浅谈社区卫生体系的建设

随着社会的发展与进步，社区卫生服务应运而生。社区卫生服务是以人群和基层作为着眼点，是医疗卫生服务与人群的第一级接触，其核心是初级卫生保健。发展社区卫生服务是一条既符合中国国情又遵循低成本、高效益原则的卫生事业发展之路。     

浅谈社区卫生体系建设

随着社会的发展与进步，社区卫生服务应运而生。社区卫生服务是以人群和基层作为着眼点，是医疗卫生服务与人群的第一级接触，其核心是初级卫生保健。发展社区卫生服务是一条符合中国国情，遵循低成本、高效益原则的卫生事业发展之路。     

社区护理存在的问题与对策

随着社会进步和医疗事业的发展,社区卫生服务越来越受到人们的关注,社区护理服务作为社区卫生服务的重要组成部分,是随着社区卫生保健的加强而产生的。它增添了新的护理内容,扩展了护理工作的职能,服务的对象从病人扩大到健康人群,服务范围由医院走向社区、家庭,服务内容从单纯的医院护理扩大到预防保健和提高人群的生活与生命质量等多方面,所以也越来越被重视。但社区护理在实际操作中存在一些问题,笔者从事社区护理工作多年,现就本辖区社区护理工作存在的问题和应对策略探讨如下。     

社区护理存在的问题与对策

随着社会进步和医疗事业的发展,社区卫生服务越来越受到人们的关注,社区护理服务作为社区卫生服务的重要组成部分,是随着社区卫生保健的加强而产生的.它增添了新的护理内容,扩展了护理工作的职能,服务的对象从病人扩大到健康人群,服务范围由医院走向社区、家庭,服务内容从单纯的医院护理扩大到预防保健和提高人群的生活与生命质量等多方面,所以也越来越被重视.但社区护理在实际操作中存在一些问题,笔者从事社区护理工作多年,现就本辖区社区护理工作存在的问题和应对策略探讨如下.     

社区卫生服务在城市失能老人长期照料体系中的作用研究

分析长期照料失能老人人群现状,实地调查研究浙江老年关怀医院、拱墅区老人公寓和宁波市海曙区社区卫生服务介入失能老人长期照料的模式,即社区卫生服务机构长期照料模式、社区卫生服务站进驻养老机构模式、社会化居家养老模式,探讨社区卫生服务在城市失能老人长期照料体系中的作用;提出应加快适合我国国情长期照料服务体系的构建,推动与社区卫生服务相结合的长期照料服务体系基本框架的建立。     

高年资护士在社区卫生服务的作用

社区卫生服务机构担负着人群的预防、医疗、保健、康复、健康教育和计划生育技术指导“六位一体”的基本卫生服务[1],由于许多单位的撤并、分离、倒闭等,加上现代社会就业的自由度加大,因此加剧了社区人群的流动,从而增加了社区卫生服务机构的工作量,要完成“六位一体”的工作任务,社区护士的工作不可低估,本文着重探讨高年资护士在社区卫生服务中的作用.     

我国社区卫生服务发展现状及面临的挑战

发展社区卫生服务是我国深化医药卫生体制改革、实现人人享有基本医疗卫生服务的基础保障。不论是"2011中国卫生论坛",还是"第六届中国社区卫生服务发展论坛",都就"十二五"期间医改专题规划中重点推进的五项工作,即建立健全中国特色的全民医保制度、拓展深化公立医院改革、突出抓好人才培养培训、深入推进药品生产流通领域改革和继续提升公共卫生服务均等化水平进行了深入探讨。可见,"十二五"期间将是社区卫生巩固、发展和提高的五年。在社区卫生发展所面临的众多挑战中,社区卫生人才建设是发展的关键环节。而在今后全面落实社区团队服务模式,加强在岗社区卫生人员的培训和优化人员结构过程中,有必要进一步探索社区护理人员的工作内容、角色、职责,加强社区护理人员的队伍建设,提升社区护理人员的能力与素质,发挥社区护理在基本卫生保健中的重要作用,将有助于推动基层卫生服务的落实,提高人群对服务的满意度,改善服务人群的健康结局。为此,我们特别策划了这一组文章,从我国社区卫生服务发展、社区护理服务、社区护理教育、社区护理研究等多方面来探讨社区护理人才培养和护理服务模式,以便为社区护理的整体发展提供一定的借鉴。     

社区卫生服务中实施健康管理的思考

随着中国经济的高速发展,社会结构、经济结构以及人们的生活方式发生了一系列的变化;人们的健康意识和对健康的消费需求也在不断提升。人们在不断追求健康、维护健康,健康管理即应运而生。所谓健康管理是指一种对个人或人群的健康危险因素进行全面监管的过程。实施健康管理的主要是一些组织机构,比如健康体检中心、专业的健康管理公司、部分保险公司等等。近几年,随着社区卫生服务工作的不断推进,各地社区卫生服务机构都在努力探索一条可持续发展的道路,既能兼顾六位一体的服务,提高人们的健康水平,     

浅谈社区卫生体系建设

随着社会的发展与进步,社区卫生服务应运而生。社区卫生服务是以人群和基层作为着眼点,是医疗卫生服务与人群的第一级接触,其核心是初级卫生保健。发展社区卫生服务是一条符合中国国情,遵循低成本、高效益原则的卫生事业发展之路。1发展社区卫生服务的意义1.1合理利用现有卫生资源,控制医药费用过快增长由于医疗卫生机构没有统一的规划,多头设置,布局难以合理,特别是大中城市医疗卫生机构过于集中,根本没有考虑服务半径和居民需求状况,加之卫生资源配置又过多流向大医院,致使病人就医出现严重倾斜。一方面大医院“人满为患”;另一方面二级医…     

社区护理——朝阳事业——月坛社区卫生服务中心主任杜雪平谈社区护理的发展

社区护理,是社区卫生的重要组成部分。2005年卫生部发布的《中国护理事业发展规划纲要(2005-2010年)》提出:在社区卫生服务中,大力发挥护理服务的作用和功能,提供符合社区人群健康服务需要的多样化护理服务。北京月坛社区卫生服务中心隶属于首都医科大学附属复兴医院,是全国社区卫生服务的典范,复兴医院副院长、月坛社区卫生服务中心主任、中国社区卫生协会常务理事杜雪平教授不仅在心血管内科和全科医学方面有着颇深的造诣,对社区护理也有着独到的见解,本刊记者对她进行了独家采访。     

社区卫生服务中心儿童保健团队的服务模式与效果

目的探讨社区卫生服务模式,提高社区儿童保健工作质量。方法在某社区卫生服务中心建立儿童保健模式,改造服务流程,合理分工,确定服务内容,实施团队式服务管理模式。结果 0~3岁儿童的系统管理率提高;社区居民满意度提高,差异均具有统计学意义(P0.01)。结论社区儿童保健服务管理模式可以提高儿童保健的服务质量。     

Do women want women health workers? Women's views of the primary health care service

This paper sets out to explore key aspects of women's views of women GPs and practice nurses within primary health care settings The extent to which women actively seek female health workers for the provision of their primary health care needs, including preventive health care, is examined The findings presented m this paper are from a 3-year research project employing both quantitative and qualitative methods, which aimed to develop an understanding of the role women primary health care workers play in the construction and provision of primary health care services for women The findings indicate that for specific 'women's health issues' the gender of the worker is clearly important for women However, for other health needs factors such as the personal approach of the provider become paramount Consideration of the role of the practice nurse suggests that there is considerable potential for practice nurses to further develop a specific role with women Although lack of awareness among women of nursing skills and expertise raises issues for the presentation of the role of the practice nurse within the primary health care service In conclusion the paper highlights that women's views should be understood in terms of a complex range of preferences and needs     

An evaluation of services for women with long-term mental health problems

This paper presents the results of an evaluation study of services for women with long-term mental health problems. The study, which was conducted in a long-term rehabilitation and community care service, examined the adequacy, accessibility, and responsiveness of services provided for women users; explored differences between the men and women using the service and those newly admitted to it; and explored the views and experiences of service providers and the women users themselves. The results of the study confirm and extend those of previous studies and suggest a number of service recommendations. The unevenness in attention to the needs of women across services needs to be addressed. Services should be more attractive to women. Agencies and facilities for women outside mental health services should be supported to ensure the they can accommodate women with long-term mental health problems, and the women themselves need to be offered the support necessary to ensure they have access to such facilities. Finally, efforts must be made to ensure that services both recognize the losses that women with long-term mental health problems have experienced and foster their continued hopes and aspirations for the future.     

Mental health nurses’ contributions to community mental health care: An Australian study

Australian mental health policy is focused on providing mental health care in the community setting and community mental health teams provide services to clients in a shared model with primary care. The historical literature reports that community mental health nurses’ experience high levels of stress and are often allocated the most complex and challenging clients managed by the team. Yet information on their specific roles remains limited. This paper reports on research conducted at one Australian public mental health service to identify the components of the community mental health nursing role and to quantify the time nurses spent in each component during the study period. Six focus groups were conducted with community mental health nurses to identify their perceived role within the team. Data analysis identified 18 components of which 10 were related to direct clinical contact with clients and eight covered administrative and care coordination activities. A data collection tool based on the findings of the focus groups was designed and nurses recorded workload data on the tool in 15‐min intervals over a 4‐week period. Seventeen nurses collected 1528 hours of data. Internal coordination of care was identified as the top workload item followed by clinical documentation and national data collection responsibilities supporting the complexity of the community mental health nursing role. The high rating attached to the internal coordination of care role demonstrates an important contribution that community mental health nurses make to the functioning of the team and the delivery of quality mental health care.     

Notes on health care and traditional birth attendants in the region of Yogyakarta, Indonesia

A major in health care services in Indonesia since the 1950s is the development of a national health system with emphasis on service to rural communities. To achieve this a network of 5000 public health centers, or PUSKEMAS, was built throughout the country. Staffing depends upon a nationally legislated requirement that medical school graduates complete 3-5 years of mandatory service in a rural area before they can apply for training in a clinical specialty or go into private practice. The health care system is organized into a hierrachy of resort, with the local health centers screening high-risk cases of all types, which then are referred to regional hospitals and, if necessary, to the university hospital which maintain a full array of health care specialists. Philosophically, there is a strong emphasis on service and coummunity health and a deemphasis on premature adoption of sophisticated technologies. The values of community orientation, service, and sensitivity to cultural differences are trangibly expressed in an interdisciplinary rural community health project now being carried out at Gadjah Mada University (GMU), with funding from the government of the Netherlands. Students make weekly visits to a rural village where they have a simple program foccusing on the weighing of babies. During this process, health screening, health education in proper nutrition, child development, and continuation of breadt feeding are done. Another grassroots coumunity health project is a research project in which members of women's clubs in the rural villages volunteer to do rudimentary screening for high risk pregnancy. The women were trained to check on a monthly basis blood pressure, height, and weight, and to report any significant changes to health professionals at the nearest PUSKEMAS. A shift from simply providing health services to a strong emphasis on health education is advocated. Near Yogyakarta, the midwife holds a respected position within her coummunity and provides supportive assistance in the home during the delivery and for 35 days thereafter, during which time daily massage is given to both mother and baby. The women do not recognize the need for prenatal care and usually seek help only at the time of delivery. The traditional birth attendant, because of her integration and high status within her community, traditional birth attendant, because of her integration and high status within her community, can be an effective allay in the effort to reduce infant and maternal morbidity and mortality.     

完善社区卫生护理服务的3点思考

社区卫生护理服务是医疗卫生服务的重要组成部分,随着医疗制度改革的深化,社区卫生护理服务也越来越广泛,如何提高社区护理服务无疑是摆在我们面前的一个重要课题。本文从提高社区护士素质、扩充社区护理范畴及应用护理程序上进行了探讨。     

重庆市全科团队服务模式下社区护士工作内容的调查研究

目的了解重庆市全科团队服务模式下社区护士的工作内容。方法采用自制调查问卷对重庆市主城区12个社区卫生服务中心的210名社区护士进行问卷调查,并对结果进行分析。结果重庆市全科团队服务模式下的社区护士目前最常做的工作内容主要有健康管理、老年人保健、健康教育、慢性病管理以及基本医疗服务;而妇女保健和死因调查等工作内容开展相对较少。结论重庆市社区护士的工作内容既有基础医疗服务又有公共卫生服务,社区护理“六位一体”功能正在逐渐完善。     

Mobilizing the community to address the prenatal health needs of Immigrant Punjabi women

In Canada, although prenatal education is available to all women, there are groups who do not access these services. One such group is Immigrant Punjabi women residing in the Lower Mainland of British Columbia. It was apparent that structured prenatal education, even when translation was available, would not meet the needs of this group. Efforts were required to help bring this issue into the community so that the community would endorse women's participation in prenatal preparation. The purpose of the project described in this article was to explore how community mobilization strategies could be used to improve the health of pregnant women in the Punjabi community. A collaborative approach was used with representatives from a variety of service agencies and the community. The mobilization strategy involved creating a platform to communicate with the community about prenatal health and health care, creating "buy-in" from the physicians serving the women of the community, and providing prenatal sessions that built on the existing knowledge of the women. We describe the mobilization process and discuss the insights gained.     

Evaluating the clinical efficacy of a primary care-focused, nurse-led, consultation liaison model for perinatal mental health

In Australia, perinatal mental illness is common, although poorly identified and treated. Improved perinatal mental health depends on service provision models that reflect a focus on promotion, prevention, and early intervention, while facilitating improved referral pathways between primary health and specialist mental health services. In 2008, a contemporary community-based model of mental health service provision was developed as an alternative to the pre-existing hospital-based service model. The model is delivered primarily by mental health nurses using a consultation liaison framework. It provides for specialist mental health assessment and brief intervention in collaboration with the general practitioner, who remains the primary health provider. It also aims to raise community awareness and build capacity for the management of perinatal disorders in the primary care sector. Evaluation of the clinical effectiveness of the model, and the improvement in access for primary health providers and women, was conducted at 2 years from its implementation. Clinical effectiveness was evaluated by using comparative data from the Edinburgh Depression Scale and Depression Anxiety and Stress Scale, and the results demonstrated clinical efficacy. Improved attendance rates indicated that women preferred this community-based service model as an alternative to the pre-existing service model.     

医学隔离社区卫生服务人员的心理护理

目的调查武汉市社区抗击新型冠状病毒肺炎疫情过程中我社区卫生服务人员的创伤后心理危机现状。方法采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对56名医学隔离社区卫生服务人员的心理健康状况进行问卷调查。结果56名医学隔离社区卫生服务人员心理护理干预前后的SAS评分和SDS评分比较差异有统计学意义(P<0.05)。结论新型冠状病毒肺炎疫情期间,对隔离社区卫生服务人员加强心理护理,可有效缓解其心理紧张和焦虑情绪,有效改善其心理状态。