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Objective:To evaluate the application feasibility of the post competency index system of rural general practice assistant physicians, and to analyze and compare the post competency of rural general practice assistant physicians with different characteristics through a survey among rural general practice assistant physicians in China.Methods:This study was a cross-sectional study. A questionnaire survey was conducted among rural general practice assistant physicians in 10 provinces/municipalities selected by stratified cluster sampling method from October 2020 to September 2021. The post competency scores were self-evaluated based on the post competency index system of rural general practice assistant physicians. The results of the survey were analyzed and the application feasibility of the index system was evaluated.Results:A total of 1 123 questionnaires were distributed and 1 024 valid questionnaires were returned with a recovery rate of 91.2%. Of the 1 024 respondents, 529 were males (51.7%), 435 were aged 40-49 years (42.5%), 434 had a secondary school education or less (42.4%), and 531 were junior practitioners (51.9%). The Cronbach′s α coefficient of the overall questionnaire was 0.987, and the Cronbach′s α coefficient of the first level index ranged from 0.897 to 0.974. The cumulative variance contribution rate of exploratory factor analysis was 72.012%. The confirmatory factor analysis showed χ2/ df=3.926, RMSEA=0.076, CFI=0.858, IFI=0.859, indicating that the model fit was basically good. The average self-evaluation scores of the first level index ranged from 3.95 to 4.25, and the average self-evaluation scores of the second level index ranged from 3.74 to 4.36. There were significant differences in self-evaluation scores of post competency among rural general practice assistant physicians with different working years, professional titles, working units and economic regions( F=4.67, 10.54, 22.16 and 20.90,all P<0.05). People with low self-evaluation scores of post competency had the following characteristics: working 10-19 years, intermediate or above titles, working in community health service centers, located in the eastern region.People with high self-evaluation scores of post competency had the following characteristics: primary professional title, working in the village clinic. Conclusion:The competency index system of rural general practice assistant physicians has good application feasibility,and it can be used to evaluate post competency for the education and training of rural general practice assistant physicians.
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Objective@#To evaluate the effectiveness for the construction of "mosquito-free village" in Xuejia Village, Pujiang County, Zhejiang Province, so as to provide the guidance for the construction of "mosquito-free village" in other rural areas.@*Methods@#Density of adult mosquitoes in Xuejia Village was investigated using light trap method and density of larval mosquitoes was investigated using larval straw method from April to November each year. Totally 30 households of villagers were randomly selected, and their awareness rates of mosquito control knowledge, mosquito control behavior forming rates and satisfaction rates were surveyed through questionnaires. Investment during construction (from August 2016 to December 2018) and maintenance period (from 2019 to 2023) of "mosquito-free village" were investigated through data review and interviews. Long-term effects of "mosquito-free village" construction in Xuejia Village were evaluated in terms of mosquito density from 2016 to 2023, effectiveness of health education for villagers, satisfaction and investment.@*Results@#Compared with the year 2016, the densities of adult and larval mosquitoes in Xuejia Village were significantly decreased from 2017 to 2023. The average monthly density of adult mosquitoes in 2023 decreased by 98.34%, and the average monthly 100 household index of larval mosquitoes decreased by 98.45% compared to 2016. The average monthly density of adult mosquitoes from 2019 to 2023 was less than or equal to one mosquito per light trap in a night, and the average monthly 100 household index of larval mosquitoes was less than or equal to five places per 100 households. The awareness rate of mosquito control knowledge was 93.33%, the behavior forming rate was 86.67%, and the satisfaction rate was 90.00%. By December 2023, the total investment during construction and maintenance period was 450 thousand Yuan, with an average annual investment of 60.7 thousand Yuan and average annual investment of 206.61 Yuan per household. The average annual investment during maintenance period was 36.2 thousand Yuan, and the average annual investment per household was 109.70 Yuan.@*Conclusion@#The mosquito density, effectiveness of health education for villagers and satisfaction of "mosquito-free village" in Xuejia Village all meet the evaluation criteria of "mosquito-free village", and the investment is reasonable, making it suitable for promotion to other rural areas.
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Este estudo tem como objetivo analisar os sentidos atribuídos pelos enfermeiros ao seu trabalho na Atenção Primária à Saúde em áreas rurais. A relevância desta pesquisa está no fato de existirem lacunas em relação ao trabalho dos profissionais da Atenção Primária à Saúde rural, tendo em vista que o Brasil ainda não tem uma política de Atenção Primária à Saúde específica para áreas rurais que direcione o trabalho dos profissionais. Pesquisa qualitativa, descritiva-exploratória, com enfermeiros de equipes da Estratégia de Saúde da Família rurais do município de Campina Grande, Paraíba. Utilizaram-se entrevistas semiestruturadas, com análise a partir da técnica de Análise de Conteúdo. Constatou-se que o sentido do trabalho dos enfermeiros está na satisfação pessoal, contribuição social, na identificação com o trabalho em áreas rurais e na existência de vínculo com a população rural e equipe; e como perda de sentido para o trabalho, as condições de trabalho precárias, além da ordenação dos serviços, e a distância do ponto de vista físico e relacional entre a gestão municipal e os profissionais de áreas rurais, que não oferece suporte para o desenvolvimento eficaz das ações. A partir desta pesquisa, pôde-se constatar a influência dessas dimensões na atribuição de sentido ao trabalho exercido pelos enfermeiros de Atenção Primária à Saúde de áreas rurais. Este estudo pode contribuir na orientação de pesquisas de enfermagem em sistemas e serviços de saúde, em se tratando de áreas mais vulneráveis, como as rurais e remotas.
This study aims to analyze the meanings attributed by nurses to their work in Primary Health Care in rural areas. The relevance of this research lies in the fact that there are gaps in relation to the work of rural Primary Health Care professionals, given that Brazil still does not have a specific Primary Health Care policy for rural areas that directs the work of professionals. Qualitative, descriptive-exploratory research, with nurses from rural Family Health Strategy teams in the city of Campina Grande, Paraiba. Semi-structured interviews were used, with analysis based on the Content Analysis technique. It was found that the meaning of nurses' work lies in personal satisfaction, social contribution, identification with work in rural areas and the existence of a bond with the rural population and the team; and as a loss of meaning for work, precarious working conditions, in addition to the ordering of services, and the distance from the physical and relational point of view between municipal management and professionals in rural areas, which does not offer support for effective development of the actions. From this research, it was possible to verify the influence of these dimensions in the attribution of meaning to the work carried out by primary health care nurses in rural areas. This study can contribute to guiding research on nursing in health systems and services, when it comes to more vulnerable areas, such as rural and remote areas.
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Nursing , Working Conditions , Primary Health CareABSTRACT
Objective@#To investigate the current status and influencing factors of knowledge, attitude, and practice of hypertension prevention and control among rural residents in Shanxi Province, so as to provide insights into implementation of health education pertaining to hypertension control in rural areas. @*Methods@#A total of 7 403 residents were sampled using a multi-stage cluster random sampling method from rural areas of Yangqu, Daning, and Yonghe counties of Shanxi Province from November 2020 to July 2021 for face-to-face questionnaire surveys and physical examinations. Residents' basic characteristics, knowledge, attitude, and practice of hypertension prevention and control, and height, weight, blood pressure were collected, and factors affecting knowledge, attitude, and practice of hypertension prevention and control were identified using a generalized linear model. @*Results@#A total of 7 403 questionnaires were allocated, and 7 031 effective questionnaires were recovered, with an effective response rate of 94.98%. The respondents included 3 035 men (43.17%) and 3 996 women (56.83%), and had a mean age of (58.45±13.75) years. The median scores of hypertension prevention and control knowledge, attitude and practice were 5 (interquartile range, 4), 16 (interquartile range, 5) and 14 (interquartile range, 7) points, with scoring percentages of 48.40%, 80.55% and 54.41%, respectively. Generalized linear model analysis showed that an educational level of junior high school and above, annual family income per capita of ≥4 000 RMB, family history of hypertension, development of hypertension among family members or friends, overweight/obesity and presence of depression resulted in high scores for hypertension prevention and control knowledge; annual family income per capita of ≥10 000 RMB, family history of hypertension, presence of hypertension among family members or friends, mild/severe insomnia and presence of depression resulted in high scores for hypertension prevention and control attitude, while age of ≥65 years and blood pressure of ≥140/≥90 mmHg resulted in low scores for attitude; females, age of ≥45 years, an educational level of junior high school and above, blood pressure of ≥140/≥90 mmHg, family history of hypertension, presence of hypertension among family members or friends and overweight/obesity resulted in high scores for hypertension prevention and control practice, and residents had a low body weight had a low score for practice (all P<0.05).@*Conclusions@#The hypertension prevention and control attitude is satisfactory among rural residents in Shanxi Province; however, the hypertension prevention and control knowledge and practice are poor. Health education pertaining to hypertension prevention and control should be strengthened, and personalized health education is needed targeting individuals with a low educational level and low income.
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Objective@#To investigate the influencing factors of depressive symptoms among rural elderly patients with chronic diseases in China, so as to provide insights into depression prevention and control among the rural elderly patients with chronic diseases.@*Methods@#The basic demographics, health status, and lifestyle of rural residents at ages of 65 years and older who had at least one chronic disease were retrieved from The Chinese Longitudinal Healthy Longevity Survey (CLHLS) database in 2018, and participants' depressive symptoms were assessed with The Center for Epidemiological Studies Depression-10 (CES-D-10) scale. Factors affecting the depressive symptoms were identified with a multivariable logistic regression model. @*Results@#Totally 5 146 rural elderly patients with chronic diseases were enrolled, including 2 373 men (46.11%) and 2 773 women (53.89%). The prevalence of depressive symptoms was 27.13%. Multivariable logistic regression analysis identified having two and more children (OR=0.614, 95%CI: 0.387-0.975), living alone (OR=1.450, 95%CI: 1.192-1.764), life satisfaction (general, OR=1.933, 95%CI: 1.651-2.264; low, OR=5.366, 95%CI: 3.488-8.254), self-assessed health status (general, OR=2.697, 95%CI: 2.284-3.185; poor, OR=5.338, 95%CI: 4.262-6.685), disability in instrumental activities of daily living (OR=1.592, 95%CI: 1.328-1.908), sleep duration (normal, OR=0.502, 95%CI: 0.429-0.586; too long, OR=0.494, 95%CI: 0.405-0.603), exercise (OR=0.721, 95%CI: 0.607-0.856), watching TV (OR=0.787, 95%CI: 0.664-0.933), and gardening activities (OR=0.781, 95%CI: 0.626-0.975) as factors affecting depressive symptoms among rural elderly patients with chronic diseases.@*Conclusions@#The prevalence of depressive symptoms was 27.13% among rural elderly patients with chronic diseases. Number of children, living style, life satisfaction, health status, sleep duration, exercise, watching TV, and gardening activities are associated with the development of depressive symptoms among rural elderly patients with chronic diseases.
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Objective: To assess and compare the knowledge, attitude, and practice of mothers of pre-school children in urban and rural areas toward maintaining child oral health.Materials and Methods: A cross-sectional comparative study was conducted in a convenient sample of 400 mothers of pre-school children (aged 9 months to 3 years) visiting the outpatient department of the Department of Dentistry, Shyam Shah Medical College, Rewa (M.P), India between February 1 and April 21, 2022. The study sample was divided into two groups based on whether they belonged to a rural area (Group A) or urban area (Group B). Group A included 236 participants, and Group B 186 participants. They were served a 24-item questionnaire to assess and compare their knowledge, attitude, and practice toward child oral health. The data were represented as mean and proportions, and a student t test and analysis of variance were performed.Results: In Group A and Group B, 93.64% and 98.17% mothers respectively had the knowledge of cariogenic food. While 66.10% of mothers in Group A and 73.78% in Group B were aware that regular cleaning of teeth protects against tooth decay, only 5.49% of mothers in Group B and none in Group A reported taking their children to routine dental visits; the majority (94.07% in Group A and 78.05% in Group B) had never taken their children to the dentist. Urban background was significantly associated with better knowledge, attitude, and practice scores. Mother’s’ age and education level were significantly associated with better Knowledge, Attitude, and Practice scores in both groups.Conclusion: Mothers can play an important role in promoting positive attitudes and healthy practices toward oral health care in children. Knowledge, attitude, and practice score were found to be significantly low in mothers who belonged to the rural subgroup.
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Objective:To survey the competency characteristics of rural general practitioners using behavioral event interview.Methods:The competency characteristics of rural general practitioners were extracted by literature research method, and the behavior event interviews were conducted with 18 rural general practitioners nationwide from January to April 2019. According to the interview results, the items were modified and refined. On this basis, the benchmark competencies and excellent competencies of rural general practitioners were extracted.Results:A total of 45 885-second audio recordings and 174 523-word transcripts were obtained from the interviews. Eight identification competencies and 10 benchmark competencies were extracted. Identification competencies included "professionalism, altruism and dedication, love and compassion, visiting a patient at home, establishing good relationships, achievement-oriented, having expertise, and mastering community population dynamics and health status actively". Benchmark competencies included "diagnosis and treatment of common diseases, basic medical skills, learning consciousness and ability, solving medical problems with traditional Chinese medicine, health care for focal groups, rational administration of drug, referral services, managing chronic non communicable diseases, understanding health care system and related policies, and emergency treatment ability".Conclusions:This study preliminarily obtains the identification competencies and benchmark competencies of rural general practitioners. Managers can improve the service quality of rural general practitioners according to these elements.
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@#Introduction: This study aims to provide the current situation of leprosy prevalence and clinical findings in one of the endemic regions of North Gresik City that has already achieved elimination status. Leprosy remains a public health problem in some developing countries, including Indonesia. Indonesia, with two other big countries, India and Brazil, contributed 74% of all the new leprosy cases detected. Even though Indonesia achieved the elimination target from WHO in 2018, the endemic pockets are still scattered, and new cases remain detected each year. Methods: This study is a one-decade retrospective analysis descriptive record based on newly diagnosed cases of leprosy from 2010 until 2020. We use total data sampling of all newly diagnosed leprosy cases and analyze using SPSS. Result: This study found that newly diagnosed cases of leprosy are still discovered each year. 15.7% of newly diagnosed cases were children. MB type was dominated type in this study. MB types are statistically significant in male subjects (35.5%) diagnosed more than one year after the symptoms appear. 40.7% were found with deformity when first diagnosed. Conclusion: This study reports a high rate of contracting leprosy disease in children, with 15.7% of cases. It indicates that disease transmission remains high in the community and might be out of control. The new cases diagnosed dominated with MB type, and 40.7% had deformity when first diagnosed. There was a delayed diagnosis reported that could be caused by ineffective surveillance for early diagnosing new cases.
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Objective@#To investigate the influencing factors of infectious disease-specific health literacy (IDSHL) among rural residents in Dongxiang Autonomous County, and to construct a nomogram-based model for prediction of IDSHL.@*Methods@#Totally 1 250 rural residents at ages of 15 years and older were sampled from Dongxiang Autonomous County using a stratified random sampling method. Participants' IDSHL was evaluated using the IDSHL Assessment Scale among Chinese Residents, and factors affecting the participants' IDSHL were identified using a multivariable logistic regression model. A nomogram-based model was created, and the predictive effectiveness of this model was evaluated using the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test and C-index.@*Results@#A total of 1 223 valid respondents were enrolled, including 687 men (56.17%) and 536 women (43.83%), and the proportion of IDSHL was 48.48%. Multivariable logistic regression analysis identified age (reference: 60 years and older; 30 to <40 years: OR=4.273, 95%CI: 2.397-7.617; 40 to <50 years: OR=3.938, 95%CI: 2.238-6.928), education level (reference: illiteracy/semi-illiteracy; primary school: OR=2.140, 95%CI: 1.456-3.144; high school/vocational high school/technical secondary school: OR=2.914, 95%CI: 1.652-5.138; junior college and above: OR=4.514, 95%CI: 2.261-9.011), healthcare seeking/medications in the past 2 weeks (reference: yes; no: OR=2.025, 95%CI: 1.346-3.046), self-rated health (reference: good; generally: OR=0.603, 95%CI: 0.376-0.966; poor: OR=0.462, 95%CI: 0.284-0.751) and daily average duration spent online (reference: no internet access; <1 h: OR=1.859, 95%CI: 1.306-3.437; 1 to <2 h, OR=1.996, 95%CI: 1.344-3.380; 2 to <3 h: OR=2.132, 95%CI: 1.109-3.116; 3 h and longer: OR=2.119, 95%CI: 1.175-3.390) as factors affecting IDSHL among rural residents in Dongxiang Autonomous County. The area under the ROC curve of the model was 0.774 (95%CI: 0.741-0.807) and the model had high calibration and differentiation levels [Hosmer-Lemeshow test: χ2=13.276, P=0.103; internal model validation (bootstrapping): mean absolute error=0.019; C-index=0.764].@*Conclusions@#Age, education level, healthcare seeking/medications in the past 2 weeks, self-rated health status and daily average duration spent online are factors affecting IDSHL among rural residents in Dongxiang Autonomous County. The nomogram model created based on these factors has a high efficiency and applicability for prediction of IDSHL among rural residents in Dongxiang Autonomous County.
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Objective: Early detection and effective management of high-risk pregnancies can substantially contribute to the reduction of adverse maternal and fetal outcomes. This study aimed to determine the prevalence and clinical profile of women with high-risk pregnancies in rural areas who utilize antenatal services in a primary health center (PHC).Materials and Methods: A retrospective analysis was carried out over a six-month period by reviewing the mother and child protection cards maintained at the PHC’s Maternal and Child Health Center. During the study period, 950 pregnant women were registered, of whom 793 were included in the study based on the completeness of the records. Data analysis was performed using the licensed Statistical Package for the Social Sciences (SPSS) software version 21.0.Results: The prevalence of high-risk pregnancy among the antenatal women was 272 (34.3%) with 95% CI [31.1–37.7]. Of the 272 women, 240 (88.2%) had a single high-risk factor, while 32 (11.8%) had more than one high-risk factor. The major factor contributing to high-risk pregnancy was hypothyroidism (43.7% with 95% CI [37.9–49.6]), followed by a previous lower segment Caesarean section (LSCS) (19.1%).Conclusion: The study found that the prevalence of high-risk pregnancies was 34.3% in this rural setting. The majority of high-risk pregnancies were due to hypothyroidism, followed by more than one previous LSCS or abortion. Further research is required to track high-risk pregnancy outcomes and investigate the newborn thyroid profile of women with hypothyroidism.