The Development of Community-Based Family Healthcare: A Cross-Sectional Study in Haidian, Beijing, China

The outbreak of Covid-19 affects China’s health delivery system, and the current status of primary health services after the Covid-19 pandemic is not yet clear. To further explore the current status of demands of family health services, we conducted a cross-sectional survey, in the community of Haidian District, Beijing. Chi-square test analysis and multivariate logistic regression models were used to identify factors influencing residents’ demands for family healthcare services. Results show that population of married (OR = 3.108), living with parents (OR = 2.171), degree of Junior high school and above (OR = 7.250) and high school (OR = 7.670), Annual income: 0 - 56,000 (OR = 3.680) and 72,001 - 88,000 (OR = 1.690) have significant demands for family health care. The approach to building primary health services in Haidian District is worth promoting, but it is also important to pay attention to the health inequalities that can occur when patients are moved down to the grassroots level. .

Role of Community Health Practitioners in National Development: The Nigeria Situation

This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunity of the community to prevent transmission of disease pathogen to cause a disease. Community Health Practitioners are the frontline Primary Health Care Professionals charged with the responsibility of implementation of immunization programmes in Nigeria and therefore contributing significantly to the prevention and control of targeted vaccine preventable diseases in Nigeria Health System. Our findings on factors militating against Community Health Practitioners’ Roles in National Development as elicited in this paper may form basis for empirical studies to determine the level of significance of each of these factors. In conclusion, it is when the Community Health parameters are adequately addressed that we can ensure sustainable National Development and we can say we have succeeded in our various strategic agenda of government at whatever level that makes up the complex whole. This brings to fore, the importance of the roles of Community Health Practitioners in health care delivery to National Development in the context of our country, Nigeria.

Roles of mutual help of local community networks in community health activities: Improvement for the quality of life of older people in Thailand

Objectives: This study aimed to describe work and activities of community networks focusing on the improvement of the quality of life (QOL) of older people in Thailand.The understanding of the work can help enhancing the community development and strengthening of local communities and their networks.Methods: Qualitative methods including in-depth interview,observation,and focus group discussion were employed to the study.64 participants participated to the study and were recruited from 4 key actors within the community.Content analysis was used to analyze the obtained data.This study was conducted in 6 local administrative organizations (LAOs) which selected from the outstanding areas of the project.Each LAO represents one sub-district of the regions of Thailand namely;(1) the upper north,(2) the lower north,(3)the upper eastern,(4) the lower eastern,(5) the central and (6) the south.Results: The findings of this study were categorized into three main themes: (1) Social capital including people in the community,social groups,and organizations,(2) Mutual help/collaboration activities composed of six sets of activities related to social capitals working on the improvement of QOL of older people,and (3) Impacts of the mutual help/collaboration activities on older people and local communities who help to improve of QOL of older people.Conclusion: The findings are important features for the community development.These themes should be recommended for community nurses,health related groups and organizations for the improvement of QOL of older people in the community.

Family Medicine and Community Health期刊简介

宗旨和内容Family Medicine and Community Health(FMCH,《家庭医学和社区卫生》)(ISSN 2305-6983)是一本同行评议的开放性英文期刊(季刊),主要关注流行病、慢性病管理、社区卫生服务及家庭医学教育和培训。期刊旨在促进家庭医学领域知识和技能的即时沟通,以便为更好的医疗服务作指导。文章内容包括卫生政策、临床研究和实践、教育培训及社区卫生中心管理等。栏目包括但不限于,社论、原创研究、临床技能。

Family Medicine and Community Health 2016年2期目次选登

·An evaluation of a screening programme for immigrant women to Taiwan关于台湾移民妇女筛查项目的评价·Methodological challenges of cross-language qualitative research with South Asian communities living in the UK对生活在英国的南亚移民进行定性研究时在方法学上所遇到挑战·Process engineering for primary care:quality improvement

Role of community health nurse in the prevention of elderly dehydration:A mini-review

As dehydration is related to negative health outcomes in the elderly,including an increased risk of disability and death,prevention may help improve health,functional status,and quality of life.Dehydration diagnosis can be challenging in the elderly as the traditional physical indications of dehydration may be absent or ambiguous.Numerous etiologies place the elderly at an increased risk.The role of the community health nurse(CHN)derives from the responsibilities attached to her,and the Betty Neuman’s Systems Model of health care with three levels of protection is usually applied to the CHN.In this mini-review,we try to integrate the Betty Neuman’s Systems Model with the results of identified articles.This study includes a literature search of reputable international databases such as SpringerLink,PubMed,Embase,and Wanfang,particularly for the period 2005 to the present.Ten articles that met the qualifying criteria were included in this study.The findings of this study draw a picture of the role of CHN in preventing dehydration across the three levels of prevention as mentioned by Betty Neuman.

<i>Partenariat Santé</i>: Results of a Community Program to Improve the Cardiovascular Health among Adult Population

Partenariat Santé (PS) launched in Québec in 2016, is inspired from the Cardiovascular Health Awareness Program (CHAP) and consists of a free session held in the community by students coming from different health sciences programs. The program’s mission is to make available early detection of modifiable CVD risk factors, raise awareness of participants about their impact on CVDs, and promote healthy life changes. In order to gather information to optimize the implementation of this program and eventually to enlarge its implementation to other sites, the first objective of this study was to explore the characteristics of the adult population participating in the PS program and to identify the risk factors they want to modify. The second objective was to evaluate one month later the effective implementation of the action plan elaborated during the motivational interview. The third objective was to evaluate the satisfaction of the participants with the PS program. One hundred ten subjects who attended PS sessions during this period were enrolled in the study. About 30% of participants have blood pressure values ≥ 140/90 mmHg and 40% present a waist circumference associated with higher risk profile. The behaviors to be changed mostly targeted by the participants were physical inactivity and nutrition. A motivational interview was conducted with the elaboration of an action plan to support the behavioral/outcomes changes. Sixty participants (54.5%) completed the questionnaire in the one-month follow-up. Forty-one (68.3%) participants revealed that they had put their action plans into practice, while 63.3% claimed that they mostly reached their objectives. Motivation remains high after one month for participants who put their action plans in place (7.8 ± 1.9 versus 7.4 ± 1.6;p = 0.214), whereas it decreased significantly for those who did not (6.8 ± 2.1 versus 5.8 ± 2.0;p = 0.029). The majority of them agreed that PS program was useful (75%) and led them to change their lifestyle related to cardiovascular health (62%). In conclusion, our results suggest that the PS program can produce benefits on the promotion of cardiovascular health in the community adult population, being evaluated as useful to change the lifestyle related to CVD risk.

Family Medicine and Community Health 2016年3期目次选登

·An evaluation of a screening programme for immigrant women to Taiwan关于台湾移民妇女筛查项目的评价·Methodological challenges of cross-language qualitative research with South Asian communities living in the UK对生活在英国的南亚移民进行定性研究时在方法学上所遇到挑战·Process engineering for primary care:quality improvement

Community health worker model for health care delivery and environment programs focused on initiatives in USA and India

Community health workers are equipped with the tools and resources necessary to bring about a change in the form of a rapid chain reaction.The community health workers model focuses on the practices,strategies,plans,and implementation techniques needed to organize a community health event based on diverse agendas:health,environment,and minorities.This model encompasses past experiences as a guide with tested strategies to assist future health interns with a ground framework and resources to showcase the importance of adopting healthy and environmentally friendly practices.The basic outline of the model is based on data collected from various community health events in Illinois(United States of America)and New Delhi(India).These events included back to school fairs,cleanliness drives,health camps,and educational events.As community health workers can help in implementing better practices in the masses through one-on-one interactions,this model of community health worker programs would outline event organization tips,predicted outcomes,targeted audience,and required material templates.The next phase of this model highlights utilizing the data and experience from these events to report to the health ministries of different countries for the incorporation of the proposed practices in their health agendas and policies.This model,if implemented unanimously,could bring about a revolution in the arena of health workers.They will be assisted at each step,will establish connections with health workers globally,and share their health and environment-based agendas to collaborate and organize important events.This model envisions a strong established network of community health workers,display of their agenda,and creation of a ripple effect throughout the society by the means of these programs.

Assessment of Knowledge and Practices of Community Health Nurses on Data Quality in the Ho Municipality of Ghana

Background: High data quality provides correct and up-to-date information which is critical to ensure, not only for the maintenance of health care at an optimal level, but also for the provision of high-quality clinical care, continuing health care, clinical and health service research, and planning and management of health systems. For the attainment of achievable improvements in the health sector, good data is core. Aim/Objective: To assess the level of knowledge and practices of Community Health Nurses on data quality in the Ho municipality, Ghana. Methods: A descriptive cross-sectional study was employed for the study, using a standard Likert scale questionnaire. A census was used to collect 77 Community Health Nurses’ information. The statistical software, Epi-Data 3.1 was used to enter the data and exported to STATA 12.0 for the analyses. Chi-square and logistic analyses were performed to establish associations between categorical variables and a p-value of less than 0.05 at 95% significance interval was considered statistically significant. Results: Out of the 77 Community Health Nurses studied, 49 (63.64%) had good knowledge on data accuracy, 51 (66.23%) out of the 77 Community Health Nurses studied had poor knowledge on data completeness, and 64 (83.12%) had poor knowledge on data timeliness out of the 77 studied. Also, 16 (20.78%) and 33 (42.86%) of the 77 Community Health Nurses responded there was no designated staff for data quality review and no feedback from the health directorate respectively. Out of the 16 health facilities studied for data quality practices, half (8, 50.00%) had missing values on copies of their previous months’ report forms. More so, 10 (62.50%) had no reminders (monthly data submission itineraries) at the facility level. Conclusion: Overall, the general level of knowledge of Community Health Nurses on data quality was poor and their practices for improving data quality at the facility level were woefully inadequate. Therefore, Community Health Nurses need to be given on-job training and proper education on data quality and its dimensions. Also, the health directorate should intensify its continuous supportive supervisory visits at all facilities and feedback should be given to the Community Health Nurses on the data submitted.

Why Multi-Sectoral Approaches Are Rarely Applied in Community Health Interventions in Some Countries in Sub-Saharan Africa?

The objective of this work is to analyze the reasons why community health interventions in Africa do not consider multisectoral approaches. To achieve it, we perform a mini-review of health development policies and plans available online in seven countries from four regions of Sub-Saharan Africa. Thus, two main reasons have been highlighted. First, national strategic plans and policies for health development, in their formulation, neither sufficiently emphasize multisectoral approaches, nor sufficiently make these approaches operational in strategies and activities. Second, the mindset of health professionals due to their initial training orientation based on the biomedical approach, stands that disease is only a result of a physiological imbalance in the body;therefore, to restore health, such an imbalance only needs sophisticated procedures and interventions to be overcome. Such an orientation completely ignores the social, cultural and economic context in which the individual lives, which has an irretrievable influence on the health imbalance. However, health, influenced by the conditions in which people are conceived, born, grow, live, work and aged, cannot be effectively improved in a sustainable way without taking into account all these conditions. Whence the importance of approaches based on every sector of human activity that influences the living conditions.

Community Health Management and Nursing Strategies for Elderly Hypertension

Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected.The control group took conventional care and guidance.The research group carried out community health management and nursing strategy guidance on the basis of the control group.Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’satisfaction with nursing.Results:Through comparison,it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing.After nursing,the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg.The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg.There are obvious differences in the comparison of the two sets of data.By comparing the two groups of patients’satisfactions with nursing care,it can be seen that among the 32 patients in the study group:31 were very satisfied and basically satisfied,with a satisfaction rate of 96.87%.Among the 32 patients in the control group,28 were very satisfied and basically satisfied,with a satisfaction rate of 87.5%.The data of the two groups of patients are clearly comparable.Conclusion:Through community health management and nursing strategies,the satisfaction and treatment effect of elderly hypertensive patients can be improved,thereby contributing to the recovery of patients.

Community workers contribution for data quality improvement in routine health information system: Live births number estimation by capture recapture method

The lack of reliable vital statistics raises questions about the role of the health information system in acquiring such data, which are essential for planning health services and for the general management of the population’s needs. This study analyzed completeness of the vital data registration system and assessed the potential contribution of a community worker net-work to this system in rural Benin. The capture-recapture method was used in this interventional study to estimate the number of live births from three sources: the Routine Health Information System, the municipality, and community workers in two groups of villages. Log linear modelling was carried out with a Bayesian Information Criterion-weighted estimate of the number of live births. The exhaustiveness of the Routine Health Information System was improved by the contribution of the community workers from 29.3% to 42.5% in the first group, and from 61.7% to 77.5% in the second group. Estimating live births by the capture method in rural settings based on the contribution of community workers could be a more efficient alternative to censuses in acquiring reliable vital statistics.

Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study

Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.

Rural Resilience: A Comprehensive Study on Water Supply, Sanitation, Disease Patterns, and Hygiene Practices in Munshiganj, Bangladesh

This research project investigates the current status of water supply, sanitation, and hygiene practices in Munshiganj District, Bangladesh. Data collection involved a structured questionnaire and a reconnaissance survey. Findings reveal that 30% of individuals rely on surface water (hand-tube wells, rivers, and ponds), prioritized as canal > river > pond, while 70% depend on groundwater (subterranean electric motor, deep tube-well). Drinking water is generally sufficient, with 95% reporting adequacy throughout the year. About 45% use hand tube-well water, 28% use deep tube-well water, and 11% use supply tap water for various purposes. Bathing trends include underground water through electric motor > pond > hand tube-well water > river, while for cooking, the order is underground water through electric motor > pond > hand tube-well water > river. Toilet water supply ranks as supply tap water > hand tube-well water > deep tube-well water. Although sanitation awareness is high, some lack knowledge of good hygiene practices. After defecating, handwashing methods include soap, ash, soil, or water. Children’s waste disposal varies, with some discarding it in open areas. Approximately 40% suffer from diseases like Diarrhoea due to unsafe water, primarily affecting children and elders. Training exists, but a significant portion lacks sanitation education. Dry skin or exposure to cold water may cause temporary irritation. Local government involvement in sanitation efforts is less active compared to non-governmental organizations. Results emphasize the need to enhance community awareness of safe water supplies and sanitation practices. .

Prediabetes and cardiovascular complications study:Highlights on gestational diabetes, self-management and primary health care

International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.

The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya

Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.

The nurses’ voice of working in a newly established community based 24-hour support center for people with psychiatric disabilities

This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.

Efficacy of a Community-Based Trauma Recovery Program after a Fire Disaster

As industries develop,fire disasters and their associated damage are increasing.Investigating the mental health of victims is imperative because this is an essential issue for community recovery after a disaster.This study was conducted to determine the efficacy of a program implemented by a community mental health center based on the investigation of the victims’depression and post-traumatic stress disorder(PTSD)levels immediately after the disaster and at one-year follow-up.As a result,victims’depression and PTSD recovered over time,and more changes were confirmed.In particular,the high-risk group for PTSD showed a high program participation rate,and there was significant recovery over time compared with the group without PTSD.Based on these results,community mental health programs are an effective way to increase community mental health after disasters.In the future,community-based recovery programs after disasters should be expanded,and administrative support for them should be developed.

Ability of community-based prostate cancer screening to target an appropriate and underserved population

Screening is not universally beneficial due to over-and under-diagnosis,and false positives that beget additionaltesting and associated adverse events and expense.We examined data from all men who participated in a mass community prostate cancer screening between May 2009 and September 2010.The data contained information regarding patient demographics,family history of prostate cancer,lower urinary tract symptoms,prior history of prostate cancer,most recent digital rectal examination,and the presence of an established relationship with a physician.Current American Urological Association screening recommendations were then applied to determine the appropriateness of our outreach effort.A total of 438 men(mean age 66.5 years) underwent screening.A total of 106(24.2%) patients in our study met contemporary criteria for screening.Of these men,the vast majority was well educated,well insured,and well informed about the need for prostate cancer screening.Based on these data,mass community-based prostate cancer screening does not appear to identify and screen at-risk men.Future efforts at mass screening should more carefully target men most likely to benefit.