Analysis of the effect of using integrated health education to nurse elderly patients with hypertension in institutions in poor areas / 中国实用护理杂志

Objective To analyze the effect of applying KTH [knowledge-attitude-belief practice model (KABP model), transtheoretical model of behavior (TTM) and health belief model (HBM)] integrated health education into nursing of elderly patients with hypertension in institutions in poor areas. Methods KTH integrated health education was established. Before the intervention and 12 weeks after intervention, the Questionnaire of Hypertension Knowledge, the Primary Hypertension Patients′Compliance Scale and Chinese version of the World Health Organization Quality of Life Questionnaire (WHOQOL-100) were used to investigate 84 cases of elderly patients with hypertension of four pension institutions in three poverty-stricken counties of Chaoyang city. Results After 12 weeks of intervention, the awareness rate of hypertension knowledge, compliance behavior and quality of life scores were higher than those before intervention, the complete awareness rate was 100.0% (84/84) vs. 3.5% (3/84);the high level of compliance behavior was 48.8%(41/48) vs.15.5%(13/84),the difference was significant (χ2=156.41, 86.27, P<0.01). The total score of quality of life was 86.95±5.41, higher than that before the intervention (76.93±6.60), the difference was statistically significant (t=8.662, P<0.01). Conclusions KTH integrated health education is an effective way to be applied in pension institutions of poor areas.

Personnel turnover in county-level healthcare institutions in poor rural areas from 2002 to 2006 / 中华医院管理杂志

ObjectiveTo probe into the HR development of healthcare professionals in poor rural areas. Methods51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. ResultsThe number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.

Qualitative study on health care seeking behavior of impoverished rural residents in Zhongxian Village / 重庆医科大学学报

Objective:The purpose of this paper is to study the utilization condition of basic medical service of rural residents in Zhongxian Village,especially the vulnerable groups,and to provide evidence for making suggestions.Methods:The individual interview was created to investigate the rural residents of 24 families in Zhongxian Village.The second data of the third investigation of health care service in Chongqing was also used.Results:The low income and poor health care awareness are vital factors influenting the utilization of health care.Conclusions:In order to improve the health level of rural residents,we should improve the medical quality of working staffs,make more health care knowledge known to the rural residents and promote the establishment of medical and health security system in rural areas.

Medical care expenditure of residents in urban poor area / 영남의대학술지

This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered q'iestionnaires completed by housewives. The survey was conducted. from , March 1 to May 31; 1992. The mean age was 31. 1 years in the poor area and 37. 1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The averge monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%). while hospital and clinic (37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2,800 Won in the poor area and 6.300 Won in the control area.

Morbidity pattern of residents in urban poor area by health screening / 영남의대학술지

The purpose of this study was to assess the morbidity pattern of urban residents in the poor area by health screening for the community diagnosis. The items of health screening were history taking and physical examination by medical doctor and hearing test, check blood pressure, test for hematocrit, liver function (sGOT, sGPT), urine sugar and protein, and chest X-ray. The examinee in health screening were 437 persons and they occupied 16.9% of total residents in the poor area. Male examinee were 129 persons (9.9% of total residents) and female examinee were 308 persons (23.9% of total residents). Age group of above sixty years old, 42.0% of total residents in the poor area were participated, but only 5.9% were participated in age group of 10 to 19 years old. Among the 437 examinee, 191 persons (43.7%) had one or more abnormal findings in health screening. In male 38.7% had abnormal findings, and somewhat lower than that of female (45.8%). Age group of above sixty years had most high rate of abnormal findings (69.8%), in contrast to age group of 10 to 19 years old (10.9%). Diseases of the digestive system was the most common and which occupies 23.7% of total abnormal findings. And diseases of the circulatory system occupied 19.7%. Low hematocrit (14.6% of total participants of 437 persons) occupies the most common abnormal findings for screening test (hematocrit, blood pressure, hearing test, sGOT/sGPT, urine protein and urine sugar, chest X-ray) and high blood pressure (10.1%) occupied second, third; hearing impairment (5.5%), fourth; abnormal liver function (4.1%), fifth; sugar in urine (2.3%), sixth; protein in urine (1.4%) and lastly abnormal chest X-ray (0.9%). The positive rate of abnormal findings in health screening was very high compared with morbidity rate by health interview. It is supposed that some portion of this high rate is by selection bias in examinee in health screening specially high participating rate in older age, and the other portion is due to the low socioeconomic status and bad environment of the residents of the poor area. These findings will be good information for the research and development of health care system in the urban poor area.

Child Rearing Practice of Working Mothers in a Poor Area of Pusan / 예방의학회지

To identify the problems in child rearing practice of employed mothers in urban poor area, all of 201 women with children under 6 years old living in Yun San 3 Dong, a poor area of Pusan city, were interviewed with a questionnaire by a trained interviewer from 10th April to 10th May 1989. Among 201 women, 51 women were employed and 150 women were unemployed. Of the employed mothers 78.5% got their jobs because of economical need and 31.4% of them worker for 60-69 hours per week. Their average monthly income was 100,000-190,000 Won in 33.4% and 200,000-290,000 Won in 25.4%. Breast milk was fed in 66.0% of the children of unemployed mothers while 49.0 of the children of the employed mothers were breast-fed (p<0.05). The most common reason for not breast feeding was shortage of breast milk among unemployed mothers (58.9%) but that of the employed mothers was their job(63.6%). The basic immunization for children was completed in 70.5% of children of employed mothers as compared with 82.0% of the children of the unemployed mothers were completely immunized (p<0.1). Accident experience rate of children among the employed mothers was 23.5% and that of the children of the unemployed mothers was 17.3%. The most common cause of accident in children of the unemployed mothers was carelessness while they were playing(34.6%) but in children of the employed mothers it was traffic accident(25.0%) and falling(25.0%). Most of the traffic accidents took place while the children's brother or sister of age under 14 years were baby sitting. When the accident took place 73.1% of the unemployed mothers were just at home, but 58.3% of the employed mothers were out of home for work. In case of the employed mothers, 58.7% of their children were looked after by an adult mainly grandparents, 15,7% by the children's brothers and sisters under 14 years old, and 3.9% of the children were left alone. A majority of the unemployed mothers wanted to get a job if someone could take care of their children. To facilitate the women employment and for the safety and health of the children, good nurseries for working mothers need to be established at a cost they can afford.