Evaluation is the foundation of empirical science, yet the evaluation of evaluation itself – so-called meta-evaluation – remains strikingly underdeveloped. While methods such as observational studies, design of experiments (DoE), and randomized controlled trials (RCTs) have shaped modern scientific practice, there has been little systematic inquiry into their comparative validity and utility across domains. Here we introduce a formal framework for meta-evaluation by defining the evaluation space, its structured representation, and a benchmark we call AxiaBench. AxiaBench enables the first large-scale, quantitative comparison of ten widely used evaluation methods across eight representative application domains. Our analysis reveals a fundamental limitation: no existing method simultaneously achieves accuracy and efficiency across diverse scenarios, with DoE and observational designs in particular showing significant deviations from real-world ground truth. We further evaluate a unified method of entire-space stratified sampling from previous evaluatology research, and the results report that it consistently outperforms prior approaches across all tested domains. These results establish meta-evaluation as a scientific object in its own right and provide both a conceptual foundation and a pragmatic tool set for advancing trustworthy evaluation in computational and experimental research.

BACKGROUND:Road traffic injuries are the leading cause of death in children. Parents' health literacy (HL) is closely related to child safety, especially for the young children. This study aimed to develop an intervention-oriented parent HL scale: Parents' Health Literacy Scale on Preventing Road Traffic Injuries (PHLS-PRTIs). METHODS:We developed the scale including four parts: (1) definition and conceptualisation of PHLS-PRTIs; (2) domain and item development; (3) instrument construction; and (4) psychometric property validation. 685 parents participated in process of development (n=333) and validation (n=352). Cronbach's α and test-retest correlation were used to assess reliability. Content validity and construct validity were used to assess validity. RESULTS:The scale consisted of five domains (access, understand, belief, communication and use) and 16 subdomains. The Cronbach's α for each domain and the whole scale was 0.85, 0.70, 0.87, 0.80, 0.79 and 0.85, respectively. The test-retest reliability was acceptable (intraclass correlations >0.70). Content validity was good (item-level content validity index >0.79, average of the scale-level content validity index >0.80, kappa >0.74). For construct validity for domain understand, χ2/df=1.723, p=0.009, standardised root mean square residual (SRMR)=0.0404, root mean square error of approximation (RMSEA)=0.045, Comparative Fit Index (CFI)=0.942, Tucker-Lewis Index (TLI)=0.910; and for the other four domains, χ2/df=1.840, p<0.001, SRMR=0.043, RMSEA=0.049, CFI=0.958, TLI=0.952. CONCLUSIONS:PHLS-PRTIs was developed and validated by a rigorous process, providing a tool for community doctors to measure parents' HL on child road traffic safety and develop targeted health education interventions.

Abstract Objectives To explore the framing effect of health promotion information on processes of change and decision balance among community residents in the context of primary prevention of hypertension. Methods A randomized controlled trial was conducted, enrolling 314 volunteers from Jiangchuan Community Health Service Center, Minhang District, Shanghai. Participants were randomly assigned to either a gain-framed group (positive framing, n = 159; information emphasized the benefits of ceasing unhealthy behaviors) or a loss-framed group (negative framing, n = 155; information emphasized the harms of engaging in unhealthy behaviors) using a random number table. Participants’ cognitive level (depth of information processing and problem-solving) and future orientation (attention to future outcomes when making decisions) were assessed. Processes of change and decisional balance were evaluated before and after the intervention, and stratified analyses were performed by sex, age, cognitive level, and future orientation. Results Both gain-framed and loss-framed interventions led to significant improvements in scores for processes of change (all P < .05). Regarding subdimensions, 8 dimensions improved in the gain-framed group, whereas 6 dimensions improved in the loss-framed group. Before the intervention, no significant difference was observed in decisional balance scores between the 2 groups [96.0 (88.0, 104.0) vs 98.0 (90.0, 106.0), Z = 1.459, P = .144]. After the intervention, decisional balance score was significantly improved in both groups (all P < .05), and was higher in the loss-framed group than that in the gain-framed group [102.0 (94.0, 110.0) vs 99.0 (91.0, 108.0), Z = 2.157, P = .031]. Stratified analyses by gender showed that both male and female participants exhibited significant improvements in scores for processes of change and decisional balance after intervention. Among different age groups, for people under 39 years old, both indicators (scores for processes of change and decisional balance) increased after intervention in gain-framed group, while only decision balance score improved after intervention in loss-framed group (both P < .05); for people aged 39-55 years, only score for processes of change improved after intervention in both groups (both P < .05); for people over 55 years old, both indicators increased after intervention in loss-framed group, while only score for processes of change increased after intervention in gain-framed group (both P < .05). Stratified analyses by cognitive levels showed that in subjects with low-cognition, only score for processes of change increased after intervention in both groups (both P < .05); in subjects with medium-cognition, only decisional balance score increased after intervention in loss-framed group, while both indicators increased after intervention in gain-framed group (both P < .05); in subjects with high-cognition, only score for processes of change increased after intervention in gain-framed group (P < .05), while there were no statistically significant changes in both indicators after intervention in loss-framed group (both P > .05). Stratified analyses by future orientation showed that in reality-oriented participants, both indicators increased after the intervention in both groups (both P < .05); in balance-oriented participants, there were no statistically significant changes in both indicators after intervention in loss-framed group (both P > .05), while both indicators increased after intervention in gain-framed group (both P < .05); in future-oriented participants, both indicators increased after intervention in loss-framed group (P < .05), while the change in the 2 indicators was not statistically significance in the gain-framed group (both P > .05). Conclusion The framing effect of health promotion information plays a significant role in the primary prevention of hypertension. Both gain-framed and loss-framed information can improve processes of change and decisional balance scores, but their effects are different: gain-framed information has a broader impact on processes of change across more dimensions, whereas loss-framed information has a more pronounced effect on decisional balance. The effectiveness of framing interventions varies by sex, age, cognitive level, and future orientation, suggesting that tailoring information framing according to target population characteristics may optimize health behavior promotion.

BACKGROUND:Understanding the patterns of unintentional injuries (UIs) among children admitted to the Pediatric Intensive Care Unit (PICU) is crucial for effective prevention and management. We aimed to explore the demographic, situational and clinical characteristics of children with UIs admitted to the PICU. METHODS:We conducted a cross-sectional, retrospective study of patients under 18 with UIs admitted to the PICU of Children's Hospital of Fudan University from October 2017 to December 2022. RESULTS:A total of 395 children were admitted, with a mean (SD) age of 5.6 (3.7) years. Road traffic injuries (RTI) (146 (37%)) and high falls (119 (30.1%)) were dominant. Patients with foreign body injuries had a lower median (Q1, Q3) age of 1.6 (1.1, 1.8) years (P＜0.001). Most UIs occurred when children were alone (318 (80.5%), P＜0.001), during recreation (61 (15.4%), P＜0.001) and indoors (212 (53.7%), P＜0.001). Injury types differed significantly in hospital stay length (P＜0.001) and prognosis (P＜0.001). Compared with RTIs, drowning and poisoning were more likely to result in poor prognosis (drowning OR=9.778 (3.515,28.537), P＜0.001; poisoning OR=3.556 (1.123,10.428), p=0.023). CONCLUSIONS:RTIs and high falls were the leading types of children with UIs admitted to the PICU. Injury patterns varied with age, situational characteristics and involved substantial medical costs. Tailored interventions based on injury patterns are essential to improve child safety and well-being.

OBJECTIVES:The EQ-5D is a brief measure for assessing health-related quality of life (HRQoL), but chronic spinal cord injury (CSCI) related psychometric evaluation of the EQ-5D-5L has not been explored. We conducted a validation study on the Chinese version of the EQ-5D-5L for individuals with CSCI in China. METHODS:A cross-sectional study was conducted in the Shanghai Sunshine Rehabilitation Center. The floor and ceiling effects, internal consistency, test and retest reliability, discriminatory power (only for EQ-5D-5L), convergent validity (using Spearman correlation coefficients), and known-group validity of the EQ-5D-5L and visual analog scale (VAS) were analyzed. RESULTS:A total of 271 individuals with CSCI were included in analysis. The mean (SD) utility and VAS scores were 0.46 (0.31) and 66.8 (20.3), respectively, and they showed no floor or ceiling effects. The EQ-5D-5L demonstrated acceptable internal consistency (Cronbach's α = 0.84) and test-retest reliability. The average Shannon index (H') and Shannon Evenness index (J') of the EQ-5D-5L were 2.01 and 0.86, respectively. Satisfactory convergent validity was shown by the correlation analysis among the 5 EQ-5D-5L dimensions, EQ-5D-5L utility, EQ-VAS, the World Health Organization quality-of-life scale brief version, 7-item generalized anxiety disorder scale (GAD-7), 9-item patient health questionnaire (PHQ-9), and General Self-Efficacy Scale (GSES). Utility and VAS scores showed the predicted pattern among a priori known groups, with effect sizes ranging from 0.06 to 0.72 for the EQ-5D-5L, and 0.02 to 1.08 for the VAS. CONCLUSIONS:The EQ-5D-5L is a reliable and valid measure of HRQoL for individuals with CSCI in China.

BACKGROUND:Road traffic injuries are a major global public health concern. Community-based interventions are an effective way to prevent unintentional injury in children aged 0-6 years. Parental health literacy is closely associated with child safety. This study explores whether the relationship and impact between the components of parents' health literacy are related to children's road traffic injuries. METHODS:We conducted a mixed-methods study. The first component involved a questionnaire to 352 participants and identified the paths between the components of parents' health literacy related to children's road traffic injuries, using structural equation modelling. The second component conducted semi-structured interviews with 35 experts and parents. RESULTS:The average total score of parents' health literacy was 76.29±7.65. Components ranked by score: 'use', 'understand', 'belief', 'access' and strengthening 'communication'. Confirmatory factor analysis global model fit well (Comparative Fit Index（CFI）=0.991,Root Mean Square Error Approximation(RMSEA)=0.024, Standardized Root Mean Square Residual(SRMR)=0.029). Significant direct effects: 'access' had an effect on 'communication', 'understanding' influenced 'belief', 'communication' and 'belief' influenced 'use', and 'use' influenced the occurrence of road traffic injuries. The standardised path coefficients were 0.200, 0.051, 0.241, 0.419 and -0.009, respectively. Two paths identified: 'access→communication→use→road traffic injury' and 'understand→belief→use→road traffic injury'. The semistructured interview identified the community-based intervention measures for addressing five priority problems. Finally, a conceptual framework was developed. CONCLUSIONS:Community health education can leverage direct effects while considering behavioural influencing factors and developing targeted interventions to improve parents' health literacy to reduce or prevent road traffic injuries among children worldwide, especially in developed cities.

Objective To analyze the research findings and development trends of parental safety literacy in relation to child injury prevention,and to establish a theoretical framework for the development of assessment tool on the parental safety literacy.Methods The literature,dissertations,expert consensus,and guidelines related to the assessment of unintentional injuries in children and health literacy tools published from January 1,2002 to January 1,2022 were retrieved from various databases including CNKI,Wanfang Dara,CQVIP,PubMed,and Web of Science.After conducting a comprehensive screening and analysis of the current state and identified shortcomings in 41 domestic and international articles concerning the assessment tools for children's unintentional injuries and health literacy,a preliminary framework for evaluating tool dimensions was established.Based on the principles of involving multiple stakeholders and achieving information saturation,a panel consisting of 18 experts was selected for group discussions or one-on-one consultations.This process resulted in the development of a preliminary framework for the assessment tool based on expert opinions.Results A total of 13 universal health literacy assessment tools and 28 specific health literacy assessment tools were obtained through a systematic literature search.The universal assessment tool comprehensively measures health literacy based on its definition,while the specific assessment tool focuses on measuring certain dimensions of health literacy.Consultation with 18 experts revealed that a systematic and comprehensive understanding of the concept of literacy forms the basis for evaluating parents'safety literacy,and the objective of the assessment tool for parents'safety literacy should be to identify high-risk parents.The final evaluation framework encompasses five dimensions:access,understanding,belief,communication,and utilization.Conclusion Currently,there is a shortage of assessment tools in China that comprehensively measure parental health literacy across all dimensions.To create a complete health literacy scale suitable for application,further summarization of the assessment dimensions of the scales is necessary.

Objective Unintentional injuries are a major threat to children's health. Community-based health management services, which include the prevention of unintentional injuries among children aged 0-6 years, are important basic national public health services. However, deficiencies exist at this stage, such as community childcare doctors not being motivated to provide guidance. Previous studies have explored the impact of the underlying reasons; however, few studies have considered the supporting factors from a social perspective. This study explored the elements supporting community childcare doctors in conducting parental health education and sought to generate a framework capable of providing recommendations. Design A qualitative study was conducted to analyse data collected through semistructured interviews and used the grounded theory method. Setting Interviews were conducted at eight health institutions, health management departments, hospital and universities in four regions of eastern China (Shanghai, Zhejiang, Anhui and Liaoning) and recorded on audio. Interviews were conducted face to face or online. Participants Key informant interviews were conducted with 39 adults (15 parents of children, 11 direct providers of child healthcare and 13 health department managers or experts). The information obtained through interviews included the current situation and difficulties faced by community childcare doctors providing parental health education, the attitudes and perceptions of parents regarding receiving health education and the degree of service acceptance. The independent transcription of interview results was performed by two coders. Results A total of 39 interview transcripts from healthcare service providers, managers and demanders were analysed. Many factors affect the provision of parental health education by community childcare doctors, including the macrodimension and microdimension. Supplier, demander, direct support and indirect support were summarised and reported as both facilitators and barriers to active provision of health services, including 18 subdomains under these four main domains. Conclusions A theoretical model of parental health education based on community childcare doctors was constructed to explain the factors influencing the implementation of education by community childcare doctors. These include individual and socialised behaviours requiring cooperation among individuals, families, governments, the general public and all workers in the healthcare sector. For demanders, it is essential to evoke their beliefs, and for suppliers, it is necessary to improve their skills and stimulate their motivation, both of which cannot be separated from macrolevel support. This model can be used to guide intervention designs aimed at enhancing the enthusiasm of community childcare doctors and further enhancing parental literacy, ultimately achieving the goal of improving children's health.

Objective To analyze the status of policy tools for health management of children aged 0-6 in Shanghai city,and to provide reference for improving the policy system of children's health management in Shanghai city.Methods We retrieved 36 official policy documents on child health management published on the websites of Shanghai Municipal Government,Shanghai People's Congress,Shanghai Municipal Health Commission,and other administrative agencies from 2009 to 2023.Based on the classification of policy instruments into mandatory/optional/mixed categories and combined with the field of child health management,we formed a two-dimensional analysis framework.Content analysis was used to extract and encode policy texts,and composition ratios were used to describe the distribution of different policy instruments for different objects.Results Of the 36 documents retrieved,the most frequently mentioned topic was the prevention and treatment of childhood diseases(32 documents),followed by guidance on child nutrition(26 documents),and the least frequently mentioned topic was the prevention of childhood injuries(18 documents).Regarding the dimension of the policy category,the most used policy terms were the mandatory type(139 terms,80.8％),followed by the mixed type(27 terms,15.7％),and the least used was the optional type(6 terms,3.5％).For the health dimension,the most common policy terms were those related to the prevention and treatment of childhood diseases(78 terms,45.3％),followed by those related to child nutrition(53 terms,30.8％),and the least common was that related to the prevention of child injuries(41 terms,23.8％).Conclusion The tilt of Shanghai's child health management policy is uneven,and the field of child injury prevention is relatively weak.

CONTEXT/OBJECTIVE:The 13-item Patient Activation Measure (PAM-13) is the most widely used generic patient activation measure, but spinal cord injury (SCI) related psychometric evaluation of PAM-13 has not been explored globally. This study aimed to assess the validity of the Chinese version of the PAM-13 (PAM-13-C) for individuals with chronic spinal cord injury (CSCI). DESIGN:Cross-sectional study. SETTING:Shanghai Sunshine Rehabilitation Center, and some participants were recruited in a WeChat group (the most commonly used social media platform in China). PARTICIPANTS:284 individuals with spinal cord injury who had lived with the injury for ≥0.5 year. INTERVENTIONS:NA. OUTCOME MEASURES:The PAM-13-C, global QoL, seven-item generalized anxiety disorder scale (GAD-7) and nine-item patient health questionnaire (PHQ-9), and General Self-Efficacy Scale (GSES) were used. RESULTS:The mean (SD) PAM-13-C score was 57.4 (16.5). The highest percentage of NA could be observed in item 9 (12.0%). Floor and ceiling effects of the total scores of PAM-13-C were small (0.7% and 6.7%), but a ceiling effect could be observed among all items. Exploratory Factor Analysis supported a one-factor model of the PAM-13-C (CFI = 0.97; RMSEA = 0.07). Construct validity was established through correlation analysis among the PAM-13-C, GAD-7/PHQ-9, global QoL, and GSES. The PAM-13-C demonstrated excellent internal consistency (Cronbach's α = 0.95) and acceptable test-retest reliability. CONCLUSION:The PAM-13-C is a reliable and valid measure of patient activation for individuals with CSCI in China.

目的:围绕儿童非故意伤害案例,探究我国儿童非故意伤害发生的影响因素组态路径.方法:基于清晰集定性比较分析方法和Haddon模型理论,对在中国权威新闻发布平台公开发布的 0-10 岁儿童非故意伤害案例进行组态路径研究.结果:最终从网络途径获得 138 个儿童非故意伤害案例,多变量组态分析结果显示,案例中共3 条路径.路径1 为儿童没有安全保护中介物,原始覆盖率为0.962963;路径2 为儿童未采取危险行为且没有成人的监护和家长在场,原始覆盖率为 0.155556;路径 3 为儿童未采取危险行为且家长在场和家长采取危险行为,原始覆盖率为0.192593.结论:儿童非故意伤害发生时父母往往在场,但由于父母素质较差导致儿童非故意伤害的发生;现代社会出现较多新型危险因素,导致儿童非故意伤害发生,但较少受到关注.亟需对家长进行干预以加强其有效监管行为,通过社会宣传强化家长的监管责任.

IntroductionUnintentional injury among children represents a major public health problem. Online-social-network-based parental-health-education is a potential way to reduce child unintentional injuries. The study aimed to explore the mechanisms by which online-social-network-based health education may reduce the unintentional injuries among children aged 0–3 years.MethodsWe conducted a participant-blinded, randomized controlled, online-social-network-based health-education intervention study from March 2019 to February 2020 in Shanghai. We established four WeChat groups (two intervention groups and two control groups). For the intervention groups, a doctor's assistant regularly delivered information regarding unintentional injuries among children, and community childcare doctors answered parents' questions concerning their children's health, including unintentional injuries. Meanwhile, the control groups did not receive any information from the assistant. The study selected one intervention group and one control group and compared the ego network and whole network indicators to determine the differences between the intervention and control groups.ResultsIn the intervention and control groups, 64.5% and 31.9% of the members, respectively, engaged in communication, and 1,736 and 273 records, respectively, were obtained. Regarding ego network, the doctor showed the largest network in the intervention group, and the size of the intervention group's network was twice that of the control group; the number of ties in the intervention group was nine times that of the control group. Fourteen and four parents in the intervention and control group played an active role, respectively. Regarding centrality, all WeChat groups were loose and multiple centers existed. Regarding subgroup cohesion, the intervention group had 28 cliques with 27 members, and the control group had 4 cliques with 4 members. For structural hole, 23.7% and 7.5% members in the intervention and control group actively participated in interactions, respectively, having strong control and influence over other parents; 69.2% and 59.1% members in the intervention and control group, respectively, had values of < 1.000, showing that they had strong ability to cross-jump structural holes.DiscussionOnline-social-networks-based health education interventions could enhance communication among parents, and between parents and community childcare doctors, and also shorten the social distance between them. Thus, online-social-network-based parental-health-education-intervention can be a feasible and generalizable means of preventing unintentional injuries among children.

Background Intervention based on family support and risk perception can enhance type 2 diabetes mellitus (T2DM) patients’ self-care activities. In addition, eHealth education is considered to improve family members’ support for patients with T2DM. However, there is little evidence from rigorously designed studies on the effectiveness of an intervention combining these approaches. Objective This randomized controlled trial (RCT) aimed to assess the effectiveness of an eHealth family-based health education intervention for patients with T2DM to improve their glucose control, risk perception, and self-care behaviors. Methods This single-center, 2-parallel-group RCT was conducted between 2019 and 2020. Overall, 228 patients were recruited from Jiading District, Shanghai, and randomly divided into intervention and control groups. The intervention group received an eHealth family intervention based on community management via WeChat, whereas the control group received usual care. The primary outcome was the glycated hemoglobin (HbA1c) level of the patients with T2DM, and the secondary outcomes were self-management behavior (general and specific diet, exercise, blood sugar testing, foot care, and smoking), risk perception (risk knowledge, personal control, worry, optimism bias, and personal risk), and family support (supportive and nonsupportive behaviors). A 2-tailed paired-sample t test was used to compare the participants at baseline and follow-up within the control and intervention groups. An analysis of covariance was used to measure the intervention effect. Results In total, 225 patients with T2DM were followed up for 1 year. After intervention, they had significantly lower HbA1c values (β=–.69, 95% CI –0.99 to –0.39; P<.001). They also had improved general diet (β=.60, 95% CI 0.20 to 1.00; P=.003), special diet (β=.71, 95% CI 0.34 to 1.09; P<.001), blood sugar testing (β=.50, 95% CI 0.02 to 0.98; P=.04), foot care (β=1.82, 95% CI 1.23 to 2.42; P<.001), risk knowledge (β=.89, 95% CI 0.55 to 1.24; P<.001), personal control (β=.22, 95% CI 0.12 to 0.32; P<.001), worry (β=.24, 95% CI 0.10 to 0.39; P=.001), optimism bias (β=.26, 95% CI 0.09 to 0.43; P=.003), and supportive behaviors (β=5.52, 95% CI 4.03 to 7.01; P<.001). Conclusions The eHealth family-based intervention improved glucose control and self-care activities among patients with T2DM by aiding the implementation of interventions to improve T2DM risk perceptions among family members. The intervention is generalizable for patients with T2DM using health management systems in community health centers. Trial Registration Chinese Clinical Trial Registry ChiCTR1900020736; https://www.chictr.org.cn/showprojen.aspx?proj=31214

目的 了解上海市宝山区糖尿病高危人群糖尿病患病情况,为社区糖尿病防治工作提供依据.方法 采用多阶段分层整群随机抽样方法抽取宝山区≥35岁常住居民,采用《上海市社区居民糖尿病风险评估表》筛选糖尿病高危人群为调查对象,通过问卷调查收集人口学信息、疾病史和用药史等资料;测量身高、体重、腰围、臀围和血压;通过空腹血糖和口服葡萄糖耐量试验筛查糖尿病;采用多因素logistic回归模型分析糖尿病高危人群糖尿病患病的影响因素.结果 纳入糖尿病高危人群3 107人,其中男性1 165人,占37.50％;女性1 942人,占62.50％.年龄为(63.58±9.77)岁.检出糖尿病674例,检出率为21.69％.多因素logistic回归分析结果显示,男性(OR=1.689,95％CI:1.357～2.104)、年龄(40岁～,OR=4.833,95％CI:1.036～22.553;50岁～,OR=2.627,95％CI:1.432～4.819;60岁～,OR=1.551,95％CI:1.119～2.150;≥70岁,OR=1.579,95％CI:1.232～2.025)、中职/高中学历(OR=2.677,95％CI:1.636～4.380),超重/肥胖(OR=1.891,95％CI:1.447～2.472)、高血压(OR=1.306,95％CI:1.049～1.626)、血脂异常(OR=1.428,95％CI:1.114～1.831)、糖调节受损(OR=15.161,95％CI:11.827～19.434)和有2型糖尿病家族史(OR=2.092,95％CI:1.619～2.704)的高危人群糖尿病患病风险升高.结论 宝山区糖尿病高危人群糖尿病检出率为21.69％,性别、年龄、文化程度、超重/肥胖、高血压、血脂异常、糖调节受损和有2型糖尿病家族史是影响因素.

目的 了解家长知识、意识对儿童乘车行为的影响,探索上海市嘉定区0～3岁儿童乘车安全行为与危险行为的影响因素并加以比较.方法 采取分层目的抽样方法,于2018年9-10月,通过自拟问卷分别于上海市嘉定区嘉定镇街道和菊园新区社区卫生服务中心对0～3岁儿童家长共计476人开展调查,利用Stata 15.0进行数据分析.结果 本研究对象中79.0％家庭有车;其中安全座椅配备率达78.7％.乘车安全相关知识满分率为64.5％;儿童总是使用安全座椅的占27.7％;相关分析结果表明,意识及知识因素在各年龄段均无统计学差异(P>0.05);有序logistic回归分析结果显示,是否配置安全座椅的影响因素是儿童年龄和母亲文化程度,安全座椅使用频率的影响因素是母亲文化程度和"意外伤害是可以预防的"意识,"让/抱孩子坐副驾驶"的影响因素是安全知识总得分.结论 安全行为主要与意识相关,危险行为主要与知识相关;社区应利用基层工作优势,针对不同行为及相应影响因素进行针对性干预.

目的 系统分析我国公立医院职能部门绩效评价指标体系研究文献的特征分布以及利用频次的影响因素.方法 从近10年发表的相关文献中选取44篇发表于国内核心期刊的论文和研究生学位论文进行文献计量分析.结果 相关核心期刊论文和学位论文每年发表数量无明显增长,59.1％的文献所有作者单位均为医院,59.0％的文献第一作者单位为东部地区;61.4％的文献未将岗位分析作为指标体系构建的基础性工作,理论方法融合度与文献下载次数呈正相关关系.结论 医院职能部门绩效评价指标体系研究尚未取得突破性进展,建议提高指标来源与医院发展战略、岗位分析结果的契合程度,引入岗位价值评估方法,通过职能部门分类和绩效管理信息系统兼顾指标体系的科学性和实践操作可行性,并关注指标间的变量共线性问题.

Aims and objectives To examine the combined effects of the patient’s and family members’ knowledge, attitudes and perceived family support on self-monitoring of blood glucose (SMBG) behaviour of patients with type 2 diabetes.Design A cross-sectional design using the framework of knowledge–attitude–behaviour (KAB) combined with family support.Setting Shanghai, China.Participants Seventy type 2 diabetes patient–family member dyads recruited from 26 residential committees in Shanghai were investigated. Twenty-three health providers were interviewed.Primary outcome measures The knowledge, attitudes and perceived family support of patients’ and their family members’ data were measured through scales. Combined effects were analysed by a fuzzy-set qualitative comparative analysis (fsQCA) using fsQCA V.3.0. Other analyses and calculations were performed by STATA V.14.0.Results SMBG was very poor (20%), and behaviour was characterised by ‘multiple complications,’ and ‘all paths lead to the same destination’ for patients. There were two solution paths toward patients’ SMBG (solution coverage=0.4239, solution consistency=0.7604). One path was the combination of ‘patients with low risk perception, the patients’ and family members’ perceived negative support’, the other was the combination of ‘patients with high risk perception, the patients’ perceived negative support’. In both paths, basic knowledge serves as an auxiliary condition.Conclusion The study revealed that for patients with high and low risk perceptions that are relatively difficult to change, we could strengthen family support to achieve the desired SMBG behaviour. Knowledge is not a prerequisite to achieving SMBG. Moreover, negative family support plays a crucial role. Perceived family support by patients is more important than perceived family support by family members, which suggests that family members should improve support for patients so that the patients can perceive more family support.