Objective:To survey the status quo of the provision of palliative care services by community health service centers in Shanghai and to investigate the related influencing factors.Methods:This was a cross-sectional survey. The status quo of the provision of palliative care services in all community health service centers (249 in total) in 16 districts of Shanghai were surveyed in December 2022. The Evaluation Form for the Quality Management of Hospice Care Work in Shanghai Community Health Service Center was used for survey, which included basic information, talent team, related department, medical services, research and training, and health education, etc. The data were collected up to November 30, 2022. The 16 districts were divided into three areas: central city (80 centers), suburb (92 centers) and exurb (77 centers). The scores of different districts were compared and the influencing factors were analyzed.Results:The average self-evaluation score of community hospice care service in 16 districts was 69.42 points. Changning District in the central city had the highest self-evaluation score (87.32 points) and Fengxian District in the exurb had the lowest self-evaluation score (44.59 points). The total scores of hospice service in central urban area and suburban area [(73.99±16.96) and (75.61±10.69) points] were higher than those in the exurbs [(56.81±20.82) points], and the scores in central urban area and suburban area were also higher than those in the exurbs ( P<0.05). Multivariate regression analysis showed that the community location, the registration status of hospice department, inpatient ward facilities, and availability of hospice information platform were independent influencing factors of community self-rating scores ( P<0.05). Conclusion:Hospice care services have been fully covered in Shanghai community health service centers, and the current situation of community hospice care services in the central city and the suburbs is better than that in the exurbs.

Objective:To survey the status quo of the provision of palliative care services by community health service centers in Shanghai and to investigate the related influencing factors.Methods:This was a cross-sectional survey. The status quo of the provision of palliative care services in all community health service centers (249 in total) in 16 districts of Shanghai were surveyed in December 2022. The Evaluation Form for the Quality Management of Hospice Care Work in Shanghai Community Health Service Center was used for survey, which included basic information, talent team, related department, medical services, research and training, and health education, etc. The data were collected up to November 30, 2022. The 16 districts were divided into three areas: central city (80 centers), suburb (92 centers) and exurb (77 centers). The scores of different districts were compared and the influencing factors were analyzed.Results:The average self-evaluation score of community hospice care service in 16 districts was 69.42 points. Changning District in the central city had the highest self-evaluation score (87.32 points) and Fengxian District in the exurb had the lowest self-evaluation score (44.59 points). The total scores of hospice service in central urban area and suburban area [(73.99±16.96) and (75.61±10.69) points] were higher than those in the exurbs [(56.81±20.82) points], and the scores in central urban area and suburban area were also higher than those in the exurbs ( P<0.05). Multivariate regression analysis showed that the community location, the registration status of hospice department, inpatient ward facilities, and availability of hospice information platform were independent influencing factors of community self-rating scores ( P<0.05). Conclusion:Hospice care services have been fully covered in Shanghai community health service centers, and the current situation of community hospice care services in the central city and the suburbs is better than that in the exurbs.

Palliative care, as an emerging discipline, is rapidly advancing in China. However, progress in quality management has been relatively slow, hindering the homogeneity of palliative care services in a certain degree. This article takes the Shanghai Palliative Care Service Management Center as an example, outlines its practical model and achievements in the field of quality management since its establishment, and further analyzes the existing problems based on the city-wide palliative care service quality evaluation results. The article summarizes relevant experiences and offers corresponding insights, enriching research cases and practical support in the quality management of palliative care, which may have practical application value for enhancing the homogeneity of palliative care services in the region.

Objective: To investigate the gender difference of left-behind adolescents mental health in rural junior middle schools, and to explore possible moderating role of parent-child interaction. Methods: Based on the data of China Education Panel Survey (CEPS) from 2014 to 2015, the self-reported parent-child interaction frequency and mental health of 3 470 eighth grade students lived in rural area were analyzed. Results: Mental health scores were higher in left-behind boys (68.90±22.45) whose parents migration compared to left-behind girls (63.59±20.83)(t=3.02, P<0.01). The two-level mixed effect linear regression model showed that the negative impact of parental migration on the parentchild interaction and mental health of left behind girls was greater than that of left behind boys (B=-0.90, -4.02, P<0.05). The frequency of parent-child interaction moderated the gender difference of mental health of left behind adolescents (P<0.01). The above-mentioned gender differences decreased after adding the frequency of parent-child interaction (B=-3.65, P<0.1). Conclusion The negative impact of parental migration on mental health of left-behind girls in junior high school is stronger than boys. It is needed to take more care of the mental health and promote parent-child communication for left-behind girls.

Objective: To understand the relationship between school environment and campus bullying behavior of junior high school students, and to provide scientific basis for the intervention of campus bullying behavior. Methods: Based on the data of "China Education Panel Survey" from 2014 to 2015, the school environment and self reported campus bullying behaviors of 9 300 junior high school students were analyzed. Results: The two level mixed effect linear regression model showed that the frequency of boys campus bullying behavior was higher than girls( B =0.356, P <0.01). Junior high school students in the school with higher student teacher ratio and school average class status had higher frequency of campus bullying behavior( B =-0.007, -0.004, P < 0.05 ). The negative correlation between school average class status and the frequency of bullying behavior of boys was greater than girls( B = -0.006 , P <0.01). Conclusion Prevention and treatment of junior high school students campus bullying not only needs to start from the individual students, families and peer groups, but also needs to pay attention to the school environment, reduce the school socioeconomic segregation, and pay more attention to boys campus bullying behavior.

Objective:To investigate the knowledge level of hospice care and the related influencing factors among health providers in Shanghai.Methods:From November to December 2019,a questionnaire survey on the hospice care knowledge was conducted among 7 074 health providers from 223 registered hospice care clinics or institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. Among the 7 027 responders, there were 1 460 males (20.8%) and 5 567 females (79.2%) with an mean age of (36.9±9.3) years; 2 682 nurses (38.2%) and 2 442 doctors (34.8%); 5 065 (72.1%) from community health service centers; 2 982 (42.4%) involving in hospice care services and 4 039 (57.5%) willing to work in hospice care. The average score of hospice care knowledge was (8.9±2.6), and the average accuracy for questions was 59.0%. Health providers had the highest awareness rate for the composition of hospice care professional team (93.9%, 6 597/7 027) and the lowest awareness rate for the emotional commitment in hospice care service (16.6%, 1 165/7 027). Health providers with junior colleges degree ( B=-0.429), vocational college degree and below ( B=-0.544), nurses ( B=-0.652), working in suburban areas ( B=-0.278), social office ( B=-0.891), without witness of dying process of end-of-life patients ( B=-0.329), not involving in hospice care services ( B=-0.283), and not willing to participating in hospice care ( B=-0.820) had low knowledge scores ( P<0.05). Conclusions:The overall level of hospice care knowledge of health providers in Shanghai is generally at a medium level, and the training of hospice care knowledge should be strengthened for the better development of hospice care.

Objective:To investigate the current training needs of hospice care among health providers in Shanghai.Methods:Based on the B.S. Bloom classification of educational objectives,a questionnaire on the training needs of hospice care for health providers in Shanghai was developed. From November to December 2019,a questionnaire survey on the training needs of hospice care was conducted among 7 074 health providers in 223 medical institutions in Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. The training needs of health providers in Shanghai exceeded 71.0% for all items,with the average score of (2.58±0.63). The degree of training needs in each dimension ranges from high to low were knowledge(2.59±0.64), action(2.57±0.68) and motion(2.56±0.70). The top three training needs were“living will and law”(80.5%,5 660/7 027),“social work methods for hospice care”(75.3%, 5 290/7 027)and“stress and adaption in hospice care services”(75.1%,5 279/7 027). Female health providers(2.61±0.62), administrators, medical personnel and other post workers(2.68±0.56),those with junior professional title(2.61±0.62), with no witness of dying process(2.65±0.58),and those without participating in hospice care service(2.68±0.55)had higher training needs( P<0.05). Conclusion:The training needs of hospice care for health providers are very high in all hospitals. It is suggested to conduct stratified and targeted training for health providers in different positions and institutions according to the different training needs of hospice care.

Objective:To investigate the attitude of health providers towards hospice care in Shanghai,and analyze the related influencing factors.Methods:From November to December 2019,a questionnaire survey on the attitude towards hospice care was conducted among 7 074 health providers from 223 medical institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. The total score of attitude to hospice care was (91.9±11.6),the average score of items was (3.7±0.5). The highest score rate was "perception of the benefits for the quality of life promotion" (87.08%),and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (60.88%).Health providers who were doctors ( B=-1.207), nurses ( B=-0.912), those without witness of dying or end-of-life patients ( B=-1.417), those without involving in hospice care services ( B=-1.203), and not willing to participating in hospice care ( B=-7.849) had lower attitude scores (all P<0.05). Conclusions:The survey indicates that health providers in Shanghai have a positive attitude towards hospice care,but the initiative to engage in hospice care service is not high. It is necessary to conduct targeted training of relevant professional knowledge to enhance the attitude and enthusiasm to hospice care among health providers.

Objective:To survey the practice of hospice care and influencing factors among health providers in Shanghai.Methods:From November to December in 2019, a sampling survey on the practice of hospice care was conducted among 2 982 health providers from 217 institutions in 16 districts of Shanghai by using the self-designed scale.Results:The overall behavior frequency of hospice care in health providers was between "occasionally" (3 points) and "often" (4 points). The item score was (3.7±0.9), and the total score was (52.1±10.0). In the aspect of building a good relationship with patients and family(77.7%, 2 317/2 982), the participants had the highest work-practice(46.4%, 1 383/2 982). However, they practiced less in recommending the hospice care institutions to terminal patients. In terms of work-practice, the average score in male providers, those with education of undergraduate and above, those being married (including divorced or widowed), medical staff, those with associated senior titles, with witness of dying, or those currently working in the hospice care service department was higher.Conclusions:The hospice care work-practice of health providers in Shanghai is generally satisfactory, however, there is still some discrepancy among health providers with various characteristics. To further improve quality of hospice care, it is necessary to strengthen policy implementation, to encourage multidisciplinary team cooperation and carry out various forms of professional training for health providers.

Objective To evaluate the feasibility of developing hospital acquired pneumonia (HAP) risk warning model in critically ill patients based on genomic copy number polymorphisms (CNPs) of the genes encoding human neutrophil peptides 1-3 (DEFA1/DEFA3).Methods Seventy-seven HAP patients (group HAP) and 109 non-HAP patients of matched age and sex in intensive care unit (ICU) (group NHAP) were enrolled in the study.The genomic CNPs of DEFA1/DEFA3 was determined by realtime quantitative polymerase chain reaction after extracting DNA from peripheral blood samples.The source of patients,condition of endotracheal intubation within 24 h after admission to ICU,Acute Physiology Score,Acute Physiology and Chronic Health Evaluation Ⅱ score,Sequential Organ Failure Assessment score,mechanical ventilation time,length of hospital and ICU stay and outcomes were obtained.The predictive model was developed using logistic regression through combining DEFA1/DEFA3 copy numbers and clinical characteristics (Acute Physiology Score and source of emergency) within 24 h after admission to ICU.The receiver operating characteristic curve was used to evaluate the predictive efficacy of the model.Results The copy numbers of DEFA1/DEFA3 were significantly lower in HAP group than in NHAP group (P ＜0.05).The area under the receiver operating characteristic curve of the predictive model developed through combining the DEFA1/DEFA3 copy numbers with clinical characteristics was 0.789 (95％ CI 0.724-0.854) when the model was used for predicting HAP.Conclusion CNPs of DEFA1/DEFA3 can be used to develop the HAP risk warning model in critically ill patients.