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The innovations in China’s primary health care reform: Development and characteristics of the community health services in Hangzhou

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Family Medicine and community health 2015年第3期3卷 52-66页

作者： Feng Lin Qihong Sun Zhangping Peng Jun Cai Philip Geanacopoulos Lin Li Yun Zhao Xin Zhang Xiaoxiao Chen ACON Primary Care Research Center 4F Tower BUnion PlazaNo.2 Zijinghua RoadHangzhouZhejiang 310023China Walter H.Shorenstein Asia-Pacific Research Center Freeman Spogli Institute for International StudiesStanford University616 Serra St.Encina Hall E311StanfordCA 94305USA

Objective:This study focuses on Hangzhou,a Chinese city with a population of nine million urban and rural residents,to examine the successful development and innovation experience of its primary health care service system during the new health reform in China since 2009 and then dis-seminate the findings through international third ***:Measures such as data analysis,study of documents and regulations,fieldwork,and expert discussions were used to systematically investigate primary health care in *** findings will have a profound practical impact on the health reform for nine million rural and urban residents throughout Hangzhou’s municipal ***:community health services in Hangzhou are characterized as follows:They are gov-ernment led;they are guaranteed with enough financing,personnel,facilities,and regulation;sup-ported by the unified information platform;general practitioners have been assigned the key role of health‘gatekeepers’;they provide primary care combined with basic public health services;there are integrated urban and rural health services and insurance coverage;and there is health care-pen-sion-nursing integration and general practitioner-contracted‘smart’*** data collection and analysis indicate that the basic health status of Hangzhou residents is superior to that of residents of China as a whole,and some health indicators in Hangzhou are comparable to those in Western developed ***:It is reasonable to believe that the primary health care level in China,including Hangzhou,will be further developed and promoted with indexed performance evaluations and more effective implementation of additional measures.

关键词： health care reforms community health services health status Hangzhou China

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Self-harm attempters' perception of community services and its implication on service provision

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International Journal of Nursing Sciences 2019年第1期6卷 50-57页

作者： Ming Leung Chun-Bong Chow Pak-Keung Patrick Ip Siu-Fai Paul Yip Central Nursing Division Princess Margaret HospitalHKSARChina Department of Paediatrics and Adolescent Medicine LKS Faculty of MedicineThe University of Hong KongHKSARChina Hospital Authority Infectious Disease Centre Princess Margaret HospitalHKSARChina Department of Paediatrics and Adolescent Medicine The University of Hong Kong-Shen Zhen HospitalShen ZhenChina Department of Social Work and Social Administration The University of Hong KongHKSARChina Jockey Club Center of Suicide Research and Prevention The University of Hong KongHKSARChina

Objective:This study aimed at exploring the attempters'perception of community social services included any barriers to seeking help and ***:The participants were patients with self-harming behavior aged 15 years or above.A set of guiding questions were designed to explore the general barriers and accessibility to community social services.A voice recording was made,which was later converted into a text transcript and then preceded for content analysis with co-occurrence and similarity matrix *** males and nine females with a history of self-harm aged between 24 and 58 years were recruited for the ***:The participants had diverse experiences and backgrounds,and attitudes toward community social ***,there was a shared perception of the need to enhance community social *** were four main themes and 12 sub themes *** main theme included the service availability,service accessibility,affordability and *** details,participants were unaware of the available types of care/social services in the community,and were unaware about the nearby social *** also suggested extending service hours and focused services should be offered to help people with different backgrounds and ***,those with experience of service utilization had both positive and negative perspectives and they gave suggestions for service delivery,mainly extending service hours and offering focused services such as for gambling control and financial *** view of interaction with service providers,counseling skills and trust were highly appreciated by the ***:The results identified common circumstances of falling into financial hardship(gambling)and social fragmentation(divorce,poor family relationships,and poor marital relationships),which also suggested to enhance services on center location,service arrangement,and skill of caregivers.

关键词： Cognition community health services Patients Self mutilation

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

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International Journal of Nursing Sciences 2019年第3期6卷 266-271页

作者： Khanitta Nuntaboot Peerapong Boonsawasdgulchai Nisachon Bubpa Faculty of Nursing Khon Kaen UniversityKhon KaenThailand

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 *** understanding of the work can help enhancing the community development and strengthening of local communities and their ***: 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 *** analysis was used to analyze the obtained *** study was conducted in 6 local administrative organizations (LAOs) which selected from the outstanding areas of the *** 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 ***: 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 ***: The findings are important features for the community *** themes should be recommended for community nurses,health related groups and organizations for the improvement of QOL of older people in the community.

关键词： Aged community-based participatory research community health services community networks Quality of life Social support

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A cross-sectional study of breastfed infants referred for tongue tie assessment and frenotomy in one Canadian health region

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Pediatric Investigation 2024年第1期8卷 53-60页

作者： Tiffany A.Lee Jessica Bishop Anne Drover William K.Midodzi Laurie K.Twells School of Pharmacy Memorial University of Newfoundland(MUN)St.John’sCanada Faculty of Medicine Memorial University of Newfoundland(MUN)St.John’sCanada

Importance:Tongue tie(TT)is a condition that can cause infant feeding difficulties due to restricted tongue *** TT presents as a significant barrier to breastfeeding,a frenotomy may be *** accepted diagnostic criteria for TT are lacking and wide prevalence estimates are *** referral processes and a Frenotomy Assessment Tool were implemented in one Canadian health region to connect breastfeeding dyads with a provider for TT evaluation and ***:To determine the proportion of babies with TT as well as the frequency of ***:This cross-sectional study included infants who initiated breastfeeding at birth and were referred for TT evaluation over a 14-month *** were collected retrospectively by chart review and analyzed using *** associated with frenotomy were examined using logistic ***:Two hundred and forty-one babies were ***-two percent(n=222)were diagnosed with TT and 66.0%(n=159)underwent *** the multivariate model,nipple pain/trauma,inability to latch,inability to elevate tongue,and dimpling of tongue on extension were associated with frenotomy(P<0.05).Most referrals in our region resulted in a diagnosis of TT;however,the number of referrals was lower than expected,and of these two-thirds underwent ***:TT is a relatively common finding among breastfed *** research should examine whether a simplified assessment tool containing the four items associated with frenotomy in our multivariate model can identify breastfed infants with TT who require frenotomy.

关键词： Breastfeeding Nutrition community health services Pediatrics

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The perceptions on good death of the older adults in the semi-urban community:A qualitative study

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International Journal of Nursing Sciences 2022年第3期9卷 389-396,I0005页

作者： Araya Tipwong Tanawat Ruamsook Thitavan Hongkittiyanon Kanit Kgowsiri College of Nursing and health Suan Sunandha Rajabhat UniversityBangkokThailand Faculty of Nursing Rambhai Barni Rajabhat UniversityChanthaburiThailand

Objective This study aimed to explore the perceptions of good death of the older adults living in Bang Nang Li Sub-District,Amphawa District,Samut Songkhram Province,*** The data of the study was collected using in-depth interviews between October 2019 to January *** data collected a total of 14 older adults who had firsthand experience in caring for terminally ill patients were recruited for the *** analysis was employed to analyze qualitative *** The results of this study revealed the perceptions of good death which were categorized into three main themes and eight sub-themes,including 1)death without suffering(not suffering from life support devices,dying with care);2)natural death(death with the end of life expectancy,death with illness or ailments);and 3)death without the worries(preparation for death,spiritual and belief practice toward preparation for death,family and property management before death,death among family members and at their familiar place).Conclusion The findings of this research provided the insight to clarify the understanding of the perceptions on a good death of older *** findings can be used to support the practice and management of nursing education and health care providers who have to be involved in palliative care for terminally ill older adults.

关键词： Attitude to death Aged community health services Qualitative research

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Social practices of nurse care coordination using sensor technologies e Challenges with an alert system adoption in assisted living communities for older adults

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International Journal of Nursing Sciences 2021年第3期8卷 289-297,I0004页

作者： Isa Jahnke Nathan Riedel Mihail Popescu Marjorie Skubic Marilyn Rantz School of Information Science and Learning Technologies University of MissouriColumbiaMOUnited States Department of health Management and Informatics University of MissouriColumbiaMOUnited States Department of Electrical Engineering and Computer Science University of MissouriColumbiaMOUnited States Sinclair School of Nursing University of MissouriColumbiaMOUnited States

Objectives:From the view of everyday practices and the socio-technical coordination lens,this study aimed to analyz the gap between creators’intention and the users’implementation(mainly nursing staff and social workers)of an alert system in assisted living ***:Qualitative methods were employed by way of five user interviews and focus groups with six system *** instruments were applied for data collection to analyze the different clinical workflows versus the expectations of the system development ***:Results indicate that the clinical workflow changed over time,which led to a mismatch of nurse care coordination,social practices,and technology *** results show different mental models of the socio-technical *** the coordination theory,the following recommendations could be developed to overcome the ***,it is recommended that nursing staff set goals ***,a communication rhythmwith the nursing staff and developer teams should be established,with guided questions to facilitate the conversation,to shed light on the different workflows and the difference in social practices when using sensor technologies or alert ***,a checklist for new employees should be created so they know how and on which devices to use the alert ***,the user experience with the alert system should be improved(e.g.,an improved user interface).Conclusions:This work indicates recommendations to close the mental model gap to overcome the mismatch between optimal use of the alert system and how the nursing staff is actually using it.

关键词： community health services health services for the aged Medical informatics applications Software

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Challenges faced by community health nurses to achieve universal health coverage in Myanmar:A mixed methods study

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International Journal of Nursing Sciences 2021年第3期8卷 271-278,I0002,I0003页

作者： Sein Yaw May Naw Clara Ohn Khin Khin Win Win Mar Aye Nandar Han Su Su Maw community health Nursing Department University of Nursing-YangonMyanmar

Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in ***:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative *** data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic *** study is registered with ***:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve *** 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career *** problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health *** are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased *** work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to *** only the health system itself but also the population and other geographical factors have contributed to many challenges to ***:Myanmar’s CHNs face many challenges in achieving *** challenges are not confined to the health *** situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare *** study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infras

关键词： community health nurses community health services health personnel Myanmar Primary health care Professional practice Social conditions Universal health coverage

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The social ecological determinants of the satisfaction and the utilization of primary care by chronically-ill patients in Xiamen

The social ecological determinants of the satisfaction and t...

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2017年中国卫生统计学学术年会

作者： Lele Chen Yanbing Zeng Ya Fang School of Public health Xiamen University

Objective Primary care is increasingly important to build a strong healthcare in China with the development of healthcare *** mode stands out among the pilot cities and is viewed as an effective mode in managing chronic diseases and promoting community health services（CHS）.The aim of our study is to examine the social ecological factors（personal characteristics,personal behaviors,Interpersonal process and primary groups,community factors,and public policy）influencing the satisfaction and the utilization of community health service（CHS）from first-contact care,and outpatient service utilization（OSU,contact and frequency）.Methods A cross-sectional survey was conducted face-to-face in 5 community health centers（CHCs）from Xiamen *** data were presented as *** perform bivariate comparisons,we used the chi-square test for categorical variables and twosided Wilcoxon test for the frequencies of *** logistic regression,ordered logistic regression,and two-part Negative Binominal Distribution Model were applied to analyze the social ecological determinants of the choice of first-contact care,satisfaction,and utilization of outpatient *** The questionnaire was completed by 1972 respondents with a response rate of 89.6%.Survey results showed that 72.46% of patients preferred CHS for first-contact care,most of them were satisfied with the CHS,and 62.2% of patients utilized outpatient services in the past two months and the average outpatient visits was *** personal characteristics,the female preferred to CHCs to see doctors and had higher satisfaction;Patients with BMI≥28 were more likely to go CHCs and utilized more visits of outpatient,however,patients who reported bad health were less likely to CHCs and higher visits in *** personal behaviors,the smoked were more inclinedto select CHCs as their first places to see doctors and more satisfied with the *** interpersonal and primary groups,education were the primary factors

关键词： community health services First-contact care Social ecological determinants Xiamen mode

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