Community-living older people’s interpretation of the Norwegian version of older people’s quality of life (OPQOL) questionnaire

The aim of this study is to investigate how community-living older people interpret the Norwegian version of Older People's Quality of Life (OPQOL) questionnaire. The original OPQOL questionnaire was translated based on guidelines for cross-cultural translation. The Three-Step Test-Interview instrument was adopted to investigate how community-living older people interpreted the questionnaire. Data were collected from 14 participants (72–89 years). The questionnaire was filled in under observation. Semi-structured interviews were then conducted to clarify the observational data and elicit the participants’ experiences and opinions. Lastly, data were analysed using a hermeneutic interpretation approach. Our findings indicate that most of the participants managed to complete the OPQOL questionnaire without problems. The data analysis resulted in four primary themes: relevance & applicability, formulation, consistency & accuracy and subjectivity. The questionnaire covered all aspects related to the participants’ quality of life. However, statements related to religion were found to be irrelevant to their quality of life. Most of the participants thought that religion, philosophy and culture should be separate rather than included in the same statement. The participants missed the option of ‘not applicable’ when the statements were irrelevant to them. The statements are formulated in both positive and negative ways, which was sometimes confusing to them. The participants perceived phases such as “around me” “local,” and “things” as ambiguous, and thus they raised concerns about whether the OPQOL questionnaire could capture consistent data regarding their quality of life. The results of this study pinpoint the issues that community-living older people faced when interpreting and answering the Norwegian version of OPQOL questionnaire. These issues were mostly caused by sociocultural differences. Our work provides an overview of the changes that must be made in the questionnaire in order to address these sociocultural differences while using the OPQOL questionnaire in the Norwegian context.     

Community-based dementia care re-defined: Lessons from Iceland

Studies of families caring for persons with dementia living at home often reflect feelings of being forgotten and abandoned by the authorities to shoulder the responsibility for care-giving. This has increased interest in how formal services can better support these families. This article analyses how health and social care professionals envision the needs of families of persons with dementia living in the community. It also describes the contributions of the formal care system to these families. The study design was qualitative. It involved interviews with professionals (N = 20), field observations from the settings where they worked, and public documents addressing care-giving for people with dementia. Data were analysed using the framework method. The findings reflected how those providing services to persons experiencing cognitive changes mainly understood the services as specialised. They focused on the diagnosis and treatment of the individual with dementia. They considered other aspects of care, such as attending to practical issues of daily life, to be a private matter, for which the family was responsible. In later stages of dementia, specialised day programs become available, offering rehabilitation to motivate positive daily living—for both the person experiencing dementia and family-centred supporters. Professionals in the field described primary care, community-based healthcare and home care services as poorly equipped to support these families. Participants acknowledged that families were often under a lot of stress and might need more support earlier in the illness. However, they saw themselves as powerless. Towards the end of the data collection, services were being re-designed to emphasise the role of primary care. In light of its holistic and family-centred approach, primary care may be well placed to integrate relational understanding of living with dementia and specialised knowledge of dementia treatment.     

What is the impact of day care on older people with long-term conditions: A systematic review

There is a lack of robust evidence regarding outcomes for day care use among older people living with long-term conditions (LTCs). Day care is provided by independent, private and voluntary and charitable sectors. This systematic review aims to establish current evidence of outcomes for older people with LTCs attending day care services and outcomes on carers, across all service models. Narrative synthesis of quantitative and qualitative data was undertaken. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search was carried out across eight electronic databases and reference lists of key journals between 2004 and October 2020 were searched. Searches returned 1,202 unique titles. Forty-five articles from 16 countries met the criteria on review of title, abstract and full article. There is limited evidence suggesting improved levels of perceived psychological health, quality of life, perceived general health, physical health and functioning for older people attending day care who have LTCs. The respite function of day care resulted in positive outcomes for carers. Studies evaluating outcomes for participants or carers were limited in quantity and quality. There is limited information regarding outcomes for day care attendance for older people with multiple LTCs from existing literature. Further research focusing on LTCs and day care attendance would benefit this field.     

To what extent do community characteristics drive health facility delivery? Findings among Women who had recent live births in Nigeria

Existing studies have established several individual drivers of health facility delivery in many developing countries. However, the community characteristics that drive health facility delivery have been less studied across developing countries. This study thus examines the extent to which community characteristics drives health facility delivery among women who had recent live births in Nigeria based on data from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample size of 7,342 women was analysed. The outcome variable was health facility delivery. The explanatory variables were selected individual and community characteristics. Results show 39.7% prevalence of health facility delivery among the women. Findings further reveals that the community characteristics have significant effects on the variations in health facility delivery across the communities. Community characteristics significantly drive health facility delivery in Nigeria. More community-based priority actions are required to improve demand for health facility delivery in the country.     

基于共享理念的急诊CTA应急平台构建与效果评价

目的基于共享理念的急诊CTA应急平台构建与效果评价。方法选取2019年1—9月急诊CTA检查患者为对照组,2019年11月—2020年8月急诊CTA检查患者为观察组。对照组采用常规急诊值班制,观察组建立急诊CTA应急平台。对申请检查科室、检查项目进行描述性统计,比较两组CTA检查时间及入院患者预后转归情况。结果申请科室以急诊内科为主,检查项目以头颅、胸腹部为主,急诊CTA检查时间对照组中位数为46 min,观察组中位数为20 min,两组对比差异有统计学意义(P<0.05),对照组37例患者中有8例(21.7%)致残,观察组103例患者中有8例(7.8%)致残,两组对比差异有统计学意义(P<0.05)。结论组建急诊CTA应急平台能缩短急诊CTA影像学检查时间,降低致残率,提高患者生活质量,优化护理人力资源,值得临床推广。     

基于社会网络分析方法的黑龙江省县域医联体建设问题分析及思考

目的:梳理与明确黑龙江省县域医联体建设中的关键问题,为黑龙江省县域医联体建设提供参考意见。方法:文献分析法、社会网络分析法等。结果:黑龙江省县域医疗体系在政策和相关卫生资源的配置上存在医疗资源薄弱、县域医联体政策、配套措施不足等问题;医联体成员间、医生间利益分配和激励机制不足、农村基层医疗机构服务能力不足以及政府对于医共体财政补助不足是目前被学者们普遍认同的关键问题。结论:重构利益分配和激励机制、以政策与相关配套措施推动县域医联体建设、补齐县级医院短板是黑龙江省县域医联体建设的必要之举。     

21世纪医疗保障制度改革的几种趋势

综观世界诸医疗保障制度改革的实践和理论研究,21世纪医疗保障制度改革有以下几种趋势：强调社会保障的人权意义,医疗保障是基本的人权保障的重要方面,医疗保障向健康保障过渡;医疗保障中适当地导入市场机制的作用,重视社区卫生服务。     

Delivering a psychosocial program for older people living in retirement homes during the Covid-19 pandemic: A process evaluation and recommendations for community interventions

The Covid-19 pandemic lockdown regulations caused retirement homes to temporarily ban in-person visitation potentially increasing the mental health risks of older people. An opportunity arose for a multistakeholder community collaboration to design a mental health program for older people. To evaluate the process of delivering a 12-week psychosocial program aimed at preventing loneliness, countering boredom, and providing older people in restricted settings with education about Covid-19 during the lockdown, in Durban, South Africa. A qualitative retrospective design was used. Data from two focus groups and six semistructured individual interviews conducted with stakeholders (volunteers, social workers, and residents) postproject were analyzed using reflexive thematic analysis. Stakeholders had varied experiences of the project, in terms of content, processes of engagement, and implementation, resulting in five themes. The study concluded with recommendations. A strong need exists for multistakeholder community collaborations when implementing a program where the context restricts physical access.     

社区老年高血压病人健康教育近期效果评价

为了解在社区老年高血压患者中进行的联合型健康教育活动的近期效果,作者重复调查了健教组社区老年人有关高血压“知-信-行”的状况,与基线和对照组的情况进行了比较分析。结果表明：本次联合型的健康教育活动使健教组在高血压的相关知识、信念、行为方面均有一定的改善。作者还对这项联合型健康教育活动的可行性及存在的问题进行了讨论。总结了本次研究的体会,并指出了进一步提高这项活动效率、效果的工作重点和建议。