昆明四城区参加农村合作医疗农民慢性病患病情况分析

目的了解昆明四城区参加新型农村合作医疗(参合)农民慢性病的影响因素。方法用分层随机抽样的方法 ,在昆明市对4个城区抽取589户2 123人进行入户调查。结果参合农民主要的慢性病包括高血压、消化系统疾病、支气管炎、心脏病、风湿等。单因素分析的结果显示不同婚姻状况、职业、文化程度、年龄的参合农民慢性病患病率不同。非条件logistic回归分析结果显示,影响慢性病患病的因素有民族和年龄。结论昆明四个区参合农民总的慢性病患病率为4.5%,影响昆明四个区参合农民患慢性病的主要因素有民族和年龄等。     

新型农村合作医疗参合农村的住院费用与补偿情况分析

新型农村合作医疗自开展以来取得了显著成效,但仍存在住院参合农民受益面窄、实际住院补偿比增幅缓慢的问题.试从参合农民住院费用和补偿情况的角度出发,探讨影响参合农民住院补偿的因素,并对进一步提高参合农民住院补偿水平提出建议.     

新型农村合作医疗不同个人筹资方式农民意向调查

农民个人筹资只有充分考虑农民的需求才能顺利进行。比较分析上门收取、协议委托和滚存式筹资3种不同个人筹资方式下的参加新型农村合作医疗农民对筹资方式以及参合的意愿,提出了农民参合的几点影响因素。     

某县参合农民对新农合监督的影响因素分析

目的了解新农合参合农民的监督情况,寻找影响参合农民监督力度的因素,为完善新农合监督机制提供科学依据。方法采用流行病学现场研究方法进行调查。结果参合农民的监督力度与监督意识、文化程度、合管办是否设立投诉电话等成正相关。结论相关部门应加强对参合农民的宣传教育,提高参合农民的监督意识,并提供切实有效的监督途径,让参合农民能有效实行监督。     

参合农民住院概率影响因素的结构方程模型分析

目的:分析参合农民住院概率的影响因素。方法:采用单因素分析、Logistic回归分析和结构方程模型分析参合农民住院概率的影响因素,并进行模型拟合与评估。结果:结构方程模型显示,健康状况直接影响住院率(直接影响权重为0.26);生理状态不仅直接影响住院率(直接影响权重为0.19),而且通过健康状况和社会因素间接影响住院率(间接影响权重为-0.30);卫生服务可得性对住院率的影响最小(影响权重为0.02),这既能解释单因素分析和Logistic回归分析的结果,也能给出较好的专业解释。结论:线性结构方程模型能较好的分析参合农民住院概率的影响因素。     

参加新型农村合作医疗农民就医行为影响因素的定性研究

[目的]对参加新型农村合作医疗（参合）农民就医行为的定性研究，分析参合农民就医行为变化，了解农民就医行为的异同及主要影响因素。[方法]在罗源和柘荣县，采用半结构式访谈、关键人物访谈和专题小组讨论等定性调查方法，访谈了两县71名农民、卫生服务提供者和卫生管理人员。[结果]调查发现这两县参合农民就医行为的变化不尽一致，柘荣县参合农民的就医行为变化不大，罗源县越来越多的参合农民前往就近乡镇卫生院就医，乡镇卫生院就医条件等成为差别的主要因素。[结论]要继续加大政府投入，加强卫生院的建设，提高乡镇卫生人员的技能和素质，改善农村地区道路交通等基础设施，以促进新农合开展。     

参合与自费农民对卫生服务需要与利用的比较研究

利用亚洲基金会新型农村合作医疗课题在云南省禄丰县的基线调查数据,比较分析参合农民 与自费农民卫生服务需要与利用情况。结果表明,参合人群的门诊卫生服务及住院卫生服务的利用情 况均优于自费组;经济因素仍是制约农民住院服务利用的重要因素;农民的门诊就诊机构以村卫生室 为主,住院以县级医院为主,但参合农民对县以上级医疗机构的利用明显高于自费组。     

运用多水平模型对新型农村合作医疗参合影响因素的研究

目的 分析影响新型农村合作医疗参合的因素,探讨利用层次结构数据进行影响因素分析时多水平模型相对于传统模型的优越性.方法 分别采用传统Logistic模型和多水平Logistic模型,对2006年中国健康与营养调查中的新农合参合数据进行分析.结果 个体/家庭水平变量中健康自评、就业情况、家庭收入对农民参合行为存在影响,县...     

不同视角下影响参合农民住院补偿因素探讨

新型农村合作医疗自开展以来取得了显著成效．但仍存在住院参合农民受益面窄和实际住院补偿比增幅缓慢的问题。文章试从新型农村合作医疗的3个参与主体——政府、农民和医疗机构的视角出发，探讨影响参合农民住院补偿的因素．并对进一步提高参合农民住院补偿水平提出建议。     

江苏省新型农村合作医疗参合率多因素分析

目的为了解江苏省农民参加新型农村合作医疗情况,反映新型农村合作医疗所取得的成绩与存在的问题,为进一步促进新型农村合作医疗可持续发展提供决策依据。方法在江苏省内使用分层随机整群抽样方法选取三个不同市区的农村社区为调查点,设计调查问卷入户调查。用SPSS11.5统计分析软件对数据做统计描述、方差分析、卡方检验等处理。结果江苏省农民对新农合的总参合率达到80.56%,在参合对象中,总自愿参合率达到93.48%;全家都参合的占到74.48%;在非全家参合的调查对象中,老年人参合率高于中青年,中青年参合率高于儿童。在调查对象中,外出打工人员的参合率低仅有7.86%。这些指标在经济状况不同的三地存在着一定的差距。多因素分析结果显示好的工作方式方法、提高农民对新农合的认知和了解有助于提高参合率。结论江苏省新型农村合作医疗具有三高一低的特征,参合率高、自愿参合率高、全家参合率高,外出务工人员参合率低。自愿参合的前提下,农民存在着一定的逆向选择。经济欠发达地区需要进一步加大投入力度,平衡地区卫生服务的差距。提高参合率以及保障外出务工农民享受合作医疗成为急待解决的问题。     

Barriers to cholesterol testing in a rural community

BACKGROUND. The purpose of this study was to investigate the factors that determine whether residents in a rural community have their cholesterol tested. METHODS. A population-based survey was conducted in 1987 as part of a community-oriented primary care project that sought to define and address the causes of and burden caused by increased cardiovascular disease in an economically depressed agricultural region of New York. All of the residents living in two towns in the region who were over 16 years of age and who lived in their homes year-round were surveyed. Demographic information was obtained from the participants, as well as information about previous cholesterol testing and their cardiovascular-risk knowledge and behaviors. The serum cholesterol of each participant was measured. RESULTS. Of the 557 households contacted, 508 (91%) households participated. A total of 1063 persons over 16 years of age were surveyed, and 973 (92%) were screened for cholesterol. Overall, 24% reported prior cholesterol testing. Logistic regression analysis identified several independent factors that were associated with a reduced likelihood of ever having had a cholesterol test. These factors included: (1) age under 45 years, (2) having less than 12 years of education, (3) having an income of less than $10,000, (4) not having health insurance, (5) not having visited a physician within the previous year, and (6) practicing three or more high-risk cardiovascular behaviors. The participants' cardiovascular knowledge made no independent contribution to having had their cholesterol levels tested. CONCLUSIONS. Many of the factors that prevent cholesterol testing are socially determined. The results of this study suggest that financial and social barriers are two of the major obstacles to residents of rural communities having their cholesterol levels tested.     

Engaging the capacity of comadronas as HIV prevention providers in rural Guatemala

Abstract

In this study the author address rural Guatemala’s poor maternal health and HIV status by integrating an effective evidence-based HIV intervention (SEPA), with local implementing health partners to extend the capacity of comadronas (traditional Mayan birth attendants) to encompass HIV prevention. I employed a multi-method design consisting of a focus group, an interview, and participant observation to identify important factors surrounding comadrona receptivity towards expanding their capacity to HIV prevention. I analyzed data using thematic analysis and identified four categories: Project logistics, HIV knowledge and risk assessment, condom perceptions, and HIV testing perceptions. I affirm comadrona receptivity toward HIV prevention, and that will guide future cultural adaptation and tailoring of SEPA for comadrona training. I will use my results to create a prototype intervention that could be applied to other similarly underserved indigenous communities.     

Social networks and contraception practice of women in rural Bangladesh

This paper analyzed the association of social networks with contraceptive use using both structural and attitudinal properties of social networks. Data were collected from seven villages in rural Bangladesh by face-to-face interviews using a structured questionnaire (N = 694). Sociometric data and the centrality positions of women in their social networks were analyzed as proxies for structural properties, and the perception of network members’ approval and encouragement towards family planning as attitudinal properties. The perception of network members’ attitude towards family planning and power within networks was found to be positively associated with contraception use. The strong association of the social network members’ encouragement of contraception and the significance over both in-degree (number of nominations received by the participant from other village women) and out-degree centrality (number of nominations given by a participant) provides further confirmation that immediate network members’ attitude is important to explain current contraceptive use of women in rural Bangladesh.     

Understanding the prevalence of female sterilization in rural south India

By analyzing the practice of female sterilization in rural Andhra Pradesh, in southern India, this article examines the role culture plays in demographic research. The popularity of female sterilization in rural Andhra Pradesh is shown to be intelligible if the symbolic value of a young mother's reproductive capacity is understood in terms of familial power relations. Through sterilization, young mothers can symbolically push their influential mothers-in-law toward old age, thus increasing their own relative prestige, and they can strive to control the ambiguity surrounding their reproductive functions. This study is based on 14 months of participant observation in three rural villages, a survey of 396 households, and unstructured interviews with 42 women and two men. It shows how demography and anthropology can be mutually supportive in their efforts to clarify population phenomena.     

Diabetes education project: community networking in rural Utah

People in rural areas often lack the financial resources, workforce, and professional network needed to sustain a diabetes education pro gram in their own community. HealthInsight, a nonprofit organization that works to improve the quality of health care in its community, developed a 2-day seminar in an effort to facilitate the networking of rural health professionals who educate patients with diabetes and to help those educators better learn how to use existing resources. Participants included nurses, dietitians, diabetes educators, quality managers, and education directors from hospitals and home health agencies in both rural and metropolitan areas. Speakers presented information on a variety of topics related to program development, and a resource manual containing numerous materials was given to each participant. At the end of the seminar, the group turned in goals for their own programs. Too often, providers of health care compete rather than collaborate with one another. There is a great need for such networking opportunities among health care professionals working on common goals--especially in rural areas.     

Occupational exposure to pesticides and health professionals' interpretation of "nervousness" among rural residents

Occupational exposure to pesticides has a strong impact on Public Health in Brazil, since the country is one of the world's largest pesticide consumers. Harm to the rural population is reflected in high pesticide poisoning and case-fatality rates. The present paper focuses on the perspective of health professionals working in districts 5 and 7 of the Municipality of Nova Friburgo, Rio de Janeiro State, in the Family Health Program, concerning rural residents' complaints of "nervousness", verifying (1) whether health professionals perceive a link between "nervousness" and symptoms of pesticide poisoning, (2) the implications of their understanding on the reporting of work-related illnesses, and (3) medication for "nervousness" (use of tranquilizers) as a potential factor of social accommodation (as occurs elsewhere in urban groups) and as a potential cause of dual poisoning among workers exposed to pesticides. The methodology included interviews, participant observation, field notes, and consultation of previous studies in the area. The study highlights health professionals' discourse in relation to the association between "nervousness" and pesticides. The authors discuss factors related to this perception and make several suggestions for future research.     

Living in the epilepsy treatment gap in rural South India: A focused ethnography of women and problems associated with stigma

In India, women with epilepsy face unique challenges. A focused ethnography of six women within the epilepsy treatment gap was conducted in rural South India. Women were asked to describe their day-to-day lives. Data were collected through open-ended, semistructured interview questions, participant observation, and field notes. Thematic analysis was done. The disease-related stigma contributed to the women's physical, psychological, and emotional struggles; the women and their family members made every effort to conceal the disease. Educational interventions to create awareness could help women seek effective treatments for their seizures, thereby reducing the stigma and improving the quality of their lives.     

A community-based evaluation of disability resources and inclusion practices in rural Botswana

BackgroundCommunity-based approaches to enhance the inclusion of persons with disabilities have proven effective; however, not much is known about cultural and contextual factors that influence the capacity of policy implementation and inclusion practices in rural Botswana.ObjectiveThe study evaluated local disability education and health resources in rural Botswana to develop a deeper understanding of cultural and contextual factors impacting inclusion practices.MethodResearchers used socio-demographic and qualitative research methods to conduct a comprehensive community-based needs assessment. Sampling techniques included maximum variation and snowball sampling. Thirty-two individuals participated in the study. Data were collected between June and August of 2019 through participant observation, in-depth interviews, and focus group discussions. An inductive thematic analysis was conducted by examining participants’ attitudes, perceptions, and experiences of community members with disabilities.ResultsFour primary themes emerged identifying factors that affect people living with disabilities in the rural community: (1) culture of vulnerability, (2) determinants of disability, (3) educational resources for persons with disabilities, and (4) effective systems integration. Findings suggested that while policies associated with disability at the government level are in place, disparities among rural communities’ hindered local responses to managing the needs of persons with disabilities.ConclusionsSocial, environmental, and physical barriers prevent the full implementation of policies that advocate for the rights of persons with disabilities in Botswana's rural settings. Increasing awareness of cultural and contextual factors may help community stakeholders facilitate inclusive practices in Botswana.     

Centralizing context and culture in the co-construction of health: localizing and vocalizing health meanings in rural India

A growing number of communication scholars have articulated the need for understanding context as a key component of health meanings. In this project, the authors seek to explore the role of context in the domain of health meanings in tribal India. The tribal population in India comprises people who have been consistently isolated and exploited, and stripped of their rights and resources. Interest in their health is propelled by this marginalization and their existence in the twilight of tradition and modernization. This article, through the use of participant narratives and a grounded theory of analysis, aims to lay out how meanings of health are contextually constructed by tribals in India. The results demonstrate the constant pain and hardship that envelop their lives, their pining for structural capabilities, and a dialectical tension between tradition and modernization in the coexistence of multiple treatment options.     

Influence of continuing medical education workshops on participant learning.

The challenge of assessing the effectiveness of continuing medical education (CME) programs is formidable and intriguing. Two workshops on program factors affecting resident recruitment, conducted at annual meetings of the American Association of Directors of Psychiatric Residency Training, were evaluated for their influence on participant learning. Based on pre- and post-workshop questionnaires, participant perceptions and attitudes changed as a result of the workshop experience. The changes closely paralleled the planned and spontaneous discussion content. In describing the workshop-related changes, factors affecting residency program recruitment and aspects of CME program evaluation are discussed. A suggestion for enhancing workshop evaluations is incorporated.