Amidst the declining fertility rate and population aging, providing effective fertility supports for reproductive-age women is urgently needed. Hence, understanding their fertility support needs is paramount. An observational design was implemented and the STROBE Checklist was adhered to ensure the study’s reporting met high-quality standards. The demographic characteristics questionnaire, fertility questionnaire and the questionnaire on fertility support needs based on Kano model and ERG theory were used. A convenience sample of 381 reproductive-age women was recruited from the First Affiliated Hospital of Hainan Medical University and Sanya Maternal and Child Healthcare Hospital in Hainan Province, China. The collected data were analyzed using descriptive statistics and the Kano model. Among the 31 fertility support needs, 3 were classified as Indifferent attributes, 18 were classified as One-dimensional attributes, and 10 were classified as Attractive attributes. In the Predominance Zone, seven needs were identified, all of which belonged to the “Relatedness Needs” dimension and were classified as One-dimensional attributes. The Secondary Improving Zone contained one need from the “Existence Needs” dimension, which was classified as an Indifferent attribute. The Reserving Zone comprised 23 needs, including two classified as Indifferent attributes, 11 classified as One-dimensional attributes, and 10 classified as Attractive attributes. Based on the sensitivity index, the top five needs were Item 16, Item 11, Item 18, Item 19, and Item 15. This study clarified the attributes of 31 distinct needs, analyzed their attribute distributions and sensitivity rankings. The findings offer evidence to support the development of more responsive and person-centred fertility support measures for reproductive-age women.

Objective To investigate developmental trajectory and influencing factors of the demand for community-based elderly services among older residents during 2008-2018 in China for evidence-based improvement of elderly service system and promotion of healthy aging.Methods The data on 2 454 residents aged 65 years and above at baseline were collected from four waves of the Chinese Longitudinal Healthy Longevity Survey(CLHLS)conducted in 2008,2011,2014,and 2018.The demand for community-based elderly services was assessed using an 8-point scale,representing eight care service items that could potentially be provided by communities.Mplus 8.3 was utilized to construct a latent growth modeling(LGM).The unconditional least squares method was employed to assess the trajectory of changes in demand for community-based elderly services without covariates,while a conditional LGM with covariates was developed to analyze the trajectory of changes in the demand and its influencing factors among the elderly population in China from 2008 to 2018.Results The mean overall scores for demand of community-based elderly services among surveyed elder residents in 2008,2011,2014,and 2018 were found to be 4.89±2.27,5.49±1.94,5.38±2.06 and 5.38±2.06 respectively with no significant difference observed between the yearly scores(P＞0.05).The results of the unconditional LGM analysis results indicate that the quadratic function LGM without constraints is the optimal model for fitting developmental trajectories of item-specific demand for community-based elderly services among older adults from 2008 to 2018.The initial demand was significantly greater than 0(intercept=4.91,P＜0.01).The constructed model revealed an upward trend from 2008 to 2011(slope=0.38,P＜0.01),followed by a downward trend from 2011 to 2018(slope=-0.12,P＜0.01).The results of conditional LGM analysis demonstrated that age(β=0.026),intercept of marital status(β=0.260),place of residence(β=-0.567),and years of education(β=0.224)significantly influenced the intercept of demand for community-based elderly services among older adults(all P＜0.05).Specifically,both age and years of education positively predicted slope 1(β1=0.021,0.018,all P＜0.05),while the predictions for slope 2 were not statistically significant(all P＞0.05).Moreover,both the intercept and slope of marital status positively predicted slope 1(β1=0.118,0.021,all P＜0.05),as well as positively predicting slope 2(β2=0.146,0.049,all P＜0.05).Additionally,place of residence had a positive predictive effect on slope 1 and slope 2(β1=0.707,β2=0.046,all P＜0.05).Conclusion The demand for community-based elderly services among elderly residents in China exhibited a non-linear growth trajectory from 2008 to 2018.There were variations in the initial level and rate of growth of this demand,which were influenced by factors such as age,marital status,place of residence,and years of education.

The number of doctor–patient conflicts and disputes in China has been increasing recently. In order to solve the current social problems of the tense doctor–patient relationship and frequent medical disputes, this article, based on grounded theory, uses qualitative analysis software to conduct grounded coding on 622 cases of doctor–patient disputes randomly selected by stratification. After successively adopting open, axial, and selective coding, the relationship structure between the causes and development of medical disputes is summarized. Furthermore, this relationship structure can be used to analyze further and discuss the causes of doctor–patient disputes from the perspective of multiple co-governance and the governance framework of doctor–patient disputes. Finally, it reminds us of the need to standardize government’s regulatory responsibilities, promote the equal distribution of medical resources, strengthen the communication awareness between doctors and patients, reduce the information asymmetry between doctors and patients, and build a preventive mechanism-oriented multi-subject collaborative governance path to promote the relationship between doctors and patients in China. We provide relevant countermeasures and suggestions for harmonious development and the smooth resolution of doctor–patient conflicts.

家庭政策是现代社会福利制度框架的重要组成部分.文章尝试将改革开放以来中国家庭政策研究划分为三个历史时期,并概括出阶段性和总体性特征.当前家庭政策研究在概念界定上已达成初步共识,转向对家庭政策构成要素与内容范围的深层探讨,理论视角和政策类型研究呈现出多元加速发展态势.既有研究多以国别个案与比较研究为主,西方化和家庭成员式人群研究特征突出,本土化实证研究略显不足.在政策设计上以家庭政策价值观和定位问题的探讨最为集中,发展型家庭政策理论及其政策建议的社会影响最大.由此笔者提出"整体性家庭政策构建""家庭政策与社会福利制度互动关系""公共政策中的家庭视角"以及"照顾问题与家庭福利体系建设"等政策理论热点议题,在新时代背景下,满足人民美好生活需要目标的提出为未来家庭政策与家庭福利服务体系提供新的发展机遇.

目的 了解乳腺癌患者住院费用情况并分析其影响因素,为降低乳腺癌患者医疗费用负担和制定合理的医疗保险制度提供依据.方法 收集海南省某三甲医院2020年1月1日至2020年12月31日收治的1279例乳腺癌患者的住院费用构成情况,采用描述性分析、秩和检验和多元线性回归分析乳腺癌患者住院费用结构及其影响因素.结果 乳腺癌患者住院费用构成中药品费占比最大(44.34％),诊疗费、材料费、手术费、床位费占比分别为14.49％、4.21％、2.76％和2.22％,其他费用合计31.97％;在医保统筹支付额度中,城镇职工患者医保统筹支付额度(8903.00元)高于城乡居民(7871.00元);单因素分析显示住院天数和治疗方式对患者住院费用有影响(P<0.05);多元线性回归分析显示住院天数(b'=0.607)和治疗方式(b'=0.252)是影响住院费用的主要因素(P<0.001).结论 应提高全社会对乳腺癌的防治意识,合理控制住院天数和药占比降低住院费用,调整医保待遇水平来减轻患者负担.

共享农庄是海南发展乡村旅游、改善旅游结构和农业产业结构的重要手段,更是乡村振兴的有力抓手.通过对四个不同模式共享农庄的个案调查,发现海南共享农庄的管理能力和相关配套基础设施难以满足农庄的发展,政府需进一步改善乡村人居环境,加强农庄人才队伍建设,以此促进共享农庄的发展,实现乡村振兴.

OBJECTIVE:The aim of this systematic review and meta-analysis was to analyze the characteristics and effectiveness of technology-based interventions in improving children sleep. METHODS:PubMed, Embase, PsycInfo, CENTRAL and Web of Science were searched to identify research articles published until 11 August 2021. The protocol for this study was registered with PROSPERO (CRD42021272348). Articles screening, data extraction and quality assessment were carried out by two independent reviewers. RESULTS:In total, the search generated 4597 studies. Of these, 15 studies (8 RCTs, 1 non-randomized control study and 6 pre-post studies) met our inclusion criteria. The meta-analysis indicated that technology-based interventions significantly increased the TST (SMD = 0.21, 95% CI = 0.06, 0.37; P = 0.007) and SE (SMD = 0.52, 95% CI = 0.17, 0.87; P = 0.003), and significantly decreased the SOL (SMD = -0.30, 95% CI = -0.47, -0.12; P = 0.001) and WASO (SMD = -0.33, 95% CI = -0.59, -0.07; P = 0.012). CONCLUSION:This systematic review and meta-analysis suggests that technology-based interventions may be effective at improving children sleep due to the advantages of online intervention. Further researches are needed to establish which technology components are most effective in improving children sleep, as well as explore better methods for increasing consistency of participation and accuracy of outcome evaluation.

The declining fertility rate has become an important social problem. The main purpose of this study was to investigate the potential relationship between work–family conflict (WFC), life stress (LS), generalized anxiety disorders (GAD) and three-child fertility intention (FI) in working women of reproductive age. The data comes from the survey of the 2021 China Family Health Index Survey. The Mplus8.3 software was used to analyze the selected cases of 1103 female workers of childbearing age between 19 and 35 years old, and they all answered the relevant questions about the willingness to have three children. The results showed that work–family conflict had a significant negative impact on three-child fertility intention of working women of reproductive age (β = −0.188, p < 0.001), The mediating effect found that anxiety disorder had a significant mediating effect between work–family conflict and three-child fertility intention of working women of childbearing age. In addition, the effect between work–family conflict and the three-child fertility intention of working women of reproductive age can be mediated through the chain-mediated effect of Life stress and anxiety disorders. At the same time, the regulating effect also found that life stress can effectively regulate the effect of work–family conflict on anxiety disorders. Therefore, it is necessary to alleviate the conflict between work and family to a certain extent, including employers giving women more understanding and care and reducing gender discrimination. In addition, relatives should also provide substantial labor support in family life. They can also rely on the community to establish childcare services, improve student night care services, and reduce the time cost of female education. Thereby alleviating the life stress and anxiety of female employees of childbearing age and improving their willingness to bear children.

为应对老年人不断膨胀的综合性服务需求，在国家的政策引导下，医养结合养老服务供给发展迅速，已然成为当前养老服务的重要方式和热点话题。我国医养结合养老服务供给实践中存在碎片化的困境，其深层根源是体制机制问题。医养结合服务供给组织的多头管理、权责壁垒，供给主体的多元分离、信息不对称，“医”“养”资源分...>>详细为应对老年人不断膨胀的综合性服务需求，在国家的政策引导下，医养结合养老服务供给发展迅速，已然成为当前养老服务的重要方式和热点话题。我国医养结合养老服务供给实践中存在碎片化的困境，其深层根源是体制机制问题。医养结合服务供给组织的多头管理、权责壁垒，供给主体的多元分离、信息不对称，“医”“养”资源分散、政策割裂，诸多因素造成医养结合服务提供困难、供需错位、有效供给不足。解决供给碎片化的路径是整合，通过组织协作、政策连接和资源整合来实现。

0～3岁婴幼儿时期是儿童早期成长最重要时期,而婴幼儿社交情绪发展是婴幼儿早期发展的重要部分.社交情绪主要分为两部分,一部分是社交,是指使某人得以与同龄人、兄弟姐妹、父母及其他成年人建立和从事积极互动行为的一系列行为;另一部分是情绪能力.情绪具备帮助个体与外界建立、维持和改变关系的功能.婴幼儿社交情绪的良好发展对儿童未来情绪管理、社交能力培养、社会关系建立及学业表现乃至成年后个人就业及经济收入等都有重要作用.因此,本文从0～3岁婴幼儿社交情绪发展的现状、评估、影响因素及干预几个方面进行了综述.

运用文献研究法和调查研究法对农村安宁疗护多元实践路径进行探究.首先,回顾农村安宁疗护的既往研究,梳理当前存在的施榕模式等多种农村安宁疗护实践路径,并探讨这些路径面临着就医模式多元化引致临终地点不确定等诸多挑战.其次,从多元视角出发揭示医学支持与社会支持在农村安宁疗护中发挥的作用.最后,提出 目前依托于城市医院和社区卫生中心的安宁疗护制度是为城市居民服务的制度,广大农村在可预见的较长时间内需要地方性资源维系对慢性病患者的安宁疗护,并且应因地制宜、根据各地社会文化状况构建多元实践路径.

In recent years, university students' employment has become an increasingly prominent problem worldwide. Improving the job search clarity of students is a great way to boost job-hunting success. Proactive personality may predict job search clarity through the mediating effects of core self-evaluation and career exploration. However, few studies have explored this relationship and the mediating roles of core self-evaluation and career exploration. To identify the relationship between a proactive personality and job search clarity and the mediating roles of core self-evaluation and career exploration, a cross-sectional survey was conducted. A total of 495 students majoring in nursing completed the questionnaire which consisted of the proactive personality scale, core self-evaluation scale, career exploration survey, and job search clarity scale. Correlation analyses and mediation analyses were conducted using SPSS 24.0 and AMOS 24.0 respectively. This study showed that students higher on the proactive personality scale were more likely to perform better on job search clarity. Core self-evaluation and career exploration have fully mediating effects on the relationship between a proactive personality and job search clarity. Therefore, interventions concentrated on cultivating proactive personality, improving core self-evaluation, and strengthening career exploration would be necessary for increasing job search clarity.

随着互联网和物联网技术的广泛应用,农业现代化和信息化是发展必由之道.智慧共享农庄模式是海南热带农业和休闲观光农业整合发展模式,在省政府大力推动下,智慧共享农庄模式在海南生根发芽.文章以海南JF智慧共享农庄为例,分析了海南JF智慧共享农庄发展模式特点和失败的原因,提出在倡导新型农业发展的同时,共享农庄发展要避免盲目开发,要在合法合规的前提下进行,违反了政府相关政策和人民利益必将以失败而告终.要发展智慧共享农庄,在信息化保障下需要改善乡村人居环境,加快人才队伍建设和提升管理服务能力.

介绍家庭灾害准备的概念,阐述家庭灾害准备的评估工具、现状、影响因素,提出应加强家庭成员灾害教育及培训、提升对有脆弱成员家庭的灾害准备服务、建立灾害信息共享网络并加强对家庭灾害准备的评估等干预策略,旨在提高家庭灾害准备水平,促进整个社会有效应对灾害.

[目的]分析海口市医疗纠纷发生的原因及特点,提出有效防范和应对措施以减少院内医疗纠纷发生率.[方法]选取2014年1月-2017年12月期间海口市某三甲医院发生的医疗纠纷作为研究对象,采用问卷调查方式对150位患者及家属和50位医护人员进行调查,研究医疗纠纷发生的原因.[结果]患者及家属选择医患纠纷产生原因居前三位的依次是服务态度差、 医疗技术水平差、 医患沟通不畅,分别占55.0％、37.1％、30.7％;医方选择居前三位的原因依次是患者期望值过高、 医患沟通不畅及医疗损害,分别占57.4％、48.9％、46.8％.[结论]医疗纠纷产生的原因复杂,主要涉及医患沟通问题、 医疗技术问题、 患者信任问题、医患双方态度问题等.

城镇化进程中农村老年人的健康状况令人担忧.通过对海南省琼中、 保亭和白沙3个黎苗族自治县的入户调查,深入了解被调查地区黎苗族老年人的健康状况和当地的卫生资源配置情况,从供给和需求两个视角分析发现,收入水平、 健康服务费用、 服务便捷性和主观意识等是影响农村老年人健康服务获得的主要因素.要解决这些问题首先要提高农民收入、 增加农村基层卫生资源和改善服务水平,关键的是把精准扶贫政策与健康保障制度协同推进满足农村老年人健康服务的有效需求.此外,老年人的精神健康问题迫切得到重视,巩固家庭责任的同时,农村社区培育各类社会组织开展志愿服务,吸引和利用社会资源来提升老年人的幸福感.

养老问题成为全社会的热点议题.在经济发展相对落后且老龄化程度高、劳动力大量外流的贵州彝族农村地区,养老形式不容乐观.通过对贵州盘县B寨村的实地调查,发现该村居民的养老方式、养老观念非常传统,其自我养老能力不足,家庭供给有限,集体、社区服务单一,社会化养老严重缺位,精神文化难以满足等诸多问题.在此基础上通过剖析彝族老年人养老问题的根源,提出增加农民收入加强自我养老能力、发挥邻里互助传统精神、拓宽社会养老的途径等有效措施来改善彝族老年人的生活状况,破解少数民族地区养老困局.

随着我国逐步进入老龄化社会,人民群众的养老护理服务需求越来越大,老年护理专业人员的需求量也随之增大.通过对海南医学院护理学院2016届护理专业毕业生的调查发现,只有30.23%的护理本科生愿意去养老护理服务行业就业.当前我国老龄化现象严重,而养老护理服务专业人员严重缺乏,在此背景下,分析影响护理专业毕业生从事养老护理服务工作的因素,并提出相应的措施,鼓励并吸引更多护理专业人才从事养老护理服务工作,从而为老龄化社会的养老护理服务提供专业保障.

解决老年残疾人的问题在于其需求的满足。我国近5000万老年残疾人的养老问题应该引起政府和社会各界的重视和关注。老年残疾人具有异质性并兼具残疾和老年双重需求特点，在生活服务提供方面需兼顾此特点，给予差异化的照料。人类生存过程中首先要满足的是最基本的生理需求。由于不同残疾类型和不同残障程度，老年残疾人的照护需求存在显著差异，在我国目前的养老体系下要有效地为老年残疾人实施差异化的养老服务，让不断增长的老年残疾人过上有质量、有尊严的老年生活。

目前我国失能老人长期照护服务供需严重失衡.问题的深层原因主要为历史造成的低出生率和预期寿命延长导致老龄化严重,也在于政府责任某些方面缺位,当前社会养老服务政策滞后且落实不到位.为解决失能老人的养老照护问题必须有效发挥政府的主导作用,落实优惠政策、加大财政投入扩大养老服务供给,实施家庭照护补贴制度,推行长期护理保险制度.在完善养老服务体系中突出政府对失能老人的责任.