孕妇分娩后2 h的SAS、SDS评分分别为(44.23±5.38)分、(43.19±5.03)分,明显低于对照组的(48.71±6.43)分、(47.34±6.19)分,差异均有统计学意义(P<0.05);观察组孕妇的第一产程、第二产程、第三产程和总产程时间分别为(198.75±51.92)min、(38.61±10.02)min、(6.23±1.14)min、(239.06±62.41)min,明显短于对照组的(241.26±62.37)min、(53.46±14.71)min、(7.86±1.82)min、(312.23±78.09)min,差异均有统计学意义(P<0.05);观察组孕妇的剖宫产率为11.11%,明显低于对照组的31.11%,观察组的产后出血量为(264.48±31.23)mL,明显低于对照组的(311.65±46.74)mL,新生儿Apgar评分和LATCHES量表评分分别为(9.26±0.51)分、(31.27±3.23)分,明显高于对照组的(8.74±0.37)分、(28.03±2.16)分,差异均有统计学意义(P<0.05)。结论中心群组化孕期保健模式联合循证护理能够有效提高高龄孕妇对孕期相关知识的了解程度和自我管理能力,孕妇孕期的负面情绪得到有效缓解,产程明显缩短,剖宫产率明显降低,孕妇的母乳喂养状况得到显著改善。 展开更多
关键词 高龄孕妇 中心群组化孕期保健模式 循证护理 妊娠结局 剖宫产率 母乳喂养
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PCIC框架下宁波市鄞州区“一体化门诊”建设实践
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作者 孙高幸 王武超 +1 位作者 陈迎宁 毕四岭 《医院管理论坛》 2024年第6期42-45,共4页
信息孤岛和服务“碎片化”是目前影响患者诊疗服务协调性和首诊医生全程诊疗管理的主要因素。为做好医疗信息和服务的碎片“整合”,更好地为患者健康服务,宁波市鄞州区搭建以健康天眼为基础的、以人的健康全貌为链条的“一体化门诊”:... 信息孤岛和服务“碎片化”是目前影响患者诊疗服务协调性和首诊医生全程诊疗管理的主要因素。为做好医疗信息和服务的碎片“整合”,更好地为患者健康服务,宁波市鄞州区搭建以健康天眼为基础的、以人的健康全貌为链条的“一体化门诊”:首先通过数字赋能及时捕捉到患者的就诊信息并将其同步到区域健康信息系统;其次针对重点疾病、重要检查、紧缺药品,统一调用全区医疗资源,并通过全面落实疾病诊治、分级诊疗、健康指导等多类措施,建立了全方位、协调性、主动干预的全科医生健康管理的创新模式。 展开更多
关键词 以人为本 一体化服务框架 一体化门诊
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PCIC框架下宁波市鄞州区“一体化学科”建设实践
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作者 孙高幸 王武超 +1 位作者 陈迎宁 毕四岭 《医院管理论坛》 2024年第9期45-47,39,共4页
为解决医疗卫生服务阶段化、碎片化、片面化、差异化问题,宁波市鄞州区率先以学科为基本单元,结合区域内主要健康问题和优势学科,以整合、连续、高效为原则,以某一疾病的全流程管理为试点,通过打通优势医疗资源、统一服务质量控制标准... 为解决医疗卫生服务阶段化、碎片化、片面化、差异化问题,宁波市鄞州区率先以学科为基本单元,结合区域内主要健康问题和优势学科,以整合、连续、高效为原则,以某一疾病的全流程管理为试点,通过打通优势医疗资源、统一服务质量控制标准体系、建立统一平台等方式建立了慢性肾病、血液病等一体化学科。运行以来,相应疾患管理服务的质量、综合性、连续性有了持续优化,居民健康获得感也持续提升,从而建立了连续性医疗服务专病管理模式,在提升整体卫生服务能力的同时减轻了群众的医疗费用负担。 展开更多
关键词 以人为本 一体化服务模式 学科整合
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中心群组化孕期保健模式在初产妇中的应用及效果探析
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作者 李璇 任娟 《中国社区医师》 2024年第23期101-103,共3页
目的:探析中心群组化孕期保健模式在初产妇中的应用效果。方法:以随机分组方式(对照组、观察组,n=50)对新疆维吾尔自治区伊宁市妇幼保健院100例初产妇患者(2022年10月—2023年10月)予以分组研究。对照组应用常规保健,观察组应用中心群... 目的:探析中心群组化孕期保健模式在初产妇中的应用效果。方法:以随机分组方式(对照组、观察组,n=50)对新疆维吾尔自治区伊宁市妇幼保健院100例初产妇患者(2022年10月—2023年10月)予以分组研究。对照组应用常规保健,观察组应用中心群组化孕期保健模式,比较两组的干预效果。结果:观察组的积极心理评分高于对照组;观察组的健康行为依从率高于对照组;观察组自然分娩率与会阴完整率、新生儿Apgar评分均高于对照组,产后出血量低于对照组;观察组对孕期保健的满意度高于对照组,差异均有统计学意义(P<0.05)。结论:对于初产妇而言,接受中心群组化孕期保健模式干预的效果更好,更利于树立其积极心理和健康行为,还可促进妊娠结局的优化。 展开更多
关键词 中心群组化孕期保健模式 初产妇 心理状态 健康行为
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