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.

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.

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。

Reform of Rural Land System from the Perspective of New Urbanization

In view of artificially high urbanization rate of China and possible causes,survey and data analysis methods were used to discuss reform of household registration system,and path for promoting rural land system reform. Results show that it is required to eliminate bottlenecks of land system in the advance of new urbanization process. In line with land system bottlenecks of new urbanization,it is recommended to take following measures.( i) Promoting land right confirmation centered land system reform.( ii) Weakening rural land ownership and stressing land use right.( iii) Establishing urban and rural integrated land market and putting an end to low cost urbanization road.( iv) Realizing asset value of rural construction land and tackling the problem of insufficient construction land.( v) Reforming the land expropriation system and increasing the share of gain in land value to farmers.( vi) Implementing different land policies to promote coordinated development of regional social economy.( vii) Establishing land circulation access system to ensure unchanged land use purpose and high efficient use.

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.

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.

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.

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.

Chinese rural reform:experience,problems and the future

Chinese rural reform has made great achievements and accumulated a wealth of experience since the beginning of reform and opening up 30 years ago.At the core is the rapid and sustained development of the national economy.Currently,there are obstacles in rural reform;for example,the supply and demand of primary products are frequently out of balance,shortages of rural labor occur thanks to structural problems on the supply side,and the equality system between rural and urban citizens has yet to be established.Therefore,to make important breakthroughs,we must change our ideas of controlling the food market;we must improve rural land policy, loosen rural financial supervision,adjust the fiscal expense structure,protect farmers’ legal rights and interests,accelerate the building-up of democracy at the grassroots level,and intensify overall planning and coordination.

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。

Effects of a Stress Management Program Based on Psychological Risk Factors of Cardiovascular Disease after Retirement in an Underpopulated Area: A Pilot Study

Background: To develop an effective health education program to prevent cardiovascular disease in middle-aged residents after retirement in underpopulated areas, we explored the effects of a stress management program based on the type A behavior pattern. Methods: This study was carried out in a rural city in Japan recognized as underpopulated and participants were civil servants aged 45 - 64 who joined a stress management program offered as part of staff training. Learning materials for the program were developed based on the type A behavior pattern. Measures for the impact evaluation were Bloom’s learning domains and stage of change for stress management practice. Measures for the outcome evaluation were KG’s Daily Life Questionnaire (KG Questionnaire), the Hospital Anxiety and Depression Scale (HADS) and the Framingham 10-year cardiovascular risk score (CVD risk score). We statistically analyzed changes in each item between time points. Results: Eighteen participants completed questionnaire surveys at pre-, post-, and 4 weeks post-program and eleven had complete blood pressure and weight measurements at pre- and post-program. In the impact evaluation, the Friedman test found significant differences between the three time points in all of Bloom’s learning domain scores and stage of change for stress management. In the post hoc analysis, a significant increase was seen between pre- and post-program and between pre- and 4 weeks post-program in cognitive domain score, psychomotor domain score and stage of change for stress management. In the outcome evaluation, a significant decrease in systolic blood pressure was seen between pre- and post-program. Conclusion: The present study suggested that a stress management program using learning materials based on type A behavior could promote stress management practices and reduce the risk of cardiovascular disease. This stress management program is expected to be useful as a health promotion activity for middle-aged residents after retirement in underpopulated areas.

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。

以农村全面深化改革发展农业新质生产力

加快发展农业新质生产力是推进农业农村现代化的重要举措。中共十八届三中全会以来,中国在深化农村土地制度改革、建设现代农业经营体系、推进农村集体产权制度改革等方面作出了一系列重要的改革举措,在保障国家粮食安全稳定、消除绝对贫困和农民增收、促进城乡融合发展、完善乡村治理体系等方面取得了历史性突出成就。农业新质生产力代表农业领域的先进生产力,既是加快建设农业强国的内在要求,又是重塑国际竞争新优势的战略选择。当前,中国农业农村发展仍存在一些短板。为了加快形成和发展农业新质生产力,应从提高农业科技创新能力、科技人才支撑力度和农业劳动生产率等方面着手,充分发挥新型举国体制的优势,疏通农业高质量发展的卡点堵点,因地制宜发展农业新质生产力,推动农业新质生产力成为中国从“大国小农”迈向“大国强农”的关键力量。

农村养老机构公建民营改制:何以可能又何以可为?

人口老龄化和城乡人口倒置的加深使得农村养老问题日益突出,在家庭养老照护功能减弱的情况下,对农村养老机构实行公建民营改制是完善农村社会化养老体系的重要举措。然而,农村养老机构公建民营改制虽拓宽了多元主体参与的渠道,但实际也遭遇了政策初衷扭曲、实践效果不佳等诸多瓶颈。研究发现,对改制主体权责关系的讨论是解决改制瓶颈的关键。通过福利多元主义中“多元福利主体”和社会治理中“多元主体治理”这两个概念,构建“多元主体识别多元主体参与多元主体协同”的分析框架,探讨农村养老机构公建民营改制的可能前提和可为进路。中部某省A县的改制实践表明,对多元主体的权责厘清是实施改制的前提条件,而多元主体本身各持逻辑则是导致改制困境的根源,具体表现为政策内卷导致的县民政局越位管理、科层逻辑导致的乡镇政府工作缺位、过度依赖导致的市场主体目标偏离和生活理性导致的机构院长经验欠缺等。为此,要确保县民政局把握导向不越位、重塑乡镇政府监督和沟通责任、明确市场配置作用和产品定位以及完善院长角色定位和能力提升,实现多元主体的协同发展,以期达成农村养老机构公建民营改制的初衷和目标,完善农村机构养老建设体系,为农村社会化养老的多样态高质量发展提供助力。

供给侧结构性改革促进了城乡基本公共服务均等化吗?

在区域发展不均衡的现实背景下,政府能否通过深化供给侧结构性改革提升基本公共服务供给水平,进而促进城乡基本公共服务均等化具有重要的现实意义。基于2010—2021年268个地级市面板数据,利用熵权法分别测度城市与农村基本公共服务供给水平,并引入信息熵概念计算得出均等化程度,据此进一步进行回归分析。研究结果表明:供给侧结构性改革对基本公共服务供给水平的提升具有促进作用,并且供给侧结构性改革通过提升公共服务财政支出水平与加强数字基础设施建设两条作用路径提升城乡基本公共服务均等化程度。此外,对西部和低均等化城市而言,供给侧结构性改革对城乡基本公共服务均等化程度的促进作用更加明显。研究的政策启示在于:实现城乡基本公共服务均等化的目标,仍需持续推进供给侧结构性改革,尤其需要发挥公共服务财政支出的调节作用,并进一步提升数字基础设施建设水平及其赋能功效;同时根据区域发展情况、均等化程度实施差异化供给策略,提升公共服务供给侧结构性改革的精准度和有效性。

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。

新型城镇化背景下农村土地管理制度优化

农村发展应新型城镇化要求需在相关体制上进行追本溯源的、创新性的改革,尤其是农村的土地管理制度,存在诸多与新型城镇化发展相矛盾的问题。如今,新型城镇化的任务推进能够为农村不断完成新农村建设作出指导。为此,基于新型城镇化背景,探讨了其对农村土地管理制度改革的需求,分析了农村土地管理与新型城镇化的适配度问题,指出了农村土地管理制度中的问题,并针对相关问题提出建设性的优化策略。

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。