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.

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.

Impact of State Equity Participation on Family Enterprises’ Innovation Input

Whether the mixed-ownership reform whereby the state invests in nonstate enterprises will be effective is a question that has attracted widespread attention and discussion.This paper uses sample data from family-owned enterprises listed from 2009 to 2016 and empirically tests the impact of equity participation by the state in the family enterprises on their innovation input and the underlying mechanisms.Our results show that state investment has positive impacts on innovation input in the family enterprises.This effect is even more significant for high-tech family enterprises and/or those family enterprises confronting high policy uncertainty.Our results also reveal that when state investment is accompanied by a greater degree of state participation in enterprise operations or when the investment originates locally,there is a greater increase in innovation input.Further analysis of the underlying mechanisms reveals that state investment increases innovation input by increasing both willingness to innovate and the resources available for innovation.This paper provides new theoretical support and empirical evidence for pushing the mixed-ownership reform and stepping up the sustainable development of non-state enterprises including family ones.

A Concept Analysis of Decision-Making by Families in Critical Life Situations

Background: In 2017, the elderly made up 27.3% of Japan’s population, accounting for 57.2% of all ambulance trips. When an elderly person is in a critical life situation, it is difficult to ascertain their decisions about treatment choices, and for family members who become surrogate decision-makers, this is a grave responsibility. Aim: This study aimed to shed light on the constructs that support decision-making by family members and medical staff in critical situations, and to investigate decision-making by families of the elderly in critical situations. Method: We selected 29 papers published in Japan and elsewhere that focused on families involved in treatment decisions in critical life situations and analyzed them using Rodgers’ concept analysis approach. Results: From 475 codes, we extracted six attributes, four antecedents, and four consequences. The unusual setting of the “critical care unit”, lack of time, and unstable psychological state are all considered by family members making treatment decisions, along with the patient’s prognosis, their relationship with the patient, conjecture about the patient’s wishes, and taking other family member’s views into account. Medical staff supports the family throughout the process, through provision of treatment, preparing family members to face reality, empathizing with the difficulty of decision-making, building relationships with family members, monitoring the decision-making process, and being attentive to family members’ feelings until the end. Conclusion: Our results indicate the importance of advance confirmation of patients’ wishes, and the role played by cultural context and family relations in decision-making by family members of the elderly.

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.

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.

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.

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.

Prioritizing the efforts:lived experiences of family when taking care of people with cancer

Objective:Cancer has one of the highest disease mortality rates.Families are very important in the treatment of people with cancer.By using a phenomenological design,this study aimed to explore the experience of families in caring for a person with cancer and to identify the needs of these families.Methods:First,eight interviews were under taken with family members selected through a purposive sampling method.Then,another three interviews were conducted for data validation.The collected data were analyzed using the framework method of analysis.Results:The core theme,“Prioritizing the efforts:Being aware of the best we could do for our family,”reflected family’s experiences of caring for a person with cancer and was underpinned by five themes:“Decisions to make,”“Keeping up the good support,”“Acknowledging the others’contributions,”“Assisting my family to alleviate the disease,”and“Adapting to the current situation.”Conclusions:The results suggest that building mutual trust and communication between family and healthcare professionals is vital in decision-making for people with cancer.Family may also work with the person in fulfilling their needs,without disregarding the needs of the family.When suppor ting the needs of people with diabetes,the family requires appropriate information,and thus,healthcare professionals wisely select which information can help the family make a decision regarding the treatment.After administering the treatment and providing information for people with cancer and their family,asking for feedback is required for evaluation.

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。

母婴床旁及延续护理促进产妇康复效果的实证研究

目的探讨母婴床旁及延续护理对产妇康复的应用效果。方法选取2021年4月1日至5月27日到广西壮族自治区妇幼保健院厢竹院区产科一区收治的280例顺产、单胎的初产妇为研究对象,按照随机数字表法将其分为对照组(n=140)与试验组(n=140),对照组予常规护理+延续护理,试验组予母婴床旁护理+延续护理。对照组与试验组产妇及家属出院后开展电话随访、建立QQ群等延续母婴护理指导。比较两组产妇的母婴护理知识及技能、自我护理能力(ESCA)、中文版育儿胜任感(C-PSOC)、中文版压力知觉(CPSS)的评分。结果干预后,试验组产妇的母婴护理知识及技能掌握程度优于对照组,ESCA、C-PSOC评分均高于对照组,CPSS低于对照组,差异有统计学意义(P<0.05)。结论母婴床旁及延续护理指导,提高产妇母婴护理知识及技能、产妇自我护理能力、育儿胜任感,降低产妇压力感知,促进产妇康复,值得推广应用。

文化参与的家庭代际传承效应——来自中国家庭文化消费调查的微观证据

家庭是社会的基本细胞,是文化传承的重要载体。在中国家庭结构从传统向现代转型的背景下,基于“2022年中国家庭文化消费调查”数据,从微观视角对家庭文化传承的影响和机制的研究发现:文化参与可以在家庭代际间传承,与没有文化参与父母的子女相比,有文化参与父母的子女进行文化参与的概率高35.8%,这个过程通过家庭文化资本的积累和家庭成员从事文化职业的影响来实现;父母接受过高等教育,文化参与的代际传承效应更大,且文化传承还会促进下一代文化参与的多样性和高品质;文化参与传递过程在多代间具有持久性和溢出效应。研究结论可为通过家庭文脉的代际传承促进文化参与、提升社会精神文明程度提供政策启示。

急诊危重症患者替代决策者参与医疗决策期望现状及影响因素分析

目的了解急诊危重症患者替代决策者参与医疗决策期望现状及影响因素,为改善急诊危重症患者及家属就医体验,提升其医疗决策参与能力提供参考。方法采用便利抽样法,选取2022年10月至2023年6月在广西某三级甲等医院急诊科参与替代决策的226名危重症患者家属为研究对象,通过问卷调查一般资料、应对方式以及决策倾向性,分析其参与医疗决策期望现状及影响因素。结果急诊危重症患者替代决策者参与医疗决策期望的总分为(50.10±5.10)分;Pearson相关性分析显示,急诊危重症患者替代决策者参医疗决策期望总分与积极应对呈正相关,与消极应对呈负相关(P<0.05);多元线性回归分析显示,替代决策者文化程度、与患者的关系、患者疾病种类以及是否理解医生的病情谈话内容均是急诊危重症患者替代决策者参与医疗决策期望的影响因素(均P<0.05)。结论急诊危重症患者替代决策者参与医疗决策期望较高且受多种因素影响,文化程度较高、患者子女、急性病就诊患者、理解医生的病情谈话内容的替代决策者参与医疗决策期望更高,采用个性化的决策辅助方案能够帮助医护人员改善其决策参与意愿,提高决策质量。

女性就业、家庭决策权及其幸福感

经济赋权是增进女性获得感、安全感和幸福感,实现共同富裕的重要措施。使用2017年中国综合社会调查数据(CGSS),采用OLS模型,实证检验女性就业参与对其幸福感的影响及作用机制。研究表明:有薪酬的劳动力市场就业参与对女性幸福感存在显著的积极影响,已就业参与女性较未就业参与女性的幸福感明显更高。该结论在利用处理效应模型(TEM)和拓展回归模型(ERM)尽可能缓解内生性问题,以及进行一系列稳健性检验后,仍然成立。异质性分析表明,对于性别分工观念平等、性别就业价值观念平等以及配偶在业的女性,其就业参与的幸福效应更强。机制分析表明,家庭决策权是女性就业参与提升其幸福感的重要渠道。已就业参与女性在父母奉养、子女教养和家用支出分配等方面拥有决策权的概率,分别是未就业参与女性的1.514倍、1.471倍和1.276倍。拓展分析表明,与未就业参与相比,非正规就业参与、正规就业参与均能有效提升女性幸福感。因此,增进女性福祉,既要鼓励女性有薪酬的劳动力市场就业,又要发展并规范非正规就业劳动力市场,还要树立平等的性别观念。

家族所有权涉入与企业国际化--基于企业规模与国资参股的视角

家族所有权涉入对企业国际化的影响通常被认为是线性的。关于两者之间是否存在非线性关系,现有研究尚未得出一致结论。基于中国创业板和中小板上市家族企业2013-2019年的平衡面板数据,采用多元回归分析,并结合门槛模型,探讨家族所有权涉入的不同阈值水平对企业国际化的影响。分析结果表明,家族所有权涉入与企业国际化之间存在非线性关系,企业规模、国资参股具有双重门槛效应,在这两种情境特征下家族所有权涉入对企业国际化会产生不同程度的影响。进一步分析结果表明,在2020-2022年的样本中,家族所有权涉入对企业国际化的积极影响有所减弱,这说明外部风险与极端环境会对家族企业的国际化策略具有明显影响。此外,不同经济区域的家族企业,其所有权涉入对国际化的影响表现出明显的异质性。研究结论为家族企业更好地面向国际化经营提供了新的理论支撑与实践启示。

长期护理保险的劳动力市场化配置效应——基于女性劳动参与行为的分析

以长期护理保险政策试点作为准自然实验,利用CHARLS2011—2018年的数据实证检验了长期护理保险政策试点实施对子代女性劳动参与行为的影响,结果显示:长期护理保险试点显著提高了子代女性进入劳动力市场的概率,且主要通过改善老年人健康水平和增加正式照护行为两条路径产生影响;异质性分析发现,多主体筹资、比例给付和服务给付的政策细则对子代女性劳动参与产生了更好的促进效果,这一促进效果在农村地区更为明显。因此,需要从认可家庭照护劳动价值、扩大长期护理保险制度覆盖面和提高长期护理保险待遇水平等方面做出努力,以支持女性根据个人比较优势在家庭—市场场域进行有序流动,改进女性劳动力要素配置效率。

城市家长教育参与的行为、特征及提升策略——基于三所不同层级小学的研究

本研究在理论层面构建了家长教育参与行为分析框架,通过对1725位城市家长的问卷调查和30位教师的访谈,考察城市家长教育参与的行为与特征。研究发现,当下家长教育参与一方面存在“家庭本位”的局限,另一方面又向学校教育“越界”,其参与行为呈现“功利化”和“放任式”的特征。为实现家长教育参与由单一狭隘到全面深入的转变,应发挥学校的主导作用,实现“单向度”参与到“多维式”参与的跨越;明晰家校的权责边界,促成“越界式”参与向良好家校共育生态的蜕化;强化家长培训,推进从学业成就导向向学生全面发展的转变。

京津冀三地家庭体育锻炼行为的实证研究

体育锻炼对于拓展京津冀三地体育发展空间,丰富群众生活,培养体育人才,提高全民族身体素质、生活质量,促进经济社会协调发展,具有重要意义。本研究结合国内外已有的研究成果,采用京津冀三地城市居民体育健身休闲活动状况调查数据,从家庭结构层面研究京津冀三地居民体育锻炼行为,调研论证了京津冀三地居民体育锻炼的参与方式、家庭成员锻炼程度与目的、锻炼项目与接受指导情况以及与不同变量之间的相关性。研究结果从实证层面检验了家庭体育锻炼各微观层面的内在联系:京津冀三地居民体育锻炼方式首选和朋友、同事一起,其次是个人锻炼,再次是与家人一起;与家人一起参加体育锻炼的人员中,经常参加体育锻炼的居民占比87%,家庭参与正成为京津冀居民体育锻炼的主要方式之一;随着青少年年龄的增长,父母有更多时间直接参加体育锻炼,经常参加体育锻炼的比例逐渐加大。

幼儿教育中家园社三方协同育人路径探究

家庭、幼儿园和社会在幼儿教育中扮演着重要角色,家庭是幼儿成长的摇篮,幼儿园是幼儿教育的专业机构,社会则是幼儿学习、生活区域的延伸和拓展。为提高幼儿教育效果,幼儿园和社会要加强对幼儿家长的引导,建立有效的信息沟通平台,促进家庭与幼儿园、社区的互动合作,以此充分发挥家园社三方的协同作用。同时,家庭、幼儿园和社会要树立全员育人责任意识,促进幼儿健康成长、全面发展。