Objective To understand the willingness of general practitioner(GP) to enhance working competence in community healthcare centers in Shanghai and provide a basis for the competence training of GPs in community healthcare centers. Methods In August 2023,GPs were selected from some community healthcare centers in Shanghai and their willingness to enhance working competence were studied by a questionnaire survey.The survey included 39 secondary indicators in three dimensions:general practice theory,skills,and humanity. Results A total of 1 192 GPs completed the questionnaire,with an effective rate of 100%.The total score of GPs' willingness to enhance their working competence was 258.45±80.93,and the mean score of the three dimensions was 6.63±2.08.The score for the general practice theory was the highest (6.92±1.95),while that for general practice humanity was the lowest (6.44±2.34) among the three dimensions.The score of willingness to enhance working efficiency differed across different age ranges (P<0.001),professional titles (P<0.001),years of work (P<0.001),and educational backgrounds of GPs (P=0.039).Those with the age younger than 30 years old,junior professional titles,less than 5 years of work experience,and a college degree or below had the highest willingness score to enhance their working competence.Among the top three secondary indicators of willingness score in each dimension,the top three methods of working competence enhancement were community general practice and specialized healthcare services combined with outpatient learning,flexible further training,and continuing education courses.Conclusions There is an urgent need for young GPs in community healthcare centers in Shanghai to enhance their working competence.Targeted enhancement plans can be provided to different groups of GPs with different characteristics through community general practice and specialized healthcare services combined with outpatient learning,flexible further training,and continuing education courses,which can further enhance the ability and quality of the GP team.
Humans ; China ; General Practitioners/psychology* ; Surveys and Questionnaires ; Community Health Centers ; Clinical Competence ; Female ; Adult ; Male ; Attitude of Health Personnel ; Middle Aged

Background: The benefits of infant massage in hospital and community settings have been documented in literature: better weight gain of preterm and low birthweight infants, shortened hospital stay, slightly better scores on developmental tests, fewer postnatal complications, and effects on physical and mental health. Objectives: This study described the perceptions and experiences of infant massage among caregivers of infants 2-6 months old consulting in two public health centers in Quezon City before and after infant massage training. Methods: This qualitative study assessed perceptions and experiences at baseline and after infant massage training of mothers and caregivers taking care of infants 2-6 months old. Pre-training interviews were conducted, as well as immediately after, and seven days after training on infant massage delivered by the Philippine League of Government and Private Midwives, Inc. (PLGPMI). Training consisted of lectures and demonstrations, after which mothers/caregivers gave their babies the massage under the trainer's supervision. Post-training interviews were conducted immediately after the training and seven days after. Responses to the interviews were transcribed. The transcripts and interview notes were analyzed independently by two research team members. Qualitative Content Analysis (QCA) was done. Disagreements were settled by discussion. Results: The infant’s mother was identified as the best person to perform infant massage. Infant massage was a new concept to many participants before the training. In general, the perception was positive. It was believed to promote the baby's physical development and bonding with the mother/caregiver. These same benefits were reported after the training. Post-training, all 11 participants who returned for follow-up interviews reported having massaged their babies at home. They were also able to describe the process and timing of massage as taught to them. The participants’ responses centered on seven (7) identified themes, identified at baseline and after training: 1) general concepts of infant massage, 2) benefits of infant massage, 3) methodologies, materials, and considerations, 4) persons credible to perform infant massage, 5) application/performance of infant massage, 6) intentions and 7) infant massage as a public health measure. Conclusion There was a positive perception of infant massage among mothers and caregivers of infants 2-6 months old, whether or not they had prior knowledge. The sharing of information and the training given enhanced this. Participants showed good reception and retention of infant massage's basic concepts and process and improved their confidence in handling their babies and massaging them.
Mother-Child Relations ; Caregivers ; Health Education ; Community Health Centers

Background: The local health center (LHC) is the locus of public health service delivery in the barangays of Makati City. It should be the first-line for consultation and should be able to address most health concerns of the community. Considering the many services offered in the LHC, one must study the reasons why constituents opt to consult in the city hospital or in private institutions rather than the LHC. Objective: This study sought to determine the correlation between community perception of the LHC and utilization of the LHC in Barangay Rizal and Barangay Southside, and the correlation between demographic variables and the utilization of the LHC in Barangay Rizal and Barangay Southside. Methods: This is an observational study that utilized a cross-sectional survey. Utilization of the Local Health Center was operationally defined as any consultation in the local health center in the past year, regardless of occurrence of illness. The survey questionnaire had a 5-point Likert Scale and utilized the Patient Satisfaction Questionnaire-18 and added other possible factors affecting utilization based on related literature. Results: Utilization of the LHC had a weak correlation with barangay (Rizal versus Southside), older age, and having more co-morbid illnesses. Community perception of General Satisfaction, Availability of doctors, and Availability of free medications had a weak correlation with consulting in the LHC and had good community perception ratings. Conclusion Patient-Doctor Relationship also showed a weak correlation with consulting in the LHC but merits attention because it had a somewhat low community perception rating.
Cross-Sectional Studies ; Community Health Centers

Throughout the past 2020, the pandemic COVID-19 has caused a big global shock, meanwhile it brought a great impact on the public health network. Trauma emergency system faced a giant challenge and how to manage trauma under the pandemic of COVID-19 was widely discussed. However, the trauma treatment of special population (geriatric patients and patients taking anticoagulant drugs) has received inadequate attention. Due to the high mortality following severe traumatic hemorrhage, hemostasis and trauma-induced coagulopathy are the important concerns in trauma treatment. Sepsis is another topic should not be ignored when we talking about trauma. COVID-19 itself is a special kind of sepsis, and it may even be called as serious systemic infection syndrome. Sepsis has been become a serious problem waiting to be solved urgently no matter in the fields of trauma, or in intensive care and infection, etc. This article reviewed the research progress in areas including trauma emergency care, trauma bleeding and coagulation, geriatric trauma and basic research of trauma within 2020.
COVID-19 ; Community Networks ; Disseminated Intravascular Coagulation/therapy* ; Emergency Medical Services ; Female ; Health Services for the Aged ; Hemorrhage/therapy* ; Hemostasis ; Humans ; Male ; Pandemics ; Public Health ; Sepsis/therapy* ; Time Factors ; Trauma Centers ; Wounds and Injuries/therapy*

Objective: Explore the usage of anti-hypertension drugs and the rationality of hypertension prescription among the primary health centers in Dongcheng District, Beijing. Method: This cross-sectional and retrospective study was applied to analyze the hypertension prescriptions from the 8 community health centers in Dongcheng District. The anatomical, therapeutic and chemical classification (ATC) codes were used to determine the drug category. ATC information was used to filter data containing antihypertensive drugs, and group the number and proportion of ATC categories. The type of drug was judged by its generic name. According to the diagnosis information in the prescription, the prescription containing the Western medicine diagnosis of hypertension was screened out. The comorbidities of hypertension in the study included 7 types of diseases including diabetes, chronic kidney disease, coronary heart disease, heart failure, atrial fibrillation, stroke, and dyslipidemia. The analysis of prescription rationality included rationality of combination medication, rationality of drug dosage and rationality of drug price. The agreed daily dose (DDD) method was used to analyze the rationality of drug dosage. The drug utilization index (DUI) was used as a quantitative indicator to estimate the rationality of medication, and overdose was expressed by DUI>1. The reasonableness of the drug price was judged based on the price of the drug and whether it was a drug in the "4+7" plan. Results: A total of 658 140 prescriptions were extracted as the final data set, involving 7 categories and 60 commonly used anti-hypertensive drugs, and the corresponding cost of medication was ￥96.58 million. Drugs were prescribed according to comorbidities, and the choice followed the international guidelines. Calcium channel blockers (CCB) were the most prescribed drugs in the prescriptions of patients with comorbidities, and α-adrenergic receptor antagonists were the least prescribed drugs. The proportion of diuretics prescribed in hypertensive patients complicating with heart failure was 21.17% (505/2 385), which was much higher than that of patients complicating with other comorbidities (P<0.05). The proportion of diuretics prescribed in hypertension patients complicating with dyslipidemia was lower than that of patients with other comorbidities (2 639 (0.94%), P<0.05), and β-blockers (BB) or angiotensin Ⅱreceptor blockers (ARB) were more likely to be selected (BB: 59 348 (21.08%), ARB: 51 356 (18.24%))in these patients. The proportion of BB in prescriptions for hypertension patients with chronic kidney disease was lower than that of patients with other comorbidities (P<0.05). The proportion of BB in prescriptions for hypertension patients with coronary heart disease was higher than that of other comorbidities (P<0.05). Hypertension patients with atrial fibrillation or stroke accounted for a higher proportion of CCB prescriptions (P<0.05). Single antihypertensive drug prescriptions accounted for the highest proportion, 61.19% (402 745/658 140). Two-combination prescriptions accounted for the highest proportion of combination prescriptions, 72.19% (184 392/255 395). CCB based two-combination prescriptions accounted for the highest proportion, 122 350(66.36%). ARB-based tri-combination prescriptions accounted for the highest proportion, 48 915(89.50%),followed by CCB based tri-combination prescriptions (44 732(81.85%)).There were 2 174 (0.33%) prescriptions with unreasonable combination therapies and DUI>1 were found in 48 out of 60 commonly used drugs. In all possible antihypertensive drugs, only 40.92% (109 227/266 993)followed the "4+7" plan. Conclusions: The anti-hypertensive agents from these prescriptions in the primary health centers are diverse, and the choice is generally complied with the guidelines, but some unreasonable situations existed, especially on the combined anti-hypertensive medication, overdose, and"4+7"plan is not followed completely.
Angiotensin Receptor Antagonists/therapeutic use* ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use* ; Antihypertensive Agents/therapeutic use* ; Beijing/epidemiology* ; Calcium Channel Blockers/therapeutic use* ; Community Health Centers ; Cross-Sectional Studies ; Humans ; Hypertension/drug therapy* ; Prescriptions ; Retrospective Studies

PURPOSE: Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation.METHODS: This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed.RESULTS: In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care.CONCLUSION: By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.
Anemia ; Child Health ; Child ; Community Health Centers ; Community Health Workers ; Community-Based Participatory Research ; Consumer Participation ; Delivery of Health Care ; Education ; Health Promotion ; Humans ; Incidence ; Infant ; Iron ; Kyrgyzstan ; Pilot Projects ; Program Evaluation ; Public Health ; Retrospective Studies ; Transients and Migrants

The purpose of this study were to identify the dietary practices of vulnerable older adults and to assess the foodservice and food provision service programs perceived by the health and welfare service providers in the community. A survey was conducted on health and welfare service providers working in outreach community centers and community health centers in Seoul. A total of 260 nurses and social workers participated in the survey and 224 responses were used for data analysis after excluding significant missing data. The respondents consisted of nurses (58.5%) and social workers (41.5%). In terms of the dietary life of the vulnerable older adults, they perceived that the food cost was burdensome to the older adults and poor dental conditions prohibited them from eating various foods. The health and welfare service providers rated highly for ‘home-delivered meal and side dish services are effective for checking older adults’ conditions' but rated low for availability of menu choices. In targeting vulnerable older adults for food and nutrition service programs, the home-delivered meal service was found to be suitable for older adults living alone, those over age of 80 years, those with mobility difficulties, and those with economic difficulties. The food provision service was appropriate for older adults living with their spouse or other family members. Vulnerable older adults are a heterogeneous population with diverse needs related to food and nutrition. Home-delivered meal/side dish service and food provision services will achieve their goals when they reach the correct targets with a customized service.
Adult ; Community Health Centers ; Eating ; Humans ; Meals ; Seoul ; Social Work ; Social Workers ; Spouses ; Statistics as Topic ; Surveys and Questionnaires

OBJECTIVES: Serious mental illnesses and substance use disorder have a high level of early mortality. This study aimed to identify the causes of their deaths among patients who had been under the care of community mental health and welfare centers and addiction management centers.METHODS: We collected information on deceased individuals, whose mortality was attributable to various causes of death, from 10 Community Mental Health Centers and Addiction Centers in Gwangju Metropolitan City. The primary variables collected included psychiatric diagnosis, cause of death, smoking habits, admission history, and several socio-demographic factors.RESULTS: A total of 214 deaths among service users were studies. In Community Mental Health Centers, 109 deaths were identified, with causes that may be itemized as follows : 27 suicides(24.8%), 56 physical illnesses( 51.4%), 14 accidents(12.8%), and 12 unknown causes(11.0%). Among the physical illnesses reported, cardiovascular illness and cancer were the most common causes of death. A history of frequent admission was common among those that had died by suicide(88.9%), compared with that observed among general service users(62.0%). In Addiction Centers, 105 deaths were identified, with causes that may be itemized as follows : 7 suicides(6.7%), 71 physical illnesses(68.3%), 7 accidents(6.7%), and 20 unknown causes(19.0%). Among the physical illnesses reported, sudden death, hepatic disorder, cancer, and cardiovascular disorder were the most common causes of death.CONCLUSION: Case managers should give due consideration to and carefully manage the physical health of individuals accessing mental health services via community mental health centers and addiction centers.
Case Management ; Cause of Death ; Community Mental Health Centers ; Death, Sudden ; Gwangju ; Humans ; Mental Disorders ; Mental Health Services ; Mental Health ; Mortality ; Smoke ; Smoking ; Substance-Related Disorders ; Suicide

OBJECTIVE: The aim of this study is to assess the prevalence and determinants of folic acid supplementation among women referred to community health centers. METHODS: This was a cross-sectional study conducted in 325 women referred to community health centers. The subjects were selected from 8 community health centers, using a stratified sampling technique. Data regarding demographics, socioeconomic status, obstetrics, folic acid supplementation status, and household food security status were obtained via questionnaires. The data was analyzed in SPSS v22. RESULTS: The prevalence of folic acid supplementation both before and during pregnancy was 54.5%. The results of the study showed that folic acid supplementation had a significant positive association with education level (odds ratio [OR],0 .441; 95% confidence interval [CI], 0.199–0.977; P<0.05), being employed (OR, 0.353; 95% CI, 0.148–0.840; P<0.05), and planned pregnancy (OR, 18.113; 95% CI, 7.371–44.51; P<0.001). However, other variables, including age, husband's age, husband's education and employment status, the number of prior pregnancies, economic satisfaction, and household food security, were nonsignificant factors affecting folic acid supplementation. CONCLUSION: Women with lower socioeconomic status are less likely to take folic acid supplements, and more effort should be made to increase their awareness of the importance of supplementation. Unplanned pregnancy is another strong risk factor for not supplementing with folic acid, and thus should be avoided.
Community Health Centers ; Contraception ; Cross-Sectional Studies ; Demography ; Education ; Employment ; Family Characteristics ; Family Planning Services ; Female ; Folic Acid ; Food Supply ; Humans ; Obstetrics ; Pregnancy ; Pregnancy, Unplanned ; Prevalence ; Referral and Consultation ; Risk Factors ; Social Class

PURPOSE: The aim of this study was to examine the effect of self-assertive training applying the reality therapy techniques (SATART) on self-esteem and internalized stigma of schizophrenia patients. METHODS: This study was a non-equivalent control group pretest-posttest design and enrolled 55 people with schizophrenia (experimental group=27, control group=28) from two community mental health centers. The SATART was offered twice a week for 6 weeks in a total 12 sessions. Data were collected from February to April, 2017, using the Korean version of the Internalized Stigma of Mental Illness Scale and Rosenberg Self-Esteem Scale. The collected data was analyzed using χ2 test, independent t-test, one-way ANCOVA, and repeated measures ANOVA with using the SPSS/WIN 22.0 program. RESULTS: The experimental group showed significant improvements in self-esteem and recudction of internalized stigma compared to the control group. However, there was no significant improvement on stigma resistance measurement among the subscales of internalized stigma between two groups. CONCLUSION: The findings indicate that the SATART program is effective and could be recommended as a psychosocial intervention for self-esteem enhancement and internalized stigma reduction of people with schizophrenia.
Assertiveness ; Community Mental Health Centers ; Humans ; Reality Therapy ; Schizophrenia ; Self Concept ; Social Stigma