Aging Characteristics and Layout Planning of Old-age Care Facilities in the Downtown Area of Nanchang City

Compared to the situation of population aging and the elderly aging, the development of oldage undertaking in Nanchang is still undeveloped in that the old-age care industry lags behind the urban renewal speed and the objective needs of aging. Apart from discussions on the composition of elderly population and the status quo of aging, this paper took the institutional old-age care in the downtown area of Nanchang for example, explored problems in the current institutional old-age care facilities through field investigation, and proposed suggestions for the layout planning of old-age care facilities in the study area.

Cultural barriers lead to inequitable healthcare access for aboriginal Australians and Torres Strait Islanders

Aims: This article seeks to address some of the factors, particularly cultural barriers, contributing to inequity in healthcare service provisions for indigenous Australians. Furthermore, this article presents ways for healthcare professionals to take action on culture-related health equity issues. Finally, this article addresses what nurses can do to support more operational interventions and enhance the quality of services for indigenous Australians and Torres Strait Islanders.Background: Recently, scholarly literature in Australia has focused on the issue of ensuring equitable access to healthcare for aboriginal Australians and Torres Strait Islanders, who are regarded as economically, socially, politically and culturally disadvantaged(Larkins et al, 2016; Lowell, 2013).^(1,2)However, in spite of significant efforts on the part of the Australian government, scholars, policy makers and communities to provide fair and equitable healthcare, this challenging and longstanding issue remains unresolved and needs to be addressed immediately(Australian Institute of Health and Welfare, 2015; Australian Bureau of Statistics(ABS), 2011).^(3,4)Data sources: Using the Population, Intervention and Outcome framework, several databases(PUBMED,MEDLINE, and SCOPUS) and government web-based literature resources were searched to identify original research articles published from 2000 to 2016.Discussion: Health inequity exists among aboriginal Australians and Torres Strait Islanders, and the cultural barriers are vital factors in addressing aboriginals' health inequity. Healthcare professionals could be part of an effective solution for diminishing racial/ethnic disparities in healthcare. Different types of nurses could play different roles in addressing aboriginal cultural barriers among aboriginal Australians and Torres Strait Islanders.Nurses are uniquely positioned to initiate and sustain contact with aboriginal Australians and Torres Strait Islanders in healthcare workplaces,as they can intervene at the points of greatest need in the community to address socially significant healthcare and social issues.Conclusions: The different roles of nurses in providing health and social care interventions to aboriginal Australians and Torres Strait Islanders could be utilized to increase equity in access to healthcare and help aboriginals attain better levels of health.

Culturally Sensitive Medical Care and Nursing Support: A Study of the Concerns of Foreign Visitors to Japan

Background: Considering the development of international transportation in modern societies, nursing care needs to be sensitive to the cultures and customs of patients from other countries. The purpose of this study is to determine, from the perspective of culturally sensitive nursing support, the cultural practices that foreigners consider important when they visit a Japanese hospital for check-ups or hospitalization. Methods: A survey was completed by 110 foreign participants at a shrine in Kyoto City. The purpose of the survey was to evaluate the concerns of foreign visitors regarding Japanese medical providers, caused by cultural differences such as customs of daily life. The statistical analyses were performed using descriptive statistics as well as cross-tabulation, chi-square, and Fisher’s exact tests. Results: After grouping participants by continent, the top concerns observed in all groups about visiting a Japanese hospital were accessibility to and cost of medical care. First, as for medical facilities, participants from North and South America (North and South American) and Europe (Europeans) were significantly more concerned than those in Asia (Asians) (P P P P P Conclusion: Nurses need opportunities to learn and understand differences in cultures. If nurses have opportunities to learn cultural differences as well as to experience caring for foreign patients, their competencies in culturally sensitive nursing support will improve over time. It can be said that this is an issue not only in Japan but also in all other countries.

Childhood Development Cross Culturally:Implications for Designing Childhood Obesity Interventions and Providing Culturally Competent Care

United States is experiencing significant growth in its foreign-born population,especially Chinese American population comprising of 1.2%of the U.S.population.Many healthcare providers are challenged in their efforts to provide culturally competent healthcare to this population.To provide culturally competent healthcare,healthcare providers should understand variations in cultural attributes that impact health.One group in which cultural variation holds great influence is that of children.Culture influences a child's behavior,development and health.This article provides a cross-cultural,comparative examination of important cultural influences on child behaviors development and health in China and the U.S.Using the findings about these two populations,interventions for childhood obesity cross culturally are addressed through the analysis of a U.S.based Children's Obesity Program.The author suggests that uniquely different approaches to childhood obesity intervention research are needed based upon the cultural differences identified within this paper.

Strategies for recruiting a sample of adults with type 2 diabetes from primary care clinics in rural Appalachia: Incorporating cultural competence

Background:Recruiting research participants from primary care in rural Appalachia is a major challenge and can be influenced by cultural characteristics,making it critically important to incorporate strategies of cultural competence in the overall design of clinical research.Objectives:The purpose of this paper is to describe culturally competent strategies used for recruitment and data collection with a sample of adults with type 2 diabetes from primary care settings in Appalachia.Design:The Purnell model of cultural competence and relevant literature served as a framework for study design.Four overarching approaches informed the organization of recruitment strategies and development of the data collection plan.Procedures:The approaches included selection of research sites,establishing collaborations,sustaining collaborative relationships,and enhancing understanding of benefits of participation.Four recruitment sites were selected based on potential to enhance diversification of participants;multiple steps were included in each of the three remaining approaches to build relationships and gain participation.A study log was maintained to provide evaluation data.Results:Recruitment took 14 months and a sample of 102 subjects provided consent with 101 participants providing complete data.Demographics were representative of the region except that African American participation was higher(6.9%)compared to current north central Appalachia(3%).Over 72%of participants indicated they would be interested in participating in future studies.Conclusions:These findings emphasize the importance of employing strategies for cultural competence in study design.Use of concepts from the Purnell model led to enhanced representativeness and potential for subsequent generalizability.

Patient Advocacy and the Affordable Care Act: The Growing Need for Nurses to Be Culturally Aware

The nurse-patient relationship is centered on patient advocacy. Patient advocacy is essential in providing individualized care and improving health outcomes. With the recent implementation of the Affordable Care Act, the patient advocacy concept requires further exploration. Published literature involving patient advocacy’s history, uses, definition, past analyses and nursing perceptions were examined. Outcomes of this literature review lead to further examining patient advocacy and how it is applied to culturally diverse patient populations, patient advocacy in nursing curricula and related research. Overall study results indicate that patient advocacy is associated with enhanced health encounters that include nurses presenting patients with understandable healthcare options and supporting patients with their healthcare preference. Although, this review identified positive outcomes of patient advocacy, nursing research must be directed toward creating a patient advocacy definition and measuring advocacy from a patient’s perspective. There is also a need for nursing leaders to consider placing a higher emphasis on cultural awareness research and education due to an increased rate of culturally diverse patients now seeking care through the Affordable Care Act.

Analysis of home care-based multi-level old-age service system

With the deepening of China＇s aging, China＇s social pension problem more obvious each day, and gradually become the focus of attention of the whole society. On the one hand, China entered the aging society, old-age needs to grow exponentially. The sixth national census shows that in our country, the population aged 60 and 13.26% of the total population over the total number of 179 million, 65 years and older the proportion of 8.87% of the total population, the absolute number of nearly 120 million. Hundreds of millions of older age groups will produce a growing demand for care services, which is the original old-age service system and the whole economic and social development is a huge pressure. On the other hand, with the economic and social transformation, the traditional model of family pension has been unable to adapt to the profound changes in modem employment, family structure, the concept of retirement, since most parts of China, ＂old before getting ricE＂ the situation, how to solve the elderly the pension problem is related to the overall situation of China＇s economic and social development, related to the overall situation of building a harmonious society in China. Under current national conditions, the emphasis on the development of a single individual body to meet the growing demand for pension service is not realistic, we must mobilize the enthusiasm of all aspects of the element, multi-service integration of resources subject to their commitment to a different responsibilities and tasks provide a full range of care services according to different types, different levels of the actual needs of the older age groups. On the aging problem is that the whole community to face, you need to multi-government body, families, communities, institutions combine effectively starting from the actual needs of the elderly population, according to the financial assistance, life care, spiritual consolation three set the specific needs of services, through a government-led, home-based care services, community care services for the core and supplementary services for institutions focused on pension and other means to provide a full range of pension services.

Construction of Xi'an ecological old-age care community in the new urbanization

The new urbanization is an important carrier of ecological civilization construction, and ecological old-age care is the concrete manifestation of the perfect combination of the two, the proper meaning of the new urbanization connotation and an inevitable trend of its development. Based on the analysis of the connotation and relationship between the new urbanization and ecological old-age care, together with the current situation and existing problems of the current nursing institutions and ecological old-age care in Xi'an area, this paper discusses the major issues that should be noticed when constructing the ecological old-age care community in Xi'an and three main construction modes.

The Experience and Enlightenment of the Development of Old-age Care Services in Russia

Through the analysis of the history and current situation of Russia＇s old-age care services system, this paper analyzes and studies the old-age care services system in Russia. By means of law and social policy, Russia can promote the active participation of the elderly in politics, economy, culture and other activities to promote the positive image of the elderly. The active aging policy in Russia and the development trend of the old-age care service to promote the social adaptation and re-employment of the elderly are of positive significance to the development of our country＇s old-age care service.

A Systematic Review of Cultural Preferences for Receiving Medical “Bad News” in the United States

According to the dominant models of medical ethics in the United States and many Western countries, physician disclosure of information such as diagnosis, treatment options, and prognosis is considered an essential precondition for patient informed consent. While being consistent with the principle of patient autonomy stressed in many Western healthcare systems, full disclosure—particularly of life-threatening diagnoses and poor prognoses—is inconsistent with the cultural values of many ethnic communities within the United States. A systematic review of research examining cultural preferences for disclosure of medical “bad news” was conducted. Results suggested that cultural preferences are more heterogeneous than has often been portrayed. Particularly when communicating with patients and families from culturally and ethnically diverse backgrounds, health care professionals should ask about preferences for receiving medical information and making treatment decisions.

Cultural Sensitivity of a Community-Based Falls Prevention Program Targeting Older Arab American

Falls are a frequent and costly cause of injuries and functional decline in the elderly. Tai Chi is a cost-effective strategy for preventing falls in older adults. Many senior centers have introduced Tai Chi programs to increase mobility and decrease the risk of falls. However, the practice has yet to be widely disseminated to ethnic minorities who are not culturally connected to Tai Chi. This paper describes implementation barriers and recruitment and retention challenges of Arab American participants in a Tai Chi intervention-based health promotion program, including issues related to community organization and staffing, recruitment and retention, need for building relationships, need for translation and interpreters, and cultural barriers & misconceptions. Understanding and paying adequate attention to these challenges may help facilitate in planning other health promotion interventions targeting Arab American population.

Nursing culture assessment tool (NCAT): Empirical validation for use in long-term care

Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice innovations.The psychometrically validated Nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change implementation.Purpose:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice implementation.Methods:A cross-sectional,exploratory investigation of the NCAT in LTC settings was conducted.Empirical construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to 0.94.Conclusion:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.

Cultural competence of nurses in Pudong New Area,Shanghai:a mixed-method study

Objective:Cultural competence has gradually attracted attention from many countries,including China.This study was undertaken to determine the cultural competence of registered nurses in Shanghai,China,and to identify the cultural competence among registered nurses in Pudong New Area,Shanghai.Methods:Qualitative interviews were conducted in combination with a quantitative survey.Fifteen clinical nurses were interviewed,and 1088 clinical nurses were recruited for the survey with cultural competence scale for registered nurses,based on the results of the qualitative and quantitative studies.Results:The overall level of cultural competence among registered nurses in Shanghai's Pudong New Area was moderate.Among the seven dimensions,cultural encounter had the highest score,followed by cultural practice,cultural awareness,cultural desire,cultural skill,cultural experience,and cultural knowledge.Age,level of hospital care,mastery of secondary level,and studying overseas were the influencing factors.Conclusions:Hospitals and universities should be aware of the importance of studying cultural competence.Cultural competencerelated courses should be increased,and various forms of training should be undertaken to enhance the interest of nurses.

Translation, Cultural Adaption and Validation of Hospital Survey on Patient Safety Culture in Kosovo

Background: An essential condition to improve patient safety is considered to ensure a supportive patient safety culture. Measuring the culture of patient safety in all health care institutions may be a first step to target improvements. Creating a culture of safety requires eliminating the culture of blame. In order to formulate actions for improvement, it is important for hospitals to assess their baseline scores for the existing safety culture and to determine the areas of priority. Aim: The aim of this study was first to measure the use, translation in Albanian and adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) assessment as a tool for improving patient safety in Kosovo Hospitals. The second aim was to measure the level of patient safety culture in Kosovo, in seven hospitals and one University Clinical Center (hospitals with over 50 beds, including psychiatric hospitals). Method: The questionnaire (HSOPSC) was translated into Albanian for use in the Kosovo. It was used forward-backward translation: the questions were translated into Albanian by one translator and then translated back into English by an independent translator who was blinded to the original questionnaire. Results: In the eight-factor model, the internal consistency of the factors and the construct validity of the HSOPSC questionnaire were mostly satisfactory. The construct validity was sufficient for all subscales, except for the 4 other subscale regarding intention to report incidents which correlated poorly with other subscales. In total, HSOPSC has 12 dimensions. Cronbach’s α showed that in Kosovarian society, we could use only 8 dimensions model. Conclusion: The hypothesis that HSOPSC would be a suitable instrument to provide important indicators for the improvement of patient safety culture was tested and it was confirmed, that HSOPSC could be used as 8 dimension model. HSOPSC is suitable to improve patient safety culture and provide each hospital with a basic profile on patient safety culture and recommendations for an oriented intervention plan.

‘Diversity Culture’in Social Services:Person-Centered Care

This article addresses the issue of‘diversity culture’in social services with the purpose of re-conceptualizing person-centered social services theory and practice.The increased participation of women,minorities,and people of different nationalities and cultures in the business world is outlining a transformation of the workforce.In parallel,there is also a diversification and heterogeneity of customers,social service users’needs,and markets and consumers’styles.The paper analyzes main groups of theories that inform social services techniques-psychological theories,cognitive behavioral theories,systemic theories,humanistic theories,and constructionist theories-with the aim of re-thinking models and practices to address the challenges that the social services are facing in responding to needs of cultural,gender,action potential,and age diversity.Specifically,social workers and the social services system are required to adapt to the changing circumstances of the social,economic,cultural and communicative environment.

Advance care planning readiness for Chinese older people:An integrative review and conceptual framework

Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration.Readiness for advance care planning is a patient's preparedness to engage in advance care planning.This review aims to develop the conceptual framework for advance care planning readiness for Chinese older people.The current knowledge from the published studies was identified and synthesized by an integrative review.The conceptual framework was developed based on the social-ecological model and the theory of planned behavior.The factors from the social environment/community,health care professionals,and individual/family layers were defined.These factors may influence an individual's medical decision-making,which in turn triggers individual behavioral mechanisms that arise from interactions between motivations,attitudes,and beliefs.Relevant factors should be considered when assessing the behavior of personnel engaged in advance care planning or formulating appropriate intervention measures to improve advance care planning par ticipation in China.This framework can be used to guide studies that explore how the social/familial/individual factors predict the readiness for advance care planning among Chinese older people,and to design intervention studies to test the effect of family function on the readiness for advance care planning.

Improvement of the Legal System for Addressing the Issue of Elderly Care in China in the Context of Population Aging

Rapid population aging is a social reality facing China at present,and the issue of elderly care has become a hot topic of social concern.Legislation to address the issue of elderly care in the context of population aging should follow systematic concepts to achieve“vertical and horizontal integration.”In terms of content,it is necessary to formulate specific legal approaches around“the elderly and children,”with a focus on guaranteeing the livelihood and protection of the rights of the elderly while taking into account childbirth,employment and other issues.the laws should not only safeguard the social participation and labor rights of the elderly,but also effectively respond to the social challenges brought about by the aging of the population.It is also necessary to optimize the family planning policy to ease the burden of child-raising,improve the population structure and promote the long-term balanced development of the population,thus fundamentally solving the problem of population aging.the effort to improve the legal system to deal with the issue of elderly care in the context of population aging will better advance Chinese modernization.

儒家生命伦理融入老年护理学课程思政的实践效果

目的:探讨儒家生命伦理融入老年护理学课程思政的实践效果。方法:采取整群抽样法,以2018级312名(对照组)和2019级266名(试验组)本科护生为研究对象,对照组采用常规教学模式,试验组开展融入儒家生命伦理的老年护理学课程思政教学,课程结束后调查试验组护生对课程思政的内容和效果的感受,分析两组护生关怀能力、服务老年人意愿和考试成绩。结果:试验组266名护生中96.2%认为我国传统文化对医学生有可借鉴的智慧和思想,83.1%认为教学设计参与性和启发性较好,92.5%对课程评价总体满意。与老人共同生活的时间、家庭关系、对老龄化问题的关注程度会影响护生服务老年人意愿(P<0.05)。试验组护生关怀能力、服务老年人意愿、考试成绩均高于对照组(P<0.05)。结论:将儒家生命伦理融入老年护理学课程思政的教学设计有助于提升护生关怀能力和服务老年人意愿,促进其道德品质提升,更好地满足社会对老年护理人才的需求。

医务工作者阅读质量与医院人文建设关系的思考与探索——基于某公立医院医务工作者阅读情况的调研分析

阅读是获取知识、提高人文素质、排解心理负面情绪的重要途径。本文基于某公立医院职工阅读情况进行调查研究,收集1508份有效样本分析,发现职工阅读偏好与学历、年龄、岗位、性别、工作年限等因素息息相关。基于以上分析结果,本文针对医务工作者提升阅读时间与质量、公立医院人文环境建设与文化建设提出建议,以期营造良好文化氛围,加强对患者的人文关怀。

急诊重症监护室血流感染患者临床结局的风险因子探讨

目的探讨急诊重症监护室(emergency intensive care unit,EICU)血流感染患者临床结局的风险因子,为临床决策提供依据。方法回顾性收集2019年1月至2023年4月我院就诊的141例EICU血流感染患者的病历资料及血培养记录,采用Logistic回归分析患者死亡的危险因素,运用Cox回归分析上述因素与患者生存时间和临床结局的关系。结果在141例EICU血流感染患者中,两种及以上细菌混合血流感染[比值比(OR)=5.68,95%置信区间(CI):1.20~26.98,P<0.05]及多重耐药菌血流感染(OR=6.39,95%CI:2.78~14.67,P<0.01)与患者死亡具有显著相关性;是否根据药敏结果及时调整用药[风险比(HR)=0.47,95%CI:0.30~0.74]和多重耐药菌血流感染(HR=2.02,95%CI:1.28~3.20)是EICU血流感染患者死亡的风险因子(P<0.01)。结论尽早采集血培养,明确感染病原菌,精准用药控制感染,可以有效降低患者的死亡率。