Objective To investigate the status of blood donation of pregnant women's family members, so as to recruit their family members and establish potential blood donation team. Methods Questionnaire survey was carried out among family members of pregnant women who participated in blood preparation plan by random sampling. Results The motivations of self-efficacy, internal reward, severity and stress of blood donors were significantly higher than those of non-donors, but non-donors concerned more about negative feelings of phlebotomy(P<0.05). People with rare blood type, low age, high income, weak negative motivation and strong positive motivation had stronger blood donation intention and higher probability of blood donation behavior(P<0.05). Conclusion It is necessary to expand blood sources through multiple channels by organizing publicity activities around targeted groups, such as establishing channels for blood donation reservation, taking the lead role of the donated crowd, so as to build up a recruitment team for voluntary blood donation.

ObjectiveTo examine changing trend and regional disparity in the insufficiency of government predominance in maternal health care financing and the maternal mortality ratio (MMR) in Beijing and Shanghai during 2000 to 2017 for exploring a rational government predominance in maternal health care financing. Methods Documents and literatures about maternal health care financing in Beijing and Shanghai published from 1995 through 2017 were searched; from which, the information on government predominance financing was extracted and the insufficiency of government predominance in maternal health care financing was evaluated with a severity score. Spearman correlation and linear regression analysis were used to analyze the relationship between the insufficiency of government predominance financing and MMR in the two municipalities. Results The severity score for the insufficiency of government predominance in maternal health care financing decreased from 3.58 in 2000 to 2.82 in 2017 in Beijing municipality; while in Shanghai the severity score decreased from 3.72 to 1.44. A significant correlation between the MMR and the severity score was observed in Shanghai municipality (r = 0.723, P < 0.01). Conclusion The government predominance in maternal health care financing increased during 2000 – 2017 in Beijing and Shanghai municipality and the government predominance financing has a more obvious influence on the reduction of maternal mortality ratio in Shanghai municipality.

This study aims to investigate the mobile phone utilization for health information seeking among adults who are 45 years or older in rural areas in China. Using Andersen's Behavioral Model (BM), we examine the factors that influence the target group's behaviors of online health information seeking and contacting healthcare providers via mobile phones. By using stratified sampling method, we conducted a survey among 607 rural adults who were 45 years or older from six villages in Jiangsu Province, China. The results reveal that participants can be excluded from such services for not using a smartphone. eHealth information literacy could serve as a strong influential factor for online health information seeking and contacting healthcare providers via mobile phones. Participants with lower emotional wellbeing are more inclined to seek health information online via mobile phones. The results indicate variables such as utilization of technological devices and eHealth literacy should be included in Andersen's model when investigating the utilization of mHealth services. This study contributes to the literature on mHealth adoption in rural areas in China and has implications for practitioners to tailor the mHealth service for socio-economically disadvantaged groups.

ObjectiveTo analyze the extent of deficit in total financial investment in maternal health care (MHC), the changing trend of maternal mortality rate (MMR) and their regional disparities in Beijing and Shanghai municipality during the period from 2000 through 2017 and to explore suitable total financial investment in MHC. Methods We searched China National Knowledge Infrastructure (CNKI) and Web of Science for research literatures on financial investment in MHC in Beijing and Shanghai municipality published during 1995 – 2017. The information on deficit in total financial investment in MHC was extracted from 205 retrieved studies for calculation of a severity score to evaluate the deficit in total financial investment in MHC. Spearman correlation and linear regression analysis were used to analyze the relationship between the deficit in total financial investment in MHC and MMR. Results For Beijing municipality, the severity score for the deficit in total financial investment in MHC decreased from 3.54 in 2000 to 2.78 in 2017, while for Shanghai municipality, the score decreased from 3.94 to 1.41. Regression analysis on the correlation between the deficit severity score and MMR resulted in statistically significant regression equations for both Beijing (P < 0.05) and Shanghai (P < 0.01). Conclusion The total financial investment in maternal health care increased gradually over the years in both Beijing and Shanghai municipality during 2000 – 2017. The influence of total financial investment on maternal mortality rate is more obvious for Shanghai. The study verified the feasibility of quantitative assessment on total financial investment in maternal health care.

依据健康老龄化理论,社区健康教育是老年健康工作的重中之重,承担着老年健康"守门人"的角色.然而,目前我国城市社区老年健康教育工作中存在着健康教育内容的针对性和有效性不足、缺乏人才支持、组织管理不够规范、忽视环境支持等问题.因此,应加强城市老人社区健康教育,从社区健康教育计划制定、人才队伍建设、建立基层管理体系、支持性环境建设等方面入手,大力提高健康教育工作的质量和效果,最终实现全面提升老年人健康素质、改善健康状况的目的.

社区老年人健康教育工作对于提升老年群体的健康素养、降低患病概率、减轻经济生活负担、减少社会整体的医疗护理支出具有重要意义.当前,社区老年人健康教育的相关研究大多从老年人所患疾病的角度出发,探究健康教育方法的可行性,本文对不同老年人参与健康教育现状及存在的问题进行分析,提出提升社区老年人健康教育成效的方法.

实践能力与创新能力是当前高校培养高素质专业人才的重要内容,然而现行卫生管理专业人才培养方案未能有效实现该目标,对于构建胜任国家健康治理体系和治理能力现代化建设的专业人才队伍形成挑战.文章在梳理和分析国内外高校卫生管理专业人才实践能力与创新能力培养现状的基础上,通过明确界定符合我国实际与专业需要的实践能力与创新能力的内涵,进一步提出我国高校卫生管理专业本科生实践能力与创新能力培养的对策建议.

文章对江苏省25家医院就诊患者对公立医院综合改革的满意度评价情况进行分析,发现患者对于公立医院综合改革效果满意度评价总体满意.医保及价格、医疗服务、分级诊疗制度、就医环境四个维度满意度对总体满意度都有影响(F=463.211,P<0.001).其中医保及价格、医疗服务两个维度满意度对患者总体满意度影响最大,标准化回归系数分别为0.406和0.298.同时苏北地区的患者满意度在全省各区域相对最低,得分4.78分.建议在医保及价格、医疗服务等方面加大公立医院综合改革力度,同时改善苏北地区医改现状,将有利于江苏省范围内综合医改的进一步深化和患者满意度的整体提升.

Objective To analyze the extent of deficit in total quantity of maternal health care (MHC) staff, the changing trend of maternal mortality rate (MMR) and their regional disparities in Beijing and Shanghai municipality during the period from 2000 through 2017 and to explore the suitable scale of MHC staff for the two regions. Methods We searched China National Knowledge Infrastructure (CNKI) and Web of Science for research literatures on human resource for MHC in Beijing and Shanghai municipality from 1995 to 2017. The information on the deficit in total quantity of MHC staff was extracted from 166 retrieved studies (79 in Beijing and 87 in Shanghai) for calculation of a severity score to evaluate the deficit. Spearman correlation and linear regression analysis were used to analyze the relationship between the deficit in total quantity of MHC staff and MMR. Results For Beijing municipality, the severity score for the deficit in total quantity of MHC staff decreased from 3.76 in 2000 to 3.40 in 2017, while for Shanghai municipality, the score decreased from 4.00 to 2.10. A significant correlation between MMR and the severity score was detected for Shanghai (r = 0.756, P Conclusion The suitability of maternal health care staff quantity increased gradually in both Beijing and Shanghai municipality during 2000 – 2017 and the impact of the increase in total quantity of the staff on maternal mortality rate is more obvious for Shanghai. The study verified the feasibility of quantitative assessment on the scale of maternal health care staff.

目的 分析2000-2017年京沪妇女保健人力资源适宜程度及孕产妇死亡率的变化趋势,明确两地差异,探讨妇女保健人力资源适宜程度.方法 收集1995-2017年涉及京沪妇女保健人员规模问题(166篇)、人员素质问题(312篇)、人员激励问题(115篇)文献,综合人员规模适宜程度、素质适宜程度、激励适宜程度等3个指标,计算妇女保健人力资源的适宜程度.运用Spearman相关、线性回归等分析妇女保健人力资源适宜程度与孕产妇死亡率的关系.结果 北京妇女保健人力资源适宜程度从2000年的26.20％升至2017年的39.00％,上海则由25.60％升至57.60％.上海孕产妇死亡率与妇女保健人力资源适宜程度回归方程有统计学意义(P＜0.01).结论 京沪两地妇女保健人力资源适宜程度逐年提高,上海妇女保健人力资源在孕产妇死亡率下降中影响更大,但妇女保健人员规模仍有待进一步优化;适宜的妇女保健体系应"规模适宜、能力胜任、激励有效";验证了量化妇女保健人力资源适宜程度的可行性.

目的 分析2000-2017年京沪妇女保健人员激励不足严重程度及孕产妇死亡率的变化趋势,明确两地差异,探讨妇女保健人员激励适宜程度.方法 收集1995-2017年所有涉及京沪妇女保健资源问题的文献,筛选所有涉及妇女保健人员激励主题的相关文献(上海纳入61篇,北京纳入54篇),摘录人力激励不足问题的相关表述,计算严重程度评分.运用Spearman相关、线性回归等分析妇女保健人员激励不足严重程度与孕产妇死亡率的关系.结果 北京妇女保健人员激励不足严重程度从2000年的3.79分降至2017年的2.61分,上海则由3.45分降至2.13分.上海孕产妇死亡率与妇女保健人员激励不足严重程度相关有统计学意义(r=0.542,P＜0.05).上海和北京的回归方程均有统计学意义(P＜0.05).结论 京沪两地妇女保健人员激励不断强化,上海妇女保健人员激励对孕产妇死亡率降低影响更大,但仍存在激励不够稳定的问题;适宜的妇女保健体系应"激励有效";验证了量化妇女保健人员激励的可行性.

目的 分析2000-2017年京沪妇女保健人员素质不足严重程度及孕产妇死亡率的变化趋势,明确两地差异,探讨妇女保健人员素质适宜程度.方法 收集1995-2017年所有涉及京沪妇女保健资源问题的文献,系统筛选涉及妇女保健人员素质主题的有关文献,进而计算妇女保健人员素质不足严重程度评分.上海纳入165篇文献,北京纳入147篇.运用Spearman相关、线性回归等方法分析妇女保健人员素质不足严重程度与孕产妇死亡率的关系.结果 北京妇女保健人员素质不足严重程度从2000年的3.53分降至2017年的3.12分,上海则由3.70分降至2.12分.上海孕产妇死亡率与妇女保健人员素质不足严重程度相关有统计学意义(r = 0.758,P<0.01).上海的回归方程有统计学意义(P<0.01).结论 京沪两地妇女保健人员素质不断提高,上海妇女保健人员素质在孕产妇死亡率降低中发挥更大作用,但人员专业能力仍需进一步提升;适宜的妇女保健体系应"人员能力胜任工作需要";验证了量化妇女保健人员素质的可行性.

目的 探究街头人群献血的促进与阻碍因素,以便充分提高街头献血者招募的准确性.方法 以计划行为理论(TPB)为框架,编制具有较高信度的无偿献血问卷,按照南京市11个辖区(域)的地理位置及经济发展状况采用多阶段分层抽样的方法,从南京市街头无偿献血人群中,按照各(个)人献血史情况分为3组:初次献血者(n=361)、献血≥2次者(n=417)和非献血者(n=241).分别从外在促进因素(参加无偿献血可以获得免费的血液检查、利己因素等)与内在促进因素(利他/利己因素、献血能够让我帮助别人等),以及外在阻碍因素(太忙没有时间去献血、我的家人反对我去献血等)与内在阻碍因素(我担心献血后会产生头晕、采血针头会让我恐惧等)4个方面调查其献血行为.采用Epidata软件建立数据库,应用卡方检验作组间统计学分析.结果 南京市街头人群人口学特征中受到促进因素(利他、利已因素)产生正向影响献血的主要人群为未婚、18～24岁、无子女、本科以下学历、基本无收入者,受阻碍因素影响小的主要人群为男性、未婚、18～24岁、基本无收入、无子女、学生这类人群.同时促进因素随着献血次数增加而增加;阻碍因素随献血次数增加而减少.结论 TPB能较好地分析和解释街头献血者中影响献血行为的促进和阻碍因素,据此有助于血站制定提高招募街头献血者措施的有效性、精准性、广泛性.

目的 了解影响南京市街头无偿献血者再献血的因素,为提高再献血(者)比例提供依据.方法 采用回顾性分析方法,以2017年5月21日～2018年5月21日南京红十字血液中心的信息管理系统中29650名南京市街头自愿献血者为抽样总体,按10％随机抽取2965人,采用电话回访方式,调查献血者再次献血与否的原因,并按是否已再次献血分为再次献血组与未再次献血组,运用卡方检验分析比较2组献血者的人口统计学特征以及献血次数,应用多因素Logistic回归对献血者再次献血行为的影响因素筛查分析.结果 本次电话有效回访率63.37％(1879/2965),2017年5月～2018年5月南京市年街头献血者再次献血率40.34％(758/1879),而全球献血者的再献血率为50％;南京市街头献血者再次献血(组)的首要原因是"帮助他人"占62.27％ (472/758),未再次献血的首要原因是"没有时间献血"占49.15％(551/1121).结论 南京市街头无偿献血者再献血率与全球水平尚有一定差距.需要进一步挖掘和强化街头献血者再献血的激励措施,采取灵活的献血招募和采血方式确保献血者的献血时间.

背景随着老龄化进程加快且慢性病患者数量不断增加,如何进一步发挥家庭医生签约服务的作用,提高基层用药服务数量和质量,促进农村地区老年慢性病患者合理利用基层卫生资源并提升居民健康水平就显得尤为重要.目的 了解江苏省农村地区老年慢性病患者对于家庭医生用药服务的利用情况和满意度.方法 于2019年7月在江苏省通过典型抽样和多阶段分层抽样选取1816例老年慢性病签约患者进行调查,采用自制患者问卷调查农村地区老年慢性病患者对家庭医生用药服务利用情况和满意度.采用二分类Logistic回归分析影响农村地区老年慢性病患者对家庭医生用药服务满意度的因素.结果 经数据清理,1583份有效问卷纳入数据分析.1167例(73.72％)在村卫生室/社区卫生服务站购买药品,184例(11.62％)在乡镇卫生院/社区卫生服务中心购买药品;1449例(91.53％)签约患者的用药方案来自村卫生室/社区卫生服务站、乡镇卫生院/社区卫生服务中心的医务人员;1546例(97.66％)按医嘱服药;621例(39.23％)有自购药品行为.1402例(88.57％)对家庭医生提供的用药服务感到满意,不同家庭总收入、合并慢性病数、购药地点、用药方案来源、自购药品行为的患者用药服务满意度比较,差异有统计学意义(P<0.05).不同购药地点患者的药费、自购药品费比较,差异有统计学意义(P<0.05).二分类Logistic回归分析结果显示:家庭医生讲解易理解程度、家庭医生控制病情发展情况和家庭医生处药费易接受程度是农村老年慢性病患者用药服务满意度的影响因素(P<0.05).结论 江苏省农村地区家庭医生用药服务利用总体情况良好.仍有1/4签约患者有自我购药行为,农村地区家庭医生用药服务不能完全满足老年慢性病患者用药需求,签约患者对药品费用满意度仍有待提高.家庭医生用药服务质量是影响签约患者满意度的主要因素.建议继续宣传家庭医生用药服务优惠政策,降低药品价格,减轻签约患者疾病负担,并着力提高家庭医生专业能力,丰富可提供药品数量和种类,增加慢病长处方用药服务,切实为农村老年慢性病患者用药提供便利.

收集1991—2017年所有涉及福建、江西(闽赣)两地慢性病工作的公开相关政策文件,运用综合量化方法量化两地慢性病经费投入明确程度,运用线性回归分析明确程度与经费投入水平之间的关系,从而对比福建、江西两省政府投入明确程度的时序变化和异同,明确投入制度保障对实现慢性病健康目标的意义,初步探讨基于政策文本视角量化政府投入明确程度的可行性.研究显示,福建、江西两省经费投入明确程度均在逐年增长;慢性病防治管理政府投入明确程度的提升对慢性病人群健康结果起促进作用;江西省慢性病防治管理政府投入明确程度对该省慢性病防治效果的提升作用略优于福建省.提示持续性稳定增长的投入是提升慢性病防治效果的物质保障;慢性病防治领域投入需要良好的政府主导制度和监管体系保障;政策文本中的投入明确程度量化方法可尝试在其他公共卫生研究领域进一步验证与应用.

背景 我国农村家庭医生签约服务质量问题日益受到关注,科学的服务质量评价是进一步针对性提升服务质量的前提,而当前国内家庭医生签约服务质量评价指标体系呈现区域碎片化问题,尚缺乏权威、可靠、具有指导性的评价工具.目的 编制家庭医生签约服务质量评价量表,为评估我国家庭医生签约服务质量提供适用的工具.方法 在我国家庭医生签约服务内涵与内容的指导下,参考国内外相关质量评价指标体系,结合现场访谈和专家咨询,设计初始农村家庭医生签约服务质量评价量表.于2019年6月,以初始量表进行预测试,根据样本(n=308)的项目分析结果 ,修订形成最终量表.于2019年7月,将最终量表用于正式调查,有效样本(n=1746)被随机分为两部分,样本1(n=843)用于项目分析、探索性因子分析和内部一致性信度检验,样本2(n=903)用于维度相关分析和验证性因子分析.结果 最终量表包括6个维度(可及性、横向连续性、纵向连续性、综合性服务、技术性、经济性)24个条目.总量表的Cronbach'sα系数为0.910,各维度的Cronbach'sα系数为0.755～0.912.Bartlett's球形检验结果 显著(近似 χ2=12492.540,P<0.05),KMO检验值为0.880,探索性因子分析的累积方差贡献率为70.347％.维度间相关系数低于各维度与总分之间的相关系数.验证性因子分析结果 为:χ2/df=7.877,残差均方根(RMR)=0.041,近似误差均方根(RMSEA)=0.087,比较拟合指数(CFI)=0.870,拟合优度指数(GFI)=0.840,规范拟合指数(NFI)=0.854.结论 本研究编制的农村家庭医生签约服务质量评价量表具有较好的信度和效度,可作为我国农村家庭医生签约服务质量评价的有效工具.

目的 比较京沪妇女保健人员与其他行业从业人员的收入水平,明确两地差异,探讨妇女保健人员收人适宜程度.方法 通过文献(2000-2017年)和统计年鉴收集京沪妇女保健人员、医院工作人员、公务员等不同行业收入数据以及住宅销售价格并将其标化为2017年水平.运用Excel 2010进行数据整理,分析妇女保健人员收人适宜程度.结果 北京和上海妇女保健人员2017年的收入分别为105 422.4元和108 498.8元,两地的妇女保健人员收入适宜程度分别为:北京37.0％,上海37.6％.结论 两地妇女保健人员收入均偏低,北京收入适宜程度低于上海,妇女保健人员收入适宜程度可以量化评价.

Introduction The policy focus of contracted family doctor services (CFDS) has been shifting to improve quality and efficiency in China. The study's objective was to establish a quality evaluation scale for CFDS based on the perceived service quality model and to assess the service quality from the perspective of patient perceptions and expectations. Methods Data were obtained from a 2-year follow-up survey of CFDS in Jiangsu, China. A total of 1264 elderly people with chronic diseases were tracked. The self-developed scale was designed based on the perceived service quality model. The product scale method was used to assign weighted values, the Wilcoxon signed-rank test was used to compare the differences over the 2 years, and pooled cross-sectional regression was conducted to evaluate the associated factors with the gap scores of service quality. Results There were significant differences between perceptions and expectations in each dimension in the 2 years (p<0.05), and the service quality gaps existed. Over the 2 years, Accessibility and Horizontal continuity were the first-ranked and second-ranked in expectations; the top three scores in perception were Horizontal continuity, Comprehensive service and Accessibility dimensions. The service quality gap in 2020 was smaller than that in 2019 (p<0.05). There were differences in the perception scores in the Vertical continuity, Technical and Economic dimensions and in the expectation scores in the Horizontal continuity, Vertical continuity and Technical dimensions between the 2 years (p<0.05). The factors that were significantly associated with each dimension score included the Jiangsu region, gender, age and education levels (p<0.05). Conclusion The quality evaluation scale of CFDS has good reliability and validity. Policy efforts should be focused on accelerating the development of medical alliances, optimising medical insurance policies and improving the capacity of family doctor services to meet the needs of the elderly with chronic diseases.

With the increasing demand from aging population and seasonal blood shortage, recruiting and retaining blood donors has become an urgent issue for the blood collection centers in China. This study aims to understand intention to donate again from a social cognitive perspective among whole blood donors in China through investigating the association between the blood donation fear, perceived rewards, self-efficacy, and intention to return. A cross-sectional survey was conducted in six cities, which are geographically and socioeconomically distinct areas in Jiangsu, China. Respondents completed a self-administrated questionnaire interviewed by two well-trained medical students. A total of 191 blood donors were included in the current study. Descriptive analysis, correlation analysis, and a generalized linear regression model were used to explore the association between demographic characteristics, psychological factors, and intention to donate again. After controlling other covariates, donors with higher fear scores reported lower intention to return (p = 0.008). Association between self-efficacy and intention to return was statistically significant (p < 0.001), whereas the association between intrinsic rewards (p = 0.387), extrinsic rewards (p = 0.939), and intention to return were statistically insignificant. This study found that either intrinsic rewards or extrinsic rewards are not significantly associated with intention to donate again among whole blood donors in China, and fear is negatively associated with intention to donate again. Therefore, purposive strategies could be enacted beyond appeals to rewards and focus on the management of donors' fear.