Local communities' participation in decision-making processes through planning and budgeting in African countries

Community participation and community based management are topical themes in current policy and discussion revolving around decision-making processes especially those dealing with natural resources management.This review shows that while governments have accepted the need to either cede or devolve control and management of natural resources to the local communities,the communities are not part and parcel of the planning and budgeting which are crucial in decisionmaking.Communities were seen to be more involved in the implementation of natural resource management programs but lacked ownership of the projects.This causes lack of commitment to the programs and at times hostile reaction from the communities.The communities are always at the receiving end when it pertains to losses in the exchange.Community participation was shown to be effective when the local population is involved not as co-operating users but as natural resource managers or owner managers.

Patient Participation in Communication about Treatment Decision-Making for Localized Prostate Cancer during Consultation Visits

Objectives: To describe the communication behaviors of patients and physicians and patient par-ticipation in communication about treatment decision-making during consultation visits for local-ized prostate cancer (LPCa). Methods: This is a secondary analysis of data from 52 men enrolled in the usual care control group of a randomized trial that focused on decision-making for newly diagnosed men with LPCa. We analyzed the patient-physician communication using the transcribed audio-recordings of real-time treatment consultations and a researcher-developed coding tool, including codes for communication behaviors (information giving, seeking, and clarifying/ verifying) and contents of clinical consultations (health histories, survival/mortality, treatment options, treatment impact, and treatment preferences). After qualitative content analysis, we categorized patient participation in communication about treatment-related clinical content, including “none” (content not discussed);“low” (patient listening only);“moderate” (patient providing information or asking questions);and “high” (patient providing information and asking questions). Results: Physicians mainly provided information during treatment decision consultations and patients frequently were not active participants in communication. The participation of patients with low and moderate cancer risk typically was: 1) “moderate and high” in discussing health histories;2) “low” in discussing survival/mortality;3) “low and moderate” in discussing treatment options;4) “none and low” in discussing treatment impacts;and 5) “low” in discussing treatment preferences. Conclusions: Findings suggest opportunities for increasing patient participation in communication about treatment decision-making for LPCa during clinical consultations.

A Study of Participation Motivation, Experience and Satisfaction in Camping Tourists

In recent years, camping is popular in Taiwan, but the research on campers’ participation behavior is still insufficient. The purpose of this research is to analyze the structural relationship between camping tourists’ motivation, experience, and satisfaction. The survey was conducted in a convenient sampling method, and a total of 464 valid questionnaires were collected. After descriptive statistics and partial least squares (PLS) statistics analysis, the results show that the higher the motivation of camping tourists, the more positive their experience and the higher their satisfaction. In addition, this research also confirms that experience has a mediating effect on motivation and satisfaction in terms of academic theory.

Factors influencing the degree of participation in surgical decision-making among Chinese patients with prostate cancer:A qualitative research

Objective:There was increasingly demand of participation in surgical decision-making among Chinese patients with prostate cancer.However,due to the complex healthcare system and advanced care settings,it is quite challenging for the patients to gain sufficient support from the institute and the government.This research aimed to investigate the factors that impact the degree of participation in surgical decision-making among Chinese prostate cancer patients.Methods:A phenomenological approach of qualitative research based on the results of semi-structured interviews was adopted,to explore the influencing factors which hinder the participation in surgical decision-making.Consolidated Criteria for Reporting Qualitative Research were utilized.Up to 160 post-operative patients who had undergone radical prostatectomy along with 68 medical and nursing staffs,were purposively recruited in this research.This retrospective study was carried out from September 2018 to August 2019.After recording and transcribing the interviews,the interview materials were evaluated via the Colaizzi's seven step approach and the NVivo Version 10 software to analyze the interview content.Results:According to the analysis and summary of the interviews,there were three factors affecting the degree of participation in surgical decision-making.Firstly,insufficient information was provided by medical and nursing staffs because of their lack of time,proper communication skills,and career experience,as well as difficulties in the development of patient decision aid and inconsistent resource availability.Secondly,the cognitive level of decision-making among patients was relatively low due to poor psychological endurance,insufficient amount of education,senility,and less knowledge and information demand.Ultimately,decisions were constantly made by family members with/without patients.Conclusions:The degree of participation of Chinese prostate cancer patients in the surgical decision-making had much space for improvement.

Participatory Technique Supporting Environmental Management: A Systematic and Bibliometric Review

The increasing need to manage natural resources sustainably, driven by population growth, requires the simultaneous use of Participatory Techniques (PT) and landscape planning for structured decision-making. We conducted a bibliometric and systematic review to provide an overview of PT usage, identifying evolution in scientific production. We considered the number of publications and citations, prominent journals, and highly cited articles on scientific papers published in the Web of Science database between 1993 and 2023. A total of 415 articles related to PT were identified. After content evaluation, 19 critical articles were selected that underpin the growing combined use of models and indices with PT, enhancing the robustness and credibility of decision-making processes.

Shared Decision-Making after Implementation of the Chronic Care Model (CCM)—An Evaluative Approach

Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient responsibility. Aim: To evaluate mental healthcare team members’ perceptions of their own role in encouraging elderly persons to participate in shared decision-making after implementation of the CCM. The CCM is not an explanatory theory, but an evidence-based guideline and synthesis of best available evidence. Methods: Data were collected from two teams that took part in a focus group interview, and the transcript was analysed by means of qualitative thematic analysis. Results: One overall theme emerged—Preventing the violation of human dignity based on three themes, namely, Changing understanding and attitudes, Increasing depressed elderly persons’ autonomy and Clarifying the mental healthcare team coordinator’s role and responsibility. The results of this study reveal that until recently, paternalism has been the dominant decision-making model within healthcare, without any apparent consideration of the patient perspective. Community mental healthcare can be improved by shared decision-making in which team members initiate a dialogue focusing on patient participation to prevent the violation of human dignity. However, in order to determine how best to empower the patient, team members need expert knowledge and intuition.

How Much Are Women Involved in Decision-Making in Family in Iran？

Studying the process of the decision-making in family is a necessity. The main aim of this study is to recognize the factors affecting decision-making in family. This investigation has been performed by using the survey method and 200 people were studied, emphasizing the approaches of Collins, Ingellhart, Weber, and Watt. The present study attempts to probe the role of women in power relationships in family. To analyze the data, the multivariable regression has been used. The result from the multivariable regression statistical analysis of participation in family decision-making equals R2 = .3. It can be concluded that the duration of marriage life, age, and men＇s age of marriage have affected the women＇s family participation. The comparison of regression quotient shows that marriage duration has the most share in dependent variable changes.

Patient-centered care through internal and external participation in medical rehabilitation

Patient-centeredness is one of the most important quality and outcome criteria in health care. Health care organizations are continually searching for approaches that will enable them to establish sustainable patient-centeredness in their daily practice. Existing approaches frequently focus on interaction between patient and health care professional (external participation). However, this is often not sufficient;other elements, such as good teamwork among the health care professionals (internal participation), are also essential. The model of integrated patient-centeredness differentiates between these two participations forms, both of which are explored from a patient and health care professional perspective in our study. The aim of the study was to confirm the model from the viewpoint of staff and patients. To this end we conducted a multi-center cross-sectional study consisting of a patient and staff survey to assess internal and external participation and patient-centeredness. A total of 15 rehabilitation clinics were involved, with 272 staff members and 536 patients included in the final analysis. Although evaluation was positive (mainly slightly above the middle of the scale), there was potential for improvement for both types of participation. Internal and external rating differed between patients and health care staff, with the first group assessing internal significantly better and external lower than the second group. The low to middle correlation of both types, as well as the correlation and regression with patient-centeredness, confirmed the model of integrated patient-centeredness. The model underlines the importance of both participation forms for patient-centeredness, as well as their interdependence. Further studies are needed in order to verify the impact of internal and external participation, as well as that of further possible dimensions of patient-centeredness, on clinical and functional outcome criteria.

多元家庭参与计划在乳腺癌乳房重建术患者院外延续性护理中的应用

目的:观察多元家庭参与计划在乳房重建术患者院外延续性护理中的应用效果。方法:以2020年9月笔者医院实施基于多元家庭参与计划的院外延续性护理干预模式为分界线,将2019年2月-2020年8月实施常规院外延续性护理的40例乳房重建术患者纳入对照组,将2020年9月-2022年3月实施基于多元家庭参与计划院外延续性护理的40例乳房重建术患者纳入观察组,比较两组患者干预前后认知偏差、体象、希望水平、生活质量及美学效果满意度。结果:干预后,两组认知偏差评分(对生命质量的影响、对他人评价、感知到的认知障碍及认知能力)均较干预前降低(P<0.05),且观察组各维度评分均低于对照组(P<0.05);干预后,两组体象评分(身体羞耻、疾病易感、身体关注、功能受限、患臂关注及透视)均较干预前降低(P<0.05),且观察组各维度评分均低于对照组(P<0.05);干预后,两组希望水平评分(未来和现实的积极态度、与他人保持亲密关系、采取积极行动)均较干预前升高(P<0.05),且观察组各维度评分均高于对照组(P<0.05);干预后,两组生活质量评分(心理状态、身体状态、性健康、假体满意度、乳房满意度、手术及信息满意度、医疗团队满意度)均较干预前升高(P<0.05),且观察组各维度评分均高于对照组(P<0.05);两组美学效果总满意率比较差异无统计学意义(P>0.05),但观察组满意率高于对照组(P<0.05)。结论:在乳房重建术患者院外延续性护理中应用多元家庭参与计划,能够有效改善患者心理状态,提高患者生活质量,值得临床推广。

智慧城市发展会提升居民幸福感吗?——基于中国健康与养老追踪调查数据的实证分析

依据2018年中国健康与养老追踪调查(CHARLS)数据,考察智慧城市发展对居民幸福感的影响。结果显示,智慧城市发展通过改善城市空气质量,提高居民医疗满意度,增加公民互联网参与等提升居民幸福感,并且对中东部地区、高收入家庭、强政策支持力度城市的居民幸福感影响更大。在采用“所在地区与杭州的球面距离”以及“所在地区与省会的球面距离”作为工具变量进行内生性检验后,结论依旧稳健。鉴于此,应重点关注城市居民的民生问题,警惕智慧城市发展中的“数字鸿沟”,缩小地区数字基础设施差距,提升居民幸福感。

志愿活动参与对中老年人生活满意度的影响:抑郁的中介作用及年龄组差异

文章基于2018年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)数据,使用线性回归模型、逐步回归法和系数乘积法分析志愿活动参与对中老年人生活满意度的影响和抑郁的中介作用,同时进一步探讨作用机制的年龄组差异。研究发现,志愿活动参与对中老年人生活满意度有显著的正向影响(β=0.041,P<0.05),抑郁具有显著的中介作用,中介效应占总效应的22.75%,且志愿活动参与对不同年龄组的影响系数及作用机制明显不同。研究结果对于预防和干预中老年抑郁,提高中老年人的心理健康和生活满意度,贯彻落实积极应对人口老龄化的国家战略均具有重要的参考意义。

离婚当事人童年创伤与婚姻满意度及解决冲突方式的关系

目的:探讨离婚当事人童年创伤与其婚姻满意度的关系及解决冲突方式在两者间的作用。方法:选取离婚当事人305名,用童年创伤问卷(CTQ)和Olson婚姻质量问卷(ENRICH)的婚姻满意度分量表、解决冲突方式分量表进行评估。结果:童年创伤检出率67.5%。CTQ总分与婚姻满意度、解决冲突方式得分均呈负相关(r=-0.14、-0.25,均P<0.05);解决冲突方式在童年创伤与婚姻满意度的关系中起完全中介作用,总效应值为-0.06,95%CI:-0.11~-0.01。结论:离婚当事人的童年创伤与婚姻满意度及解决冲突方式相关。

晚期癌症患者基于共享决策理论的预立医疗照护计划干预

目的探讨基于共享决策理论的预立医疗照护计划干预对晚期癌症患者的实施效果。方法将107例晚期癌症患者按入院时间分为两组,2023年5-7月收治的54例患者为对照组,2023年8-10月收治的53例患者为干预组。对照组实施常规护理干预,干预组在对照组基础上实施基于共享决策理论的预立医疗照护计划干预。干预4周后,比较两组预立医疗照护计划接受度、决策参与满意度及尊严得分。结果干预后干预组预立医疗照护计划接受度总分及各维度得分、决策参与满意度总分显著高于对照组,而尊严总分显著低于对照组(均P<0.05)。结论对晚期癌症患者实施基于共享决策理论的预立医疗照护计划干预,能提高其预立医疗照护计划接受度,改善决策参与满意度,维护临终患者尊严。

公共图书馆志愿者行为、满意度与持续参与意愿调查研究——以长沙图书馆为例

文章通过问卷调查和访谈调研法调查分析了公共图书馆志愿者的志愿服务动机、满意度以及持续参与意愿与影响因素。研究发现,现阶段志愿者的参与动机、满意度均与持续参与意愿有密切相关关系,志愿者持续参与意愿受到图书馆志愿服务管理、内容、培训、权益、激励等因素的直接影响,并因此提出志愿引导、内容创新、培训机制、激励机制与权益保护等提升志愿者持续参与意愿的方法和策略。

积极老龄化视域下老年人社会参与与其心理健康的关联--基于2018年中国健康与养老追踪调查的数据分析

基于2018年中国健康与养老追踪调查的数据,采用最小二乘法模型、两阶段最小二乘法模型和倾向得分匹配法模型,实证探究了社会参与对老年人心理健康的影响;阐述了积极老龄化三支柱--“参与”“健康”“保障”与老年人心理健康间的逻辑关系。研究结果表明:“参与”变量对老年人心理健康有正向显著影响;“健康”变量对老年人心理健康有显著影响,其中,自评健康对老年人心理健康有正向显著影响,慢性病对老年人心理健康有负向显著影响;“保障”变量对老年人心理健康无显著影响。提出了重视老年人社会参与,关爱老年人身体健康与关注特殊群体心理健康等针对性对策建议。

中老年人社区参与对生活满意度的影响机制

社区作为中老年人活动的常驻空间,承载居民日常活动、公共交往等需求,活动参与多样性对中老年人的健康水平具有积极影响。从多维度参与形式出发,基于太原市社区调查数据,构建结构方程模型,对中老年人参与途径与体系进行综合性分析,认识其差异性与关联性,并分析其潜在关系及对生活满意度的影响机制。研究发现,场所依恋可正向调节中老年人的生活满意水平,直接和间接产生总效应值0.595,且场所认同感有助于提高社区参与活力;社区线下参与对生活满意度产生总效应值0.132,线上参与产生总效应值0.059,社区线下参与可影响线上参与,且二者为正向促进关系;人口学变量也可在一定程度上影响中老年人的生活满意度,且影响程度从大到小依次为受教育程度、居住方式、工作类型、年龄、性别。根据研究结果提出中老年人社区参与提升的优化策略,可为城市社区参与活力的激发和提升提供参考。

基于知情行理论的农户参与农村污水治理意愿研究——以经济较发达地区为例

农户参与农村污水治理工作的意愿与行为是影响农村污水治理成效的关键。为从农户层面推进农村污水治理工作,研究基于知情行理论,从农户认知、态度因素出发,结合农户基本特征、责任主体意识共四个维度,利用江西省景德镇438个农户的调查数据,构建了经济较发达地区农户参与农村污水治理意愿的二元Logit模型,分析了满意度、参与意愿及支付意愿的主要影响因素;结合满意度量表,找出了该类地区制约农村污水治理工作满意度的短板,指出了改进农村污水治理工作的主要措施与方向。研究结果表明:该地区农户的满意度受性别、认知因素影响显著,参与意愿与农户认知因素、态度因素、责任主体意识显著正相关,支付意愿则受年龄、性别、态度因素影响显著,与经济发达和欠发达地区存在明显差异。农村居民周边水体水质情况、污水处理设施建设及使用情况是影响治理工作满意度的主要短板。提升地区的经济发展水平、强化治理工作的责任主体意识、着力优化农村污水处理设施的建设及运行,开展女性及青少年等特征群体的环保宣传教育,是综合提高农户治理意愿、助力农村污水治理的主要改进方向。研究成果可从环境行为学角度为我国农村污水治理工作的有效推进提供参考。

卫生机构工作者参与卫生学术社团情况调查

目的了解浙江某省级卫生机构工作者近5年参与学术社团活动情况,探索学术社团活动对卫生机构工作者及学科的建设性意义,并为促进卫生机构工作者与学术社团良性发展提供科学建议。方法采用问卷调查,收集浙江省某省级卫生机构工作者2018年1月—2022年12月学术社团活动参与情况,采用描述性统计分析卫生机构工作者人口学特征,采用χ^(2)检验分析不同人群参加学术社团活动情况及其满意度分布特征差异。结果有效问卷264份,被调查者职称分布分别为初中级25.00%、副高级39.39%、正高级35.61%。年龄集中于>40~50岁(41.67%);工作年限集中于>9~19年(39.39%);专技分类以医师系列为主(64.39%);学科分类主要集中于卫生管理学(15.15%)、结核病学(11.36%)和职业放射卫生学(11.36%),不同职称卫生工作者年龄、工作年限、专技分布、学科分类比较,差异有统计学意义(P<0.05)。卫生工作者参与学术社团为1~10个,平均每人参加社团数量3个;正高职称中82.98%的工作者在学术社团中担任委员以上职务;56.82%的卫生工作者经常参加卫生学术社团活动。不同职称工作者参加的社团数量、担任社团职务、参与社团活动频率的分布情况比较,差异有统计学意义(P<0.05)。43.94%卫生工作者对社团活动频率表示满意,47.73%卫生工作者认为社团活动对学科建设水平提升表示满意,43.94%卫生工作者认为社团活动对个人学术能力提升表示满意。结论卫生学术社团在人才引育、科研发展和学科建设等方面发挥着重要作用,但在人才留用、政府职能承接和运行机制等方面还存在一些亟待完善的问题。正高职称卫生机构工作者在卫生学术社团中的职务优势明显,而初中级职称卫生机构工作者参与度较低。卫生学术社团应充分发挥专家的带头示范作用,强化战略管理意识,提高投入、提升参谋能力和完善相关政策法规,更好地承接政府职能。同时,鼓励初中级职称卫生机构工作者积极参与卫生学术社团活动,形成可持续发展的人才梯队。

家属参与下的产前分娩预演对初产妇分娩结局影响

目的:观察家属参与下的产前分娩预演对初产妇分娩结局的影响。方法:纳入2020年1月-2023年6月本院产前检查并计划分娩的初产妇102例,随机数字表法分为对照组和观察组各51例,均对产妇常规护理,观察组行家属参与下的产前分娩预演干预。观察产程进展、分娩前分娩恐惧量表(CAQ)评分、抑郁自评量表(SDS)评分与焦虑自评量表(SAS)评分,分娩方式、产妇和新生儿不良结局、新生儿1min、5min Apgar评分、产妇护理满意度。结果:观察组各产程时间均短于对照组,分娩前CAQ评分(24.12±2.76分)、SDS评分(42.16±7.65分)、SAS评分(38.75±6.21分)均低于对照组(26.73±4.21分、49.65±8.62分、45.86±7.23分),自然分娩率(96.1%)高于对照组(84.3%),产妇分娩不良结局(0)与新生儿不良结局率(0)均低于对照组(9.8%、7.8%),新生儿1min Apgar评分(8.89±0.47分)、5min Apgar评分(9.93±0.05分)均高于对照组(8.23±0.61分、9.82±0.08分),产妇护理满意率(98.0%)高于对照组(84.3%)(均P<0.05)。结论:家属参与下的产前分娩预演可改善产妇分娩前不良心理状态,缩短产程,改善妊娠结局,提升初产妇分娩护理满意度。

户外徒步旅游社会支持对参与满意度的影响--基于情绪体验的多重中介效应分析

基于社会支持主效应模型,参考社会支持量表、积极/消极情绪量表、参与满意度量表对650名户外徒步旅游者进行问卷调查。建构结构方程模型考察社会支持—积极情绪体验—消极情绪体验—参与满意度4变量影响路径。结果发现,户外徒步旅游社会支持、亲友支持、群体支持、积极情绪体验、消极情绪体验两两变量间存在显著相关作用;户外徒步旅游社会支持、群体支持会正向显著影响积极情绪体验;户外徒步旅游社会支持、群体支持会负向显著影响消极情绪体验;户外徒步旅游社会支持、群体支持正向显著影响参与满意度;户外徒步旅游积极/消极情绪体验在社会支持和参与满意度间起部分中介作用;户外徒步旅游积极/消极情绪体验在群体支持和参与满意度间起部分中介作用。