Organization Of Community Health Services Research Articles

Prevalence and predictors in self-neglect: A cross-sectional study of domestic migrant older adults in China.

Insufficient information is available on the prevalence and predictors of self-neglect among Chinese domestic migrant older adults resulting from rapid aging and mass population migration. This cross-sectional study was conducted on 597 older adults in four districts of Wenzhou from May to November 2020. A self-neglect scale was used to assess the prevalence of self-neglect among such adults. Sixteen potential predictors were considered in the domains of sociodemographic, health condition, socioeconomic, social isolation, intergenerational relationship, and filial piety. The prevalence of self-neglect within this population was 72.7%. Social isolation (OR=0.823; 95%CI 0.684-0.990), physical health (OR=0.966; 95%CI 0.941-0.992), intergenerational ambivalence (OR=1.240; 95%CI 1.013-1.519), and affective-cognitive solidarity (OR=0.796; 95%CI 0.719-0.880) were found to be independent predictors of self-neglect in this population. We suggest that community health service organizations should prioritize migrant older adults with a poor health status and those with intergenerational ambivalence to reduce self-neglect in migrant older adults. Such older adults should also be encouraged to participate in community activities for more social integration.

Dual diagnosis: A systematic review of the organization of community health services.

Dual diagnosis (DD), as the co-occurrence of a substance use disorder and a psychiatric disorder, is underestimated, under-diagnosed and often poorly treated throughout the world, although it is highly prevalent in people suffering from a mental disorder. This review analyzed 48 studies from a PubMed and PsycINFO databases search, in order to verify the state of the art regarding the organization of community health services for DD treatment. Four macro-themes have been identified: service organization, critical issues, assessment tools and evidence-based interventions. An effective service recognizes the complexity of DD, promotes a common staff culture, and tailors the organization to local needs. The main critical issues in its implementation include the lack of specific staff training, the poor management of resources and the need for greater personalization of care plans, with attention to psychosocial interventions. Integrated service assessment tools can be used as a benchmark measure at the program level for implementation planning and at the national level to affect policy change. The integrated treatment model for DD should also aim to improve access to care and offer treatments based on scientific evidence. It is also evident that the integration of services can improve outcomes but it is not a guarantee for it. There is an urgent need to improve networking between mental health and addiction services in order to deal with DD and create new integrated intervention models, paying attention to an approach to the whole person, seen in his/her absolute uniqueness.

Status quo and demand of core competence post training for community nurses in Qiqihar City

Objective To understand the current situation and requirements of core competence post training for community nurses in Qiqihar City, and to provide references for improving the content and methods of core competence post training for community nurses. Methods By convenience sampling, 394 community nurses working in 65 community health service organizations in 7 district of Qiqihar city were selected from September to December of 2018. Community Nurse Core Competence Rating Scale (CNCCRS) and self-designed questionnaire were used to investigate the position training status and needs. The t test, chi-square analysis were adopted to analyze and compare the score and each dimensional score in CNCCRS for different training with different position features, and to statistically describe the needs of community nurses' core competence post training. Results The total score of CNCCRS from those who had received the post training was (145.69±30.55) . There was no significant difference in the total score of CNCCRS and the scores of each dimension between nurses who had participated in nursing related training or not (P>0.05) ; there were significant differences in the total score of CNCCRS and the scores of each dimension among nurses who had participated in different modes of training (P<0.05) . The most preferred mode of training for the nurses was in-service short online courses through initiative learning. Conclusions The core competence of community nurses in Qiqihar City who have training experience is still at the medium level, and the training has not achieved the expected outcome. It is suggested that short-term on-the-job and online independent training combining theory and practice should be carried out according to the particular needs of community nurses in the future. Key words: Community health service center; Community nurse; Core competence; Position training; Status survey

Factors influencing the work passion of Chinese community health service workers: an investigation in five provinces.

BackgroundAfter the implementation of new healthcare reform, Chinese government paid increasing attention to developing community health service (CHS). The current focus is mainly on cultivating community general practitioners but paying less attention to the working status and occupational demands of in-service CHS workers. Work passion is playing an important role for medical workers. With work passion, CHS workers’ team will become more stable and more effective, ensuring the sustainable development of CHS system. At present, the work passion of CHS workers is relatively low. Studying on influencing factors of work passion of CHS workers, promoting their work passion, and making them keep enthusiasm for work are significant.MethodsA total of 100 CHS organizations were sampled randomly in 10 cities from 5 Chinese provinces for this study. A total of 3450 CHS workers from these CHS institutions took part in the surveys. Questionnaires were used to collect data, including socio-demographic information, work passion and opinion on influencing causes, and work-related satisfaction. Pearson chi-square statistical method was used to identify the factors related to CHS workers’ work passion. Binary logistic regression was performed to determine the significant factors that influence CHS workers’ work passion.ResultsA total of 38.77% of those who accomplished the questionnaire expressed that they didn’t have passion for current work. The related factors that influence CHS workers’ work passion are (1) socio-demographic factors such as age, and years of employment, and (2) other work-related factors such as learning and training opportunities, compensation packages, work stress, and personal development opportunities. CHS workers were most dissatisfied with the balance between remuneration and workload, job promotion opportunities.ConclusionsBased on the results, the government should concern for CHS workers’ working status and work-related demands, pay more attention and meet their demands for reasonable compensation packages and self-development, balance the income and workload, provide more learning and training opportunities and personal development opportunities for CHS workers, in order to promote CHS workers’ work satisfaction, improve their work passion and enthusiasm.

Factors Influencing the Turnover Intention of Chinese Community Health Service Workers Based on the Investigation Results of Five Provinces

After the implementation of the new health reform, the Chinese government paid increasing attention to developing its community health service (CHS). The focus is mainly on cultivating community general medical practitioners but paying less attention to the working status and occupational demands of in-service CHS workers. CHS requires a stable team that can provide good service to community residents. At present, the demission rate of CHS workers is high. Studying how to increase the stability of CHS workers is noteworthy. The goal of this study is to ascertain the key factors that influence the CHS worker turnover intention to increase their work satisfaction and stability. A total of 100 CHS organizations were sampled randomly in 10 cities from 5 Chinese provinces for this study. All CHS workers from these organizations took a questionnaire survey. In total, 3,212 valid answer sheets were collected. Pearson Chi square test and Binary logistic regression were used to analyze the related influencing factors that result in CHS worker turnover intention. A total of 38.7% of those who accomplished the questionnaire intended to quit. The influencing factors that result in CHS worker turnover intention are (1) socio-demographic factors such as age, post of duty, professional title, and working seniority, and (2) other work-related factors such as pay packets, learning and training opportunities, promotion and personal development space, and working stress. CHS workers were less satisfied with the balance between payment and work quantity, promotion opportunity, and working conditions. Based on the results, the government should pay more attention to the various demands of CHS workers in service, especially by increasing their income, providing more learning and training opportunities, and increasing the degree of their work satisfaction to avoid turnover intention and ensure the stability of the CHS workforce.

A model for community health service development in depressed rural areas in China

BackgroundTo introduce a model of community health service organization (as implemented in urban areas) to less developed rural areas in China and evaluate the impact of this model on health care utilization.MethodsThe intervention involved developing leadership at county level, training rural health practitioners, providing clinical management guidelines and standards, encouraging clinic improvements and providing access to subsidies for public health work. We chose 7 townships and 49 administrative villages in Chongyi County as the intervention sites; 3 townships and 9 administrative villages in Luxi County as the comparison sites. Officers from county health bureaus and postgraduates from School of Public Health, Nanchang University visited each township hospital and village clinic in field together and made observations and interviewed clinic staff.ResultsThere was little change in health facilities or workforce in the two areas. However, there was an increase in the use of public health services at township and village level in the intervention sites in Chongyi. In these, the proportion of clinics which had developed a child health (under the age of 3) management system, maternal postpartum visit and chronic disease management increased from 53%, 51% and 47% to 78%, 73%, and 71% respectively. There was no significant change in the comparison sites.ConclusionsThe trial demonstrated that it was feasible to implement a model of community health service delivery that was adapted to depressed rural areas because it required little organizational change, additional funding or personnel. The model had a positive impact on the provision of public health programs, a finding which has implications for efforts to improve access to primary health care in rural China.

Mutual referral: a survey of GPs in Beijing

China has been engaged in the process of reforming its health care system recently. The government has attempted to rebuild the referral system to lower cost and enhance equity of the medical services. This study was undertaken to evaluate the current status of mutual referral pilot programme, perceived factors that affect referral behaviour and changes that would improve the current referral process in Beijing. Using a cross-sectional study design, we sent a postal questionnaire to 138 urban district community health service (CHS) centres in Beijing. Questions were chosen from a formal consensus process based on a nominal group technique. One hundred twenty-five of 138 (90.6%) CHS centres responded to the survey. Seventy-six (61.8%) CHS centres reported that the mutual referral system was feasible. Twenty-six (21.1%) CHS centres reported that the mutual referral programme was running smoothly. Uncertainties of diagnosis/management and access to particular medical specialty interest or skills were the two most common factors that were suggested as affecting referral behaviour. The presence of a dedicated department to accept referrals in hospitals and the use of referral guidelines were the most preferred choices as likely to improve the current referral process. Since a system of gatekeeper role by GPs at CHS organizations has not been established in Beijing, most CHS doctors agree that to ensure the smooth operation of referrals, a dedicated department should be assigned by hospitals to receive referred patients. Official guidelines on referral should be developed, and health authorities should strengthen their supervision of referrals.

UML-Based Two-Way Referral MIS Requirement Analysis

China’s community health services starts in 1997 and becomes the most important part of the urban health services system with the development of China’s social security system and community security. Two-way referral system in China came into being with the further development of community medical services. This paper studies the construction of two-way referral management information system based on the social security system platform using information management system and UML language based on the survey of the present implementation of two-way referral system. The two-way referral management information system includes the feasible analysis, the analysis of functional requirement, the on-stream analysis of two-way referral process, the on-stream analysis of two-way referral management information system, the design of functional configuration and functional module. The paper aims to reduce the cost of two-way referral and increase the visiting rate and medical care of community health service organization.

The analysis of different rank medical establishment conducting the community health service organization medical personnel's organization pledges

Objective To Understand the different rank medical establishment conducting the community health service medical personnel's organization pledges. Methods With the organization pledges, the meter carried on the questionnaire survey to Mudanjiang 326 community health service medical personnel and analyzed. Results The scores of primary, secondary and tertiary health care organizations in community health service agency staff organizational commitment at the different levels of the latitude difference between hospitals were statistically significant ( P ＜ 0. 05 ) . Conclusions The the level of organization pledges conducts the hospital rank and its scale influence third-level medical establishment the community health service. Key words: Community health service; Organization commitment; Medical establishment

Community-oriented primary care: new relevance in a changing world.

Since its inception in rural, pre-apartheid South Africa, community-oriented primary care (COPC) has intrigued and informed public health and primary care leaders worldwide. COPC has influenced such programs as the US community health center movement, the general practice movement in the United Kingdom, and recent reforms in the public health system of South Africa. We provide a global overview of COPC, tracing its conceptual roots, reviewing its many manifestations, and exploring its future prospects as an organizational paradigm for the democratic organization of community health services. We examine the pitfalls and paradoxes of COPC and suggest its future utility. COPC has important values and methods to offer disparate but powerful movements in public health worldwide.

"Nurses as health evangelists"?: The evolution of public health nursing in Canada, 1918-1939.

Public health nurses provided leadership for the advancement of public health in Canada in the early decades of this century, although leadership by nurses is not celebrated in public health history. The historical period (1918-1939) selected for this inquiry is one in which public health nurses created a legacy of achievements in public health nursing education, practice, and the organization of community health services within the most challenging of social, economic, and political contexts. The practice of public health nursing in Canada during the interwar years included strategies that were then and still are integral to the discipline--those of forming connections with the community, providing leadership in the public health movement, and facilitating community organization. It is vital to understand the significance of these origins of public health nursing as forces in the present context of practice threaten to alter fundamentally the nature of public health nursing's connection with the community. The purpose of this article is to highlight aspects of this historical legacy so that its influence can be more fully understood and strengthened in current health system transitions.

The Role of Medicine for Children with Developmental Disabilities*

Abstract The trend of the delivery of health care services for developmentally disabled children, especially those with congenital anomalies, is described. The importance of how the organization of community health services and the role of medicine and medical facilities mesh together in Japan is emphasized.

Stroke: Cause, Prevention, Treatment and Rehabilitation

This publication is a smaller version of the encyclopedic workFundamentals of Stroke Care, published in 1976 by the senior author. This earlier work, about double in size, must still be considered the source book for everything related to stroke—epidemiology, causative and risk factors, pathology, prevention, medical and surgical management, and rehabilitation. This smaller volume being reviewed fulfills the promise in the title. Particularly fine sections are the ones on epidemiology, diagnosis, nursing care, and organization of community health services for stroke. All elements of patient care receive appropriate treatment—what Lewis Thomas refers to as nontechnology, halfway technology, and decisive technology, although the latter has little application as yet to stroke. The nontechnology, addressed to the needs and life problems of patient and family, receives appropriate and extensive discussion. One might say appropriate to some future era, as it is doubtful that this aspect of stroke is as yet honored

A Public Health Home Nursing Program for Outpatients with Heart Diseases

DURING the past 10 to 15 years, programs have been developed in hospitals and health departments across the country. The primary objective of most programs has been to provide medical and nursing to patients in their own homes a,fter hospitalization. Indeed, this type of program has become so common that the term home care today virtually implies that there has been preceding hospitalization. In the past 2 or 3 years, several programs have be-en started which are aimed at patients who are ambulatory and who may never have been hospitalized. The primary objective of these programs is to keep patients out of the hospital as long as possible by providing anticipatory medical and nursing services at home. In January 1964 an anticipatory program was begun at St. Luke's Hospital Center in New York City for a group of elderly patients with chronic congestive heart failure who received their medical in the outpatient clinics of the hospital. The aim of this program was to determine if the hospital admission rate of these patients could be reduced by adding public healt,h nursing followup at to the regular routine of outpatient department c,are. 'The results of this program provide information about the medical of congestive heart failure, organization of community health services, and role of public health nurses in programs of this kind.