Affordability, Accessibility, and Quality of Maternal Health Care Services and Level of Satisfaction of Mothers in Rural Areas in China

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on satisfaction.Methods:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng City.Results:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 minutes.The issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial burden.More than 50%of respondents were satisfied with two specific dimensions(P<0.05)regarding the quality of maternal healthcare services.Conclusion:The study found that accessibility,affordability,and quality significantly affect mothers’satisfaction with maternal health services.Future research should focus on developing more suitable service pathways for rural mothers.

Impact of Village-based Health Education of Tobacco Control on the Current Smoking Rate in Chinese Rural Areas

The number of smokers in Chinese rural areas is more than 200 million, which is twice that in cities. It is very significant to carry out tobacco control interventions in rural areas. We performed this community intervention study to evaluate the efficacy of village-based health education of tobacco control on the male current smoking rate in rural areas. The population of this study was the males above 15 years old from 6 villages in rural areas. The villages were randomly assigned to intervention group or control group（3 villages in each group）. Self-designed smoking questionnaire was applied. The intervention group received the village-based health education of tobacco control for one year. The primary outcome measurement was the male current smoking rate. In the baseline investigation, completed surveys were returned by 814 male residents from the control group and 831 male residents from the intervention group. The male current smoking rate in the control group and the intervention group was 61.2% and 58.5%, respectively, before intervention. There was no significant difference between these two groups（P〉0.05）. After one-year intervention, the current smoking rate in the intervention group（51.2%） was significantly lower than that in the control group（62.8%）（P〈0.001）. Our study suggested that the village-based health education of tobacco control was effective in lowering the male current smoking rate in rural areas, which could be a suitable and feasible way for tobacco control in the Chinese rural areas.

Health and Environmental Hazards of Residential Coal and Biomass Fuel Burning in Rural Areas

Recent years have witnessed growing concern over regional atmospheric pollution in China. After the introduction of the Environmental Protection Law on January 1, 2015, governments at both central and local levels have begun to enforce a series of stricter control measures. As a result, it is expected that pollution caused by large energy-consuming sectors such as power。

Effects of livestock and poultry breeding pollution on health risks:Evidence from a hog breeding case in rural China

With the rapid development of livestock and poultry breeding industries,pollution problems caused by the discharge of wastewater and manure have become increasingly severe.However,studies on the impacts of this pollution on rural residents'health are lacking.Based on data from the Peking University's China Family Panel Studies in 2010 and 2014,this paper uses a cross-sectional and panel data probit model to estimate the probability of breeding industry development in rural areas increasing the health risks of local villagers.First,the study found that the more households engaged in breeding in the region or the larger the scale of regional breeding,the higher the health risks to local villagers,particularly in areas where pigs are raised.Second,compared with individual farming,the greater the proportion of large-scale farming,the higher the health risks to villagers.Third,the development of the breeding industry seldom includes the ecological recycling of wastes and fails to reduce the use of local pesticides and fertilizers,thereby increasing the health risks to villagers.Therefore,this paper argues that providing technology to process breeding industry waste and establish an organic industrial production chain will be crucial to reducing the impact of breeding industry pollution on human health.

Investigation and Countermeasures on the Health-Promoting Lifestyle of the Disabled Elderly in a Rural Area

Objective： To investigate the level of health-promoting lifestyle in the disabled elderly in a rural area and to provide useful countermeasures for health care workers and the government to improve the elderly＇ s lifestyle behaviors. Methods： A total of 446 disabled elderly people were recruited and examined using the General Questionnaire and Health-Promoting Lifestyle Profile II. Results： The mean score of the health-promoting lifestyle was 109.73（ SD = 16.80）, in which 90.6 percent of the disabled elderly demonstrated unhealthy lifestyle behaviors. The average score for each of the subscales includedthe following： interpersonal relations, stress management, nutrition, self-actualization, health responsibility, and sports activity. Conclusions： The health-promoting lifestyle of the disabled elderly needs to be improved; health care workers and the government should pay more attention to the countermeasures that can improve the lifestyle behaviors and promote the health of the disabled elderly.

Qualitative Rural Indonesian Study of Diabetes Knowledge, Health Beliefs, and Behaviors in Type 2 Diabetes Patients

This study was aimed at understanding diabetes knowledge, health beliefs, and behaviors among type 2 diabetes patients in Balinese rural areas. The study used the Health Belief Model (HBM) in applied thematic analysis. It involved semi-structured focus groups with 20 patients (M = 49.95 years old, SD 6.7). Three themes formulated: poor diabetes knowledge, diabetes perceived as a life burden, and the factors affecting self-efficacy in practicing healthy lifestyle. The poor diabetes knowledge was due to traditional indigenous beliefs and low health literacy. The perception that diabetes is a life burden was related with physical and psychological condition. The factors affecting the self-efficacy were the perceived barriers and external influence. It is need to understand the traditional indigenous beliefs, burdens, and lacking internal intention as the modifying factors of health beliefs. This study suggests that the development of integrated health promotion of diabetes should consider the HBM’s modifying factors in rural areas.

An investigation of the health value and self-care capabilities of the elderly in urban-rural fringe area nursing homes and the related in？uencing factors

Objective：To investigate the health value and self-care capabilities of the elderly living in urban-rural fringe area nursing homes and the factors that influence these variables.Methods：A cluster sampling method was used to select 280 elderly individuals from seven urban-rural fringe communities in Xianning to complete a survey regarding their health value and self-care capabilities.Results：The total health value and self-care capability scores of the elderly were 7.45 ± 1.45 and100.25±22.56,respectively.Both of these scores significantly differed by age,education level,marital status,and income（P 〈 0.05,P 〈 0.01）.Self-care capability was correlated with health value（r=0.521）.A multivariate linear regression analysis showed that health value,marital status,and age predicted selfcare capability.Conclusions：Elderly people living in the urban-rural fringe area with higher health values also had higher self-care capabilities.The self-care capabilities of the elderly can be enhanced by improving their health value using the ＂knowing-trusting-acting＂ model.

On Rural Medical Care and Health Undertaking Development during New Medical Reform

Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

我国基层医生社区康复服务能力现状与对策研究

背景“康复回社区”是形成合理就医格局的重点要求,也是实现人人享有康复服务的重要策略,但目前我国基层医生的社区康复服务能力与居民日益增长的康复需求仍有差距。目的了解我国基层医生社区康复服务能力的现状、特点与不足,为制定能力提升对策提供科学依据。方法2020年8月采用多阶段分层抽样与典型抽样相结合的方法对中国江苏省、安徽省、河南省、重庆市、甘肃省五地基层医疗卫生机构的医生开展问卷调查,从康复功能评定、康复医疗服务、中医药保健指导、中医理疗四个方面调查基层医生社区康复服务能力现状。结果共回收8374份问卷,接受调查的基层医生中,分别有4697名(56.1%)、6396名(76.4%)、5833名(69.7%)、4834名(57.7%)具备康复功能评定、康复医疗服务、中医药保健指导、中医理疗能力,且农村地区基层医生各项社区康复能力及综合能力具备率均高于城市地区(P<0.05)。不同年龄、学历、执业资格、岗位基层医生的康复医疗服务指导、中医药保健指导、中医理疗能力具备率比较,差异有统计学意义(P<0.05);组内两两比较结果显示,在年龄方面,30岁以下及60岁以上基层医生康复功能评定能力的具备率高于30~<45岁、45~<60岁(P<0.016),45~<60岁医生具备率高于30~<45岁(P<0.016),45岁以下的康复医疗服务指导能力具备率低于45岁以上的基层医生(P<0.016);30岁以下基层医生中医药保健指导、中医理疗能力具备率低于30~<45岁、45~<60岁和60岁以上(P<0.016),30~<45岁医生能力具备率低于45~<60岁和60岁以上(P<0.016),45~<60岁医生具备率低于60岁以上(P<0.016)。在学历方面,高中/中专及以下学历基层医生能力具备率高于大专学历和本科学历(P<0.016),大专学历医生能力具备率高于本科学历(P<0.016)。在执业资格方面,全科医师具备率高于乡村医师和执业(助理)医师(P<0.016),乡村医师具备率高于执业(助理)医师(P<0.016)。在工作岗位方面,中医岗位基层医生中医药保健指导、中医理疗能力具备率高于临床岗位和其他岗位(P<0.016),临床岗位具备率高于其他岗位(P<0.016)。基层医生康复医疗综合能力具备率高于中医康复综合能力(P<0.05)。结论基层医生社区康复服务能力总体不足,中医康复能力较为薄弱。应完善分级康复服务体系建设,促进基层医生康复经验的积累和能力的提升,加强基层医生中医康复与西医现代康复技术联合培养,完善基层康复人才队伍建设,使其能承担起社区康复的责任。

基于赋权教育的自我管理干预对农村糖尿病患者的影响

目的探讨实施基于赋权教育的自我管理干预对农村糖尿病患者自我管理能力的效果。方法选取内分泌科住院的78例农村糖尿病患者为研究对象,按照入院时间顺序分成对照组(2022年6-10月)和观察组(2022年11月至2023年3月)各39例。观察组接受基于赋权教育模式的自我管理方案;对照组接受常规的糖尿病宣教方案。比较两组干预后血糖控制水平、自我管理能力和疾病态度。结果观察组34例、对照组35例完成研究。两组出院当日,出院后3、6个月患者自我管理能力、糖尿病态度得分显著高于对照组,空腹血糖值显著低于对照组(均P<0.05)。结论实施基于赋权教育的自我管理方案可改善农村糖尿病患者对疾病的态度和血糖控制水平,提高自我管理能力。

外源内生型社会组织参与农村社会治理何以可能?

社会组织参与农村社会治理有助于提升社会治理效能,契合了国家推动社会组织积极参与乡村振兴的要求。与外源型和内生型社会组织不同,外源内生型社会组织主要由村庄外部主体动员成立,由村内精英运行,具有参与农村社会治理的优势,但因缺乏外部资源的持续性输入,导致很多外源内生型社会组织运行困难。本文以运行较好的一个外源内生型社会组织陕西省T村老年协会为个案,探讨外源内生型社会组织参与农村社会治理的机理。研究发现,通过一定的组织行为,外源内生型社会组织可以形成参与农村社会治理的各项机制,如与其他治理组织互相嵌入的组织机制,政府资助、社会捐赠与用者付费相结合的多元化筹资机制,定期活动串联重塑村庄节奏的链接机制,规范活动程序与采取预防措施的风险防范机制,以声誉、信任和互惠为关键因素巩固集体行动领导力的领导机制,从而保障外源内生型社会组织有效参与农村社会治理,助力乡村振兴。

睡眠质量对农村老年人生命质量的影响:心理健康的中介效应与跌倒风险的调节作用

为探讨农村地区老年人睡眠质量与生命质量之间的作用机制,文章采用欧洲五维三水平健康量表、匹兹堡睡眠质量量表、12项目一般健康问卷与Morse跌倒风险评估量表调查M县农村老年人,并用Bootstrap法进行中介效应与调节效应的检验。结果发现,心理健康在老年人睡眠质量和生活质量之间起到部分中介作用(效应值为-0.197,95%置信区间为-0.331~-0.072),中介效应占总效应的43.8%;中介效应受到跌倒风险的调节(R=-0.020,P<0.01),在跌倒风险较高的老年人中观察到更大的影响。因此,跌倒风险调节了老年人心理健康在其睡眠质量与生命质量之间的中介作用。降低跌倒风险,可能会提升睡眠质量差、心理健康状况不佳的老年人的生命质量。

山西省农村围绝经期女性骨质疏松症健康素养水平及影响因素

目的:调查山西省农村围绝经期女性骨质疏松症健康素养水平,分析其影响因素。方法:采用便利整群抽样的方法,在自愿原则基础上,选取山西农村40~60岁围绝经期女性2760人进行骨质疏松症健康素养调查,并分析相关影响因素。结果:共纳入2721名围绝经期女性,骨质疏松症健康素养总分为(146.76±16.57)分,健康素养具备率为21.65%;健康状况和家庭成员是否患有骨质疏松症是该人群骨质疏松症健康素养的主要影响因素。结论:山西省农村围绝经期女性骨质疏松症健康素养水平有待提升,可基于相关影响因素开展适合的健康教育,以提高该人群骨质疏松症健康素养水平。

融合农村居民意图的健康知识推荐方法

为提高农村居民健康认知水平,提出一种融合农村地区居民意图的健康知识推荐方法。考虑到村民对不同健康知识的偏好,建模用户层中村民与健康知识间的关系路径,捕获村民获取健康知识的潜在意图,利用图卷积与注意力机制传播聚合村民意图邻居节点信息,获得村民与健康知识的高阶邻域表示,通过双交叉聚合器将初始节点与邻域表示进行聚合,增强村民与健康知识的表示能力,实现村民健康知识精确推荐。基于农村健康知识数据集验证研究模型有效性,结果表明该模型在准确率、NDCG指标上均得到了一定程度的提高。

4~7岁儿童代谢综合征有关指标之间相关模式研究

目的探究4~7岁儿童代谢综合征有关指标之间的相关模式。方法依托前期开展的孕期增补复合微量营养素预防母婴不良结局项目,在河北满城、元氏2县选取参加项目孕妇所生儿童1454名,于儿童4~7岁时测量身高、体重、腰围、血压并检测血脂和血糖。采用Pearson相关分析检验体质指数(BMI)、腰围、总胆固醇(CHO)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、空腹血糖(FPG)、收缩压和舒张压共9个指标之间的线性相关关系。参照美国心脏学会标准判定儿童中心性肥胖、高血压、高TG血症、低HDL-C血症和高血糖发生情况,采用关联分析的φ系数描述5个代谢综合征组分间的相关关系。结果儿童CHO与LDL-C相关关系强(r=0.82,P<0.001),腰围与BMI、收缩压与舒张压、CHO与HDL-C相关关系较强(r依次为0.63、0.60和0.74,P均<0.001),CHO与TG、TG与LDL-C、HDL-C与LDL-C中等强度相关(r依次为0.34、0.30和0.43,P均<0.001),其他指标之间为弱相关或无相关。儿童中心性肥胖与高血压、高TG血症、低HDL-C血症三者均呈弱相关关系(φ系数依次为0.06、0.08和0.07,P均<0.05),高血压和高TG血症呈弱相关关系(φ=0.05,P<0.05),其他代谢综合征组分间的φ系数无统计学意义。结论儿童收缩压与舒张压之间、腰围与BMI之间以及几个血脂指标彼此之间相关关系较强,包括HDL-C与CHO、LDL-C均为中等强度正相关关系,而血压、肥胖与血脂三类指标之间无明显相关,血糖与所有指标均无明显相关;儿童代谢综合征各组分间相关较弱或无相关,提示儿童代谢指标间相关模式与成人不完全相同,代谢综合征这一概念应用于儿童宜审慎。

基于3S理念的健康教育对农村中老年人艾滋病认知情况的影响分析

目的:分析基于3S理念的健康教育对农村中老年人艾滋病认知情况的影响。方法:选取2019年2月—2023年6月百色市12个县区的农村中老年人1 811例作为研究对象,随机分为对照组(n=906)和观察组(n=905)。对照组实施常规健康教育,观察组实施基于3S理念的健康教育。比较两组艾滋病一般知识、传播途径的知晓情况。结果:干预前,两组艾滋病一般知识知晓率比较,差异无统计学意义(P>0.05);干预后,观察组艾滋病一般知识知晓率高于干预前及同期对照组,差异有统计学意义(P<0.05)。干预前,两组艾滋病传播途径知晓率比较,差异无统计学意义(P>0.05);干预后,两组艾滋病传播途径知晓率高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:基于3S理念的健康教育可提高农村中老年人对艾滋病一般知识、传播途径的认知水平。

新疆农村四类主要慢病的疾病经济负担研究

目的:测算分析新疆农村四类主要慢病的疾病经济负担。方法:采用多阶段分层整群抽样方法,对新疆6个县区11532名农村常住居民进行问卷调查,采用二步模型法和人力资本法测算四类主要慢病的疾病经济负担,采用多元线性回归分析门诊及住院费用影响因素。结果:2021年新疆农村四类主要慢病的患病率为16.29%;样本人群四类主要慢病的直接经济负担4.21亿元,间接经济负担0.34亿元,心脑血管疾病、恶性肿瘤、糖尿病、呼吸系统疾病经济负担分别为2.89亿元(63.53%)、0.88亿元(19.44%)、0.66亿元(14.47%)、0.12亿元(2.56%)。结论:新疆农村四类主要慢病的疾病经济负担比预想的低,可能受疫情防控的影响,以及与新疆农村地广人稀的特点有关。后疫情时代,应提高基层慢病早期筛查与管理水平,合理分级诊疗,缩短平均住院天数,切实减轻慢病患者的疾病经济负担。

2017-2022年陕西省某市农村生活饮用水中5种金属及类金属健康风险

目的评估2017-2022年陕西省某市农村生活饮用水中砷(As)、镉(Cd)、铬(VI,Cr^(6+))、铅(Pb)及汞(Hg)5种金属及类金属的健康风险。方法分析陕西省某市2017-2022年间4153份农村生活饮用水监测数据,应用美国环境保护局(US EPA)推荐的健康风险评估模型计算不同暴露水平下不同暴露水平下5种金属及类金属经饮水途径对当地居民所致的健康风险。结果陕西省某市2017-2022年农村饮用水中5种金属及类金属在一般暴露水平下经饮水途径所致的总危害指数(HI)为0.344,总致癌风险(R_(T))为3.99×10^(-4);高暴露水平下经饮水途径所致的HI为1.81,R_(T)为1.99×10^(-3)。浓度分层分析表明Cd、Cr^(6+)和Hg的浓度在枯水期均高于丰水期;江河水中As、Cd、Cr^(6+)和Pb的浓度均高于其他类型水源水,浅井水中Hg的浓度较高;部分处理水样中5种金属及类金属的浓度均高于未处理和完全处理水样。健康风险分层分析表明,经饮水途径摄入5种金属及类金属,男性的健康风险高于女性、儿童高于成人。结论陕西省某市2017-2022年农村饮用水中5种金属及类金属一般暴露水平下的非致癌风险及总危害指数均未超过可接受风险值,高暴露水平下总危害指数超出可接受风险值;Cr^(6+)无论是一般暴露水平还是高暴露水平,其致癌风险均略高于最大可接受风险(10^(-6)~10^(-4)),在风险管理中应重点关注。

脱贫山区农村社会组织发展现状、问题及对策

随着市场经济和社会格局的不断深入与发展,中国农村涌现出大量代表、服务和维护农民利益的社会组织。农村社会组织因其公益性和社会性在参与社会治理、助力乡村建设和推动经济发展等方面发挥了重要作用。然而,由于脱贫山区农村社会组织自身存在内生动力匮乏、组织管理松散和结构失衡等问题,在乡村契合和自身发展中存在一定的制约性。结合脱贫山区农村社会组织的现状、问题及作用,探析增强农村社会组织在农村建设与发展过程中的有效对策,通过加强党政赋能、创新组织体系和强化组织衔接等措施推动农村社会组织作用有效发挥,进而完善其在稳定脱贫成果、推动乡村振兴和实现共同富裕过程中的推动与衔接功能。