Care Service System Research Articles

Research on the Current Status of Pension Models for Individuals with Mental Disorders in China

Objective: By analyzing the existing literature, this paper aims to explore the current situation of the pension model for patients with mental disorders in China and put forward corresponding suggestions for improvement. How: This study analyzes the current situation of the pension model for patients with mental disorders in China by referring to the views of experts and scholars, relevant cases and statistical data through the literature and review of CNKI. Focusing on the existing elderly care service system, policy support and social cognition, this paper reveals the main characteristics and existing problems of the current Chinese elderly care model for people with mental disabilities. By comparing the advanced pension models at home and abroad, this paper puts forward some suggestions on strengthening policy support and improving service system. Results: The research shows that China's existing pension models mainly include family care, institutional pension and community service. The main problems facing: insufficient service supply, shortage of professional talents, social cognition and discrimination. Home care is still the main way, more than 70% of people with mental disorders rely on home care, but face great pressure and challenges; The construction of institutional elderly care and community service systems is gradually developing, but there are still insufficient resources, low service quality, and uneven distribution between urban and rural areas. Policy suggestions: Strengthen the construction and improvement of community support system; Improve professional training to ensure service quality; Use scientific and technological means to assist the elderly and ease the shortage of human resources. It is suggested that we should strengthen the construction of community support system and improve the level of professional service in the future. Conclusion: In China, the mode of nursing care for patients with mental disorders is in the transition period, and family nursing is still the mainstream, but it also faces great challenges. Institutional care and community services have developed, but they are not yet sufficient to replace the role of the family. The future development direction should be multi-dimensional, forming a diversified and three-dimensional elderly care service network.

Spatial context and informal caregivers’ Well-being: A case study of a Carer Café project in Hong Kong

This paper evaluates how a Hong Kong community Carer Café program reduce the informal (unpaid) caregivers’ navigation burden of social and health care service system. The cafés took place once biweekly at pantries and activity rooms of social service centers, community centers, and churches, which installed temporary decorations to create a café-like environment. his article will use the conceptual framework of spatial context, including spatial propinquity, spatial composition, and spatial configuration, to highlight four mechanisms in the process of informalization. They are (a) changing layout; (b) promoting spatial propinquity of caregivers; (c) creating a spatial composition facilitating social interaction; and (d) allowing the caregivers to use informal spaces flexibly. Qualitative data from 26 respondents, including social workers, project staff, volunteers, and users, sheds light on the details of four mechanisms. Results show that the Carer Cafés were transformed into a safe and caregiver friendly third place by the informalization process. Thus, caregivers from communities visit cafés frequently. These frequent visits facilitate the Cafés become a hub for informal caregivers access different resources and supports. This paper suggest that spatial context would be an important consideration to further explore in the future community caregiver support service practice and policy.

Informed consent in the age of smart technologies

Technology is increasingly being brought into the home care of older people. Digitalization is seen as an enabler for efficient and resource-saving operations. In the use of technology, informed consent is considered an ethical practice and part of a responsible home care service system. The aim of this article is to describe the problem of informed consent in situations where emerging technologies, such as artificial intelligence (AI) and mass data, are used as part of welfare services and home care for older people. The article discusses principles and ways to better integrate informed consent as an ethical practice into a responsible home care service system. A qualitative study was carried out to gather the views of experts in the field of elderly care and ethics. A content analysis of a semi-structured focus group was used to explore perceptions of the changing nature of informed consent. According to our findings, the informed consent model requires updating. The key is to embrace the idea that consent is a living process designed to respect people's autonomous choices and protect them from risk. If the nature of the use of the data collected from individuals changes significantly in the future, the consent should also be updated to reflect this change. This aspect is important because new technologies will change the nature of the collection and use of the data. Mass data collection combines multiple databases so that the resulting data can be used even far from the original purpose or context in which it was collected. Therefore, consent should always be tailored to the context, allowing sufficient time for the person seeking and giving consent to clarify the content of the consent. This process highlights the importance of understanding the agency of the consent giver.

Reflections on the Challenges of Old-age Security and Policy Options for an Ageing Population

The global phenomenon of population aging is advancing at an unprecedented pace, particularly in China, where the accelerating aging process poses substantial challenges to the existing pension security system. The issue of elderly care has emerged as a critical topic in the realms of society, economy, and politics, impacting national sustainability and social stability. The challenges brought about by an aging society extend beyond the pressures of pension payments and insufficient elderly care services, encompassing risks related to funding sources and management, as well as concerns over the fairness of the security system. In the face of these challenges, there is an urgent need to optimize pension policies, advance pension system reforms, enhance the elderly care service system, and strengthen the coordination between social and medical security to construct a more equitable and sustainable pension security framework. Measures must be collaboratively advanced through top-level institutional design, policy execution efficiency, and societal involvement to provide robust support in addressing the challenges of aging. This paper will delve into the impact of population aging on the pension security system, analyze the current state and shortcomings of policies, and propose strategies to enhance the system's resilience, offering insights and recommendations for strengthening the pension security framework.

Study on the Characteristics of Community Elderly Care Service Facilities Usage and Optimization Design Based on Life Cycle Theory

Abstract: As the aging population in China increases, home-based elderly care is set to become the main mode of elderly care in the future. The construction of community elderly care service facilities is receiving more and more attention from society. Currently, residential area design standards in China lack clear guidance on the spatial planning of facilities, which will lead to unreasonable facility layout planning and insufficient convenience in the utilization of facilities by the elderly. Fully considering the distribution characteristics of community elderly care service facilities and the needs of the community life circle when planning residential areas can effectively solve this problem. This study takes Xi’an City as the research object, based on the theory of life circle, through questionnaire surveys and cluster analysis, analyzes the current situation of the construction of elderly care service facilities and the characteristics of the use by the elderly. Combined with the community life circle model, the study scope is divided into community life circle levels, and put forward the planning strategies of coverage rate, number, richness, and spatial layout of the facilities, respectively. These strategies are designed to enhance the quality of life for seniors, ensuring that they have access to essential support and resources within their communities. It demonstrated that middle-aged elderly prefer community canteens and activity centers, while those with limited mobility and multiple chronic diseases have a higher demand for health service centers and community canteens. The utilization weight analysis shows that vegetable markets and supermarkets are most frequently used, whereas health service centers are the least utilized. The research proposes strategic planning enhancements, including full coverage of basic facilities, targeted increases in high-demand facilities, and tailored facilities for elderly characteristics. It recommends cross-community layouts to ensure service radius coverage, development reservations for future needs, and quality improvements to address the low satisfaction rates of existing facilities. The study concludes that a targeted approach to facility planning, considering the elderly’s diverse needs, can enhance the community elderly care service system’s sustainability and effectiveness.

Application of a new municipal management model of Home Care Service in Barcelona: Assessment of workers' labour conditions, health, and well-being.

In 2018, Barcelona City Council implemented a pilot phase of an organisational change in the municipal home care service (HCS) system. Inspired in the Buurtzorg model, the new model promotes the creation of self-managing teams operating in a restricted community setting. To assess the pilot phase of the new model, focusing on employees' working and employment conditions as well as on their health and well-being outcomes. Mixed-methods impact evaluation. First, a quantitative evaluation was conducted between October 2018 and October 2020, using a pre-post study design with one pretest and two posttest measurements in an intervention and a comparison group. The intervention group was composed of the members of the work teams implemented in the pilot phase from October 2018 onwards (baseline n = 44). The comparison group consisted of workers from the same districts working under the usual HCS system (baseline n = 72). Next, a qualitative study was conducted in workers from the intervention group in winter 2021-2022 (n = 10). The pre-post study results yielded positive changes for the intervention group in social support and autonomy, as well as in many of the employment conditions. This group also experienced increases in psychological demands, painful positions, fatigue and psychological distress. Two main themes affecting workers' well-being emerged from the interviews: factors inherent to the self-management model and external factors. Health and well-being outcomes seem to depend on the balance between job demands, resources, and ways of channelling conflicts within teams.

Suicide Mortality During the Perinatal Period

The US has the highest maternal mortality rate among developed countries. The Centers for Disease Control and Prevention deems nearly all of these deaths preventable, especially those attributable to mental health conditions. Coordination between US health care and social service systems could help further characterize circumstances and risks associated with perinatal suicide mortality. To examine contextual and individual precipitating circumstances and risks associated with perinatal suicide. This cross-sectional observational study used a convergent mixed methods design to explore factors contributing to maternal suicides and deaths of undetermined intent (hereinafter, undetermined deaths) identified in National Violent Death Reporting System (NVDRS) data for January 1, 2003, to December 31, 2021. Analyses included decedents who were aged 10 to 50 years and pregnant or post partum at death (collectively, the perinatal group) and demographically matched female decedents who were not pregnant or recently pregnant (nonperinatal group) at death. Analyses were performed between December 2022 and December 2023. Pregnancy status at death (perinatal or nonperinatal). The main outcomes included contributing circumstances associated with suicides and undetermined deaths cited in coroner, medical examiner, or law enforcement case narratives. The study examined quantitative differences between groups using a matched analysis and characterized key themes of salient suicide circumstances using qualitative content analysis. This study included 1150 perinatal decedents identified in the NVDRS: 456 (39.6%) were pregnant at death, 203 (17.7%) were pregnant within 42 days of death, and 491 (42.7%) were pregnant within 43 to 365 days before death, yielding 694 postpartum decedents. The nonperinatal comparison group included 17 655 female decedents aged 10 to 50 years. The mean (SD) age was 29.1 (7.4) years for perinatal decedents and 35.8 (10.8) years for nonperinatal decedents. Compared with matched nonperinatal decedents, perinatal decedents had higher odds of the following identified contributing circumstances: intimate partner problems (IPPs) (odds ratio [OR], 1.45 [95% CI, 1.23-1.72]), recent argument (OR, 1.33 [95% CI, 1.09-1.61]), depressed mood (OR, 1.39 [95% CI, 1.19-1.63]), substance abuse or other abuse (OR, 1.21 [95% CI, 1.03-1.42]), physical health problems (OR, 1.37 [95% CI, 1.09-1.72]), and death of a family member or friend (OR, 1.47 [95% CI, 1.06-2.02]). The findings of the qualitative analysis emphasized the importance of mental health and identified 128 decedents (12.4%) with postpartum depression. This study provides insights into complex factors surrounding maternal suicide, and it highlights opportunities for further research to understand long-term consequences of perinatal mental health. These findings also underscore the need for targeted evidence-based interventions and effective policies targeting mental health, substance use, and IPPs to prevent maternal suicide and enhance maternal health outcomes.

Analysis of the Construction of Rural Home-Based Elderly Care Service System

As my country's aging problem worsens, more and more attention is being paid to the construction of elderly care services in rural areas. This article aims to investigate the current status, problems, and challenges of rural home care services through the analysis of research literature. In the research, it was determined that the number of elderly people living alone in empty nests in rural areas increases every year, and problems such as inadequate elderly care services, low use of community elderly care facilities, and inadequate medical services are becoming more common. its importance is increasing. The current rural home care system has many drawbacks and disadvantages. It is recommended to fulfill the federal government's responsibility for community elderly care services, establish urban elderly care services, improve community elderly care services, and home care of the elderly, and participate in city and community care services for the elderly. Integration of medical and nursing care in rural areas.

The Current Situation and Optimization of the Construction of Elderly Care Service System in Qinghai Province

The Current Situation and Optimization of the Construction of Elderly Care Service System in Qinghai Province

Impact of the COVID-19 pandemic on cervical cancer screening participation, abnormal cytology prevalence and screening interval in Catalonia.

The COVID-19 pandemic led to a national lockdown and the interruption of all cancer preventive services, including cervical cancer screening. We aimed to assess the COVID-19 pandemic impact on opportunistic screening participation, abnormal cytology (ASCUS+) prevalence and screening interval in 2020 and 2021 within the Public Health System of Catalonia, Spain. Individual data on cytology and HPV testing of women aged 25-65 from 2014 to 2021 were retrieved from the Information System for Primary Care Services (SISAP). Time-series regression models were used to estimate expected screening participation and abnormal cytology prevalence in 2020 and 2021. The impact was determined by comparing observed and expected values (ratios). Additionally, changes in screening interval trends between 2014 and 2021 were assessed by fitting a Piecewise linear regression model. Cervical cancer screening participation decreased by 38.8% and 2.2% in 2020 and 2021, respectively, with the most significant impact on participation (-96.1%) occurring in April 2020. Among older women, participation was lower, and it took longer to recover. Abnormal cytology prevalence was 1.4 times higher than expected in 2020 and 2021, with variations by age (range=1.1-1.5). From June 2020 onwards, the screening interval trend significantly changed from an increase of 0.59 to 3.57 months per year, resulting in a median time of 48 months by December 2021. During the pandemic, fewer women have participated in cervical cancer screening, abnormal cytology prevalence has increased, and the screening interval is more prolonged than before. The potential cervical cancer lifetime risk implications highlight the need for organized HPV-based screening.

Challenges and solutions for discharge support of elderly people in the acute care ward: Interviews with community-based integrated care supporters and patients in Tokyo, Japan.

Japan, which has become the country with the longest-living people in the world due to rapid population aging, has an insurer function for each local government and socialized long-term care under a public system. Japan aims to build a Community-based Integrated Care System (CICS) for each municipality with the goal of integrating medical care and long-term care. However, despite the policy and management studies, the challenges and solutions for discharge support by the parties have not yet been clarified. This study aimed to obtain suggestions on challenges and solutions for discharge support in the acute care wards for the elderly for community-based integrated care support providers and patients in Kita Ward, Tokyo. Semi-structured interviews were conducted, and the obtained data were a priori analyzed by a deductive thematic analysis using a conceptual framework for integrated care based on the integrative functions of primary care. The challenges were found to include: i) disparity between medical and lifestyle perspectives, ii) competencies of medical and care workers at homes, iii) discharge support challenges related to the elderly themselves, iv) nursing care dependent on family; and v) the impact of payment of medical service in the health insurance system and payment of long-term care services. The solution that can be applied at the local government level was community connection. While aiming to build a CICS for each local government, there was a contradiction in that the challenges and solutions required examination at the national and prefectural levels.

Construction and Application of a Quality Evaluation System for Group Elderly Care Services Based on the Internet of Things

With the continuous intensification of global aging, the issue of elderly care has become an increasingly prominent social problem. The Internet of Things (IoT) technology, as an emerging field, holds broad application prospects. This article focuses on the application of IoT technology in group elderly care services and constructs a quality evaluation system for these services based on IoT technology. Through the analysis of practical application cases, the advantages and challenges of IoT technology in group elderly care services have been examined, confirming the feasibility and effectiveness of the evaluation system.

Psychometric evaluation of the Chinese version of the fear of pregnancy scale: a translation and validation study.

Many women experience fear toward pregnancy, which can impact their desire to have children and the national birth rate. Thus, assessing women's fear of pregnancy is of great importance. However, there is currently no specialized tool for assessing women's fear of pregnancy in China. The purpose of this study is to translate the Fear of Pregnancy Scale into Chinese and test its reliability and validity among women of childbearing age. Using convenience sampling combined with a snowballing method, a cross-sectional survey was conducted on 886 women of childbearing age in two cities in China. The translation was strictly carried out according to the Brislin model. Item analysis, validity analysis, and reliability analysis were employed for psychometric assessment. The Chinese version of the Fear of Pregnancy Scale comprises 28 items. Exploratory factor analysis extracted four factors with a cumulative variance contribution rate of 72.578%. Confirmatory factor analysis showed: NFI = 0.956, CFI = 0.986, GFI = 0.927, IFI = 0.986, TLI = 0.985, RMSEA = 0.032, and χ2/df = 1.444. The scale's Cronbach's α coefficient is 0.957, split-half reliability is 0.840, and test-retest reliability is 0.932. The Chinese version of the Fear of Pregnancy Scale possesses robust psychometric properties and can assess the degree of pregnancy fear among Chinese women of childbearing age. It provides a reference for formulating relevant policies in the prenatal care service system and implementing targeted intervention measures.

The distribution structure of medical and care resources based on regional characteristics throughout Japan in 2020

BackgroundGiven Japan’s rapidly aging population, the Ministry of Health, Labour and Welfare's policy of reducing hospital beds and replacing medical care with nursing care requires the establishment of a coordinated system of medical and care services tailored to regional characteristics. To gain useful knowledge for the development of such a system, this study aimed to identify differences in the structure of the relationship between medical and care resources due to differences in regional characteristics.MethodsInitially, regional characteristics were used to group all 334 secondary medical areas (SMA) in Japan by principal component analysis. Subsequently, the related structure of the distribution of medical and care resources for each group were compared. For these comparisons, first, the related structure of the distribution of medical and care resources nationwide was modeled using structural equation modeling. Secondly, multigroup analysis was conducted to investigate differences among the models across groups.ResultsThe nationwide SMAs were grouped largely based on urbanicity and middle-density regionality. The groups with high urbanicity and high middle-density regionality consisted of SMAs with a high and medium population density. By contrast, the low middle-density regionality group consisted of SMAs containing large cities with a high population density and depopulated areas with a low population density. The model of the related structure of the distribution of medical and care resources differed among these groups. In the non-urbanicity and middle-density regionality groups, nursing care abundance tended to increase acute care abundance. In addition, in all groups, nursing care abundance tended to increase long-term hospitalization care abundance and clinic care abundance (with beds).ConclusionsThe key finding of this study was that the government’s objective of reducing hospital beds may not be achieved solely by expanding nursing homes. This is because many of the models did not show a tendency that higher nursing care abundance reduces the values of the factors which increase more hospital beds. This finding was particularly relevant in middle-density regionality groups. This finding suggests that the location of nursing homes should be monitored because of concerns about the oversupply of nursing homes and sprawl in those areas.

The impact of long-term care insurance pilot on the mental health of older adults: Quasi-experimental evidence from China

The Chinese government launched pilot programs for a long-term care insurance system in response to the ongoing increase in the aging population. This study uses the difference-in-differences (DID) model to analyze the impact of long-term care insurance on older adults' mental health based on China Health and Retirement Longitudinal Study (CHARLS) four-period panel data from 2011 to 2018. This study found that long-term care insurance reduced Center for Epidemiological Studies Depression Scale (CES-D) scores among older adults by 1.059 points. Moreover, there was an improvement of 0.181 and 0.870 points in mental status and scenario memory scores, respectively. The impact of the long-term care insurance pilot program on improving the mental health of older adults was more pronounced, especially for those with chronic diseases or disabilities as well as those living in rural and western regions. This study also revealed that long-term care insurance enhances mental health by reducing medical expenses and increasing daily companionship and social interaction. Therefore, a pilot study of long-term care insurance showed a significant improvement in the mental health of older adults. To provide a comprehensive care service system for older adults, the government should expand the scope of the pilot program and increase the accessibility of mental health services for older adults.

Cardiology Service of Kazakhstan Today: Acute Coronary Syndrome, Chronic Heart Failure, Atherosclerosis.

The article focuses on the prevalence of circulatory diseases, organization and implementation of new programs in the system of cardiological care services in the Republic of Kazakhstan. Currently, three key programs are functioning at the republican level: "Acute coronary syndrome", "Chronic heart failure", and "Atherosclerosis and dyslipoproteinemia". The National Scientific Cardiac Surgery Center (Astana) is the coordinator of all these programs.

Suicide attempts and suicides as determinants of quality and safety within hospital system of mental health care services

Suicide attempts and suicides as determinants of quality and safety within hospital system of mental health care services

Trends in private caregiving cost after implementing a comprehensive nursing service covered by national health insurance: Interrupted time series

BackgroundThe Korean government has implemented a comprehensive nursing care service system (CNS) to mitigate the stress faced by caregivers. ObjectiveThis study aimed to assess trends in the estimated average costs of private caregiving and determine the difference in costs between those using CNS and those not using it. DesignA comparative interrupted time series analysis with a 2-year lag period verified total private caregiving cost trends; biannual differences in costs were evaluated based on using CNS. ParticipantsThe main unit of analysis was episode. We extracted a total of 6418 episodes of hospitalization in acute care settings that included the use of caregiving services (formal, informal caregiving and CNS). MethodsWe conducted segmented regression to assess the impact of CNS on total private caregiving costs using data from 2012 to 2018, excluding the years 2015 and 2016 of the Korean Health Panel dataset. ResultsWe presented that the immediate mean difference in total private caregiving costs between CNS users and non-users was −444.7 USD two years after the implementation of the CNS policy (95 % CI −714.5 to −174.5, p-value 0.001). Among individuals living in rural areas, two years after the implementation of the CNS policy, there was a significant immediate mean cost difference of −476.9 USD in total private caregiving costs between CNS users and non-users (p-value 0.011). Similarly, for episodes with a Charlson Comorbidity Index (CCI) score of 0 to 1, there was a substantial immediate mean cost difference in total private caregiving costs between CNS users and non-users, amounting to −399.9 USD two years after the CNS policy (p-value 0.008). ConclusionsThis study evaluated the trend of total private caregiving costs between groups using and not using CNS. After two years of being covered by CNS health insurance, those who utilized CNS paid $433 less for their total private caregiving cost over a 6-month period, compared to those who did not use CNS. The adoption of CNS may be an effective system for relieving the financial burden on inpatients in need of private caregiving services. Tweetable abstractKorean Comprehensive Nursing Service reduces private caregiving costs

ЗАСТОСУВАННЯ ПРОГРАМ ДОПОМІЖНИХ РЕПРОДУКТИВНИХ ТЕХНОЛОГІЙ В УКРАЇНІ: УПРАВЛІНСЬКІ АСПЕКТИ

The article discusses managerial aspects of the use of assisted reproductive technology programs in Ukraine. It was noted that it is now critically important for the natural recovery of the population of Ukraine to do everything possible to expand access to treatment, diagnosis and prevention of infertility, in particular with the help of programs of assisted reproductive technologies. It was determined that currently in Ukraine the most active subjects are service providers who determine the direction of development of management relations in the field of application of assisted reproductive technologies. The need to intensify the activities of the authorities regarding their role as a regulator of social relations within their competence is emphasized. Attention is focused on the development of a balanced regulatory toolkit of management, i.e. regulatory and legal acts of different legal force, follows organically from this. Attention was also drawn to the broad context of management in the field of application of assisted reproductive technologies. It is argued that within the scope of determining the priority directions for improvement of management in the field of application of assisted reproductive technology programs in Ukraine, it is expedient to develop not only medical, but also socio-humanitarian and socio-economic research on the evidence of certain reproductive health management practices. It is emphasized that in modern realities, the context of post-war reconstruction should also be taken into account in order to determine the ways of development of management in the field of application of assisted reproductive technologies. It was concluded that in order to ensure the high-quality functioning of the health care sector in the current realities, several options for solving the most acute problems are proposed: strengthening decentralization; expanding the space of freedom for autonomous work of doctors; establishment of coordination of activities between all links of medical care; introduction of new roles in the system of health care services; mental health as priorities for state funding.

Rest-in-Peace: Research on the Architectural Types and Design Ideas to Guide Design of Hospice Care Building.

In the context of an aging population, the concept of peaceful end-of-life care has gained increasing significance as an essential component of individuals' fundamental well-being. This underscores the importance of researching and developing hospice care facilities and service systems dedicated to providing a tranquil resting environment. This study focuses on selected hospice care buildings, examining their service model evolution and architectural design. Through case analyses, it explores contemporary hospice care architecture, identifying various types and spatial design features that cater to the end-of-life needs of individuals. The findings guide the design of hospice care buildings in China, emphasizing patient-living areas, medical care zones, and auxiliary functional spaces. This comprehensive approach aims to enhance terminally ill patients' comfort, serenity, and dignity. Moreover, it aims to provide emotional and post-funeral support to terminally ill patients' families.