Previne brasil e financiamento da atenção primária: facilidades e dificuldades de gestores municipais de saúde / Previne Brasil and primary care financing: facilities and difficulties for municipal health managers / Previne Brasil y financiamiento de la atención primaria: facilidades y dificultades para los gestores municipales de salud

Objetivo: compreender as facilidades e dificuldades enfrentadas por gestores municipais de saúde com o novo modelo de financiamento da Atenção Primária à Saúde. Método: estudo qualitativo, tipo Pesquisa Convergente Assistencial, fundamentado na Política Nacional de Atenção Básica. Participaram 77 gestores ou seus representantes, de 47 municípios de uma Macrorregião de saúde de Santa Catarina, Brasil. Foram realizadas três oficinas nas Gerências Regionais de Saúde, em agosto e setembro de 2022. Os dados foram analisados pela análise de conteúdo. Resultados: apresentam-se como facilidades do Previne Brasil informatização, comprometimento dos profissionais, e qualificação do cuidado. Foram descritas como dificuldades falta de informações, sistema informatizado e denominador estimado e, equipe de trabalho. Conclusão: o programa apresenta facilidades que qualificam o processo de trabalho e cuidado à saúde da população. Contudo, persistem dificuldades que devem ser consideradas pela gestão municipal para avanços na atenção integral e no financiamento da Atenção Primária à Saúde.

Objective: understand the facilities and difficulties faced by municipal health managers with the new Primary Health Care financing model. Method: this is a qualitative study, of the Convergent Care Research type, based on the National Primary Care Policy. The participants were 77 managers or their representatives from 47 municipalities in a health Macroregion in Santa Catarina, Brazil. Three workshops were held in the Regional Health Departments in August and September 2022. The data was analyzed using content analysis. Results: Previne Brasil's facilities include computerization, commitment of professionals, and qualification of care. Difficulties were described as lack of information, computerized system and estimated denominator, and work team. Conclusion: the program offers facilities that improve the work process and health care for the population. However, there are still difficulties that must be considered by municipal management in order to make progress in comprehensive care and Primary Health Care financing.

Objetivo: comprender las facilidades y dificultades que enfrentan los gestores municipales de salud con el nuevo modelo de financiamiento de la Atención Primaria de Salud. Método: estudio cualitativo, tipo Investigación Convergente Asistencial, basado en la Política Nacional de Atención Primaria. Participaron 77 gestores o sus representantes, de 47 municipios de una Macrorregión de salud de Santa Catarina, Brasil. Se realizaron tres talleres en las Gerencias Regionales de Salud, en agosto y septiembre de 2022. Los datos fueron analizados mediante análisis de contenido. Resultados: las instalaciones de Previne Brasil incluyen informatización, compromiso de los profesionales y calificación de la atención. Las dificultades fueron descritas como falta de información, sistema informatizado y denominador estimado y equipo de trabajo. Conclusión: el programa presenta facilidades que cualifican el proceso de trabajo y la atención de la salud de la población. Sin embargo, aún hay dificultades que la gestión municipal debe considerar para lograr avances en la atención integral y el financiamiento de la Atención Primaria de Salud.

Empoderamento estrutural: potencializando as competências dos enfermeiros de um hospital de alta complexidade / Structural empowerment: enhancing the skills of nurses in a high-complexity hospital / Empoderamiento estructural: potenciar las competencias de los enfermeros en un hospital de alta complejidad

Objetivo: analisar o empoderamento estrutural de enfermeiros em um hospital de alta complexidade. Métodos: estudo quantitativo, analítico e transversal, realizado com 93 enfermeiros, utilizando um questionário sociodemográfico e ocupacional e o Questionário de Condições de Eficácia no Trabalho II. Os dados foram coletados entre fevereiro e março de 2023. A análise dos dados deu-se por meio de estatística descritiva, teste de Kolgomorov-Smirnov, teste do qui-quadrado e regressão de Poisson. Resultados: os enfermeiros apresentaram nível moderado de empoderamento estrutural, com média de 20,67 (p<0,000). O componente mais pontuado foi a oportunidade (4,22 dp±0,80). Não foram encontradas diferenças significativas nos níveis de empoderamento estrutural relacionadas às unidades de trabalho (p-Valor 0,381), vínculo empregatício (p-Valor 0,352) e grau de instrução (p-Valor 0,839). O modelo de regressão de Poisson indica que tanto pode haver altos ou baixos níveis de empoderamento a depender do setor. Conclusão: os enfermeiros demonstraram possuir níveis moderados de empoderamento estrutural.

Objective: to analyze the structural empowerment of nurses in a high-complexity hospital. Methods: a quantitative, analytical, cross-sectional study was carried out with 93 nurses, using a sociodemographic and occupational questionnaire and the Questionnaire of Conditions of Effectiveness at Work II. The data was collected between February and March 2023. The data was analyzed using descriptive statistics, the Kolgomorov-Smirnov test, the chi-square test, and Poisson regression. Results: the nurses had a moderate structural empowerment level, with a mean of 20.67 (p<0.000). The highest scoring component was opportunity (4.22 sd±0.80). No significant differences were found in the structural empowerment levels related to work units (p-Value 0.381), employment relationship (p-Value 0.352) and education level (p-Value 0.839). The Poisson regression model indicates that there can be either high or low empowerment levels depending on the sector. Conclusion: nurses showed moderate structural empowerment levels.

Objetivo: analizar el empoderamiento estructural del enfermero en un hospital de alta complejidad. Métodos: estudio cuantitativo, analítico y transversal, realizado con 93 enfermeros, utilizando un cuestionario sociodemográfico y ocupacional y el Cuestionario de Condiciones de Efectividad en el Trabajo II. Los datos se recolectaron entre febrero y marzo de 2023. El análisis de los datos se realizó mediante estadística descriptiva, prueba de Kolgomorov-Smirnov, prueba de chi-cuadrado y regresión de Poisson. Resultados: los enfermeros presentaron un nivel moderado de empoderamiento estructural, la media fue de 20,67 (p<0,000). El componente con mayor puntaje fue oportunidad (4,22 DE±0,80). No se encontraron diferencias significativas en los niveles de empoderamiento estructural relacionados con las unidades de trabajo (valor p 0,381), la relación laboral (valor p 0,352) y el nivel de formación (valor p 0,839). El modelo de regresión de Poisson indica que pueden existir niveles altos o bajos de empoderamiento dependiendo del sector. Conclusión: los enfermeros demostraron niveles moderados de empoderamiento estructural.

Development and Evaluation of a Software Designed by a Nursing and Technology Team to Assess the Health Status of Adults over 65 Years of Age / Desarrollo y evaluación de un software diseñado por un equipo de enfermería y tecnología para la valoración del estado de salud de los adultos mayores de 65 año / Desenvolvimento e avaliação de um software desenvolvido por uma equipe de enfermagem e tecnologia para avaliação do estado de saúde de adultos com mais de 65 anos

Objective. This work sought to develop the Actuasalud platformas a useful tool for nursing that permits assessing health, in term of frailty, in population over 65 years of age. Methods. For the design and development of Actuasalud, two working groups were formed: one from nursing with different profiles, to identify the scientific content and a computer science group responsible for the software programming and development. Both teams adapted the scientific content to the technology so that the tool would allow for population screening with detection of health problems and frailty states. Results. The software was developed in three large blocks that include all the dimensions of frailty: a) sociodemographic variables, b) comorbidities, and c) assessment tools of autonomy-related needs that evaluate the dimensions of frailty. At the end of the evaluation, a detailed report is displayed through bar diagram with the diagnosis of each of the dimensions assessed. The assessment in the participating elderly showed that 44.7% (n = 38) of the population was considered not frail, and 55.3%; (n = 47) as frail. Regarding associated pathologies, high blood pressure (67.1%; n = 57), osteoarthritis and/or arthritis (55.3%; n = 47), diabetes (48.2%; n = 41) and falls during the last year (35.3%; n = 30) were highlighted. Conclusion.Actuasalud is an application that allows nursing professionals to evaluate frailty and issue a quick diagnosis with ordered sequence,which helps to provide individualized care to elderly individuals according to the problems detected during the evaluation.

Objetivo. Desarrollar la plataforma Actuasalud como una herramienta útil para enfermería que permita evaluar la salud, en términos de fragilidad, en población mayor de 65 años. Métodos. Para el diseño y desarrollo de Actuasalud,se constituyeron dos grupos de trabajo: uno de enfermería con diferentes perfiles para identificar el contenido científico y uno informático que se responsabilizó de la programación y desarrollo del software. Ambos equipos adaptaron el contenido científico a la tecnología de manera que la herramienta permitiese hacer un cribado poblacional con detección de problemas de salud y estados de fragilidad. Resultados. Se desarrolló el software en tres grandes bloques que incluyen todas las dimensiones de fragilidad: a) variables sociodemográficas, b) comorbilidades y c) herramientas de evaluación de necesidades relacionadas con la autonomía que evalúan las dimensiones de fragilidad. Al finalizar la evaluación, se visualiza un informe detallado mediante diagrama de barras con el diagnóstico de cada una de las dimensiones evaluadas. La evaluación en los mayores participantes mostró que el 44.7% (n = 38) de la población se consideró como no frágil, y un 55.3%; (n = 47) como frágiles. En cuanto a las patologías asociadas, destacaron hipertensión arterial (67,1 %; n = 57), artrosis y/o artritis (55.3%; n = 47), diabetes (48.2 %; n = 41) y caídas en el último año (35,3 %; n = 30). Conclusión.Actuasalud es una aplicación que permite a los profesionales de enfermería evaluar fragilidad y emitir un diagnóstico de forma ágil con secuencia ordenada que ayuda a brindar cuidados individualizados a personas mayores de acuerdo los problemas detectados en la evaluación.

Objetivo. Desenvolver a plataforma Actuasalud como uma ferramenta útil para a enfermagem que permite avaliar a saúde, em termos de fragilidade, numa população com mais de 65 anos. Métodos. Para a concepção e desenvolvimento do Actuasalud foram formados dois grupos de trabalho: um grupo de enfermagem com perfis diferentes, para identificar o conteúdo científico, e um grupo de informática que foi responsável pela programação e desenvolvimento do software. Ambas as equipas adaptaram o conteúdo científico à tecnologia para que a ferramenta permitisse o rastreio da população para detectar problemas de saúde e estados de fragilidade. Resultados. O software foi desenvolvido em três grandes blocos que incluem todas as dimensões da fragilidade: a) variáveis sociodemográficas, b) comorbidades ec) instrumentos de avaliação de necessidades relacionadas à autonomia que avaliam as dimensões da fragilidade. Ao final da avaliação é apresentado um relatório detalhado através de um diagrama de barras com o diagnóstico de cada uma das dimensões avaliadas. A avaliação nos idosos mostrou que 44.7% (n=38) da população foi considerada não frágil e 55.3%; (n=47) como frágil. Quanto às patologias associadas, destacaram-se a hipertensão arterial (67.1%; n=57), a osteoartrite e/ou artrite (55.3%; n=47), a diabetes (48.2%; n=41) e as quedas no último ano (35.3%; n=30). Conclusão. Actuasalud é um aplicativo que permite ao profissional de enfermagem avaliar a fragilidade e emitir um diagnóstico de forma ágil e com sequência ordenada que auxilia no atendimento individualizado ao idoso de acordo com os problemas detectados na avaliação.

Impact of dysmenorrhea on urban school girls in Tanzania: the need for a comprehensive menstrual health management guideline

Background: Menstrual health management is poorly understood by school girls in most low-income countries. Water, sanitation, and hygiene facilities are essential for the proper management of menstruation. Dysmenorrhea should also be considered. The current study investigated knowledge of menstrual hygiene and the prevalence of dysmenorrhea among school girls in a city in Southern Highland Tanzania. Methods: A cross-sectional study was conducted in Mbeya city in the southern highlands of Tanzania. 292 high school girls were randomly selected from three schools. Data were collected using a pre-tested structured questionnaire. The data were initially entered into the computer using Epi-info version 3.5.1 and later exported to SPSS for Windows version 20.0 for analysis. Multivariate analyses were performed with a 95% confidence interval. The significance level was set at p?0.05. Results: The mean age of the participants was 18.02±1.34 years. 68.49% had a good knowledge of menstrual hygiene (mean knowledge level; 64.64±9.13%) and 91.78% had good menstrual hygiene practices (mean score; 89.32±13.7%). Delayed age of menarche and years of menstruation were associated with good menstrual practices, OR; 3.94, 95% CI 1.49-10.72, p=0.006. 56.5% reported having moderate to severe menstrual pain. Conclusions: Most participants had good knowledge and practice of menstrual hygiene, however, the level of knowledge was lower than practice. The majority suffer from unbearable menstrual cramps that adversely affect their studies. There is an urgent need for a comprehensive guideline for menstrual health management in schools that takes into account knowledge, practice, and pain management.

Implementação de melhorias na atenção primária à saúde: protocolo de enfermagem e gerenciamento de unidades / Implementation of improvements in primary health care: nursing protocol and unit management / Implementación de mejoras em la atención primaria de salud: protocolo de enfermería y gestión de la unidad

Objetivo: Descrever a experiência da elaboração do Protocolo de Enfermagem da Atenção Primária e o gerenciamento das Unidades Básicas de Saúde de Rio Branco ­ Acre. Métodos: Trata-se de um relato de experiência, sobre a elaboração de um Protocolo, instrumento potente para a implementação de melhorias e a gerência de Unidades Básicas de Saúde. A elaboração do protocolo foi realizada por etapas: Etapa 1: Composição da Comissão; Etapa 2: Pesquisa e Construção; Etapa 3: Consulta Pública; Etapa 4: Finalização da Construção. Resultados: Foi constituído uma comissão de elaboração do protocolo. Foi observado a implementação de melhorias na assistência prestada à população durante o período de execução do projeto. A frente do gerenciamento das Unidades Básicas de Saúde, foi possível vivenciar de perto o cenário da Atenção Primária à Saúde, (financiamentos, composição de equipes e atributos), conhecer a capacidade gerencial e política para organização da assistência à saúde, como também implementar melhorias relacionadas à gestão da clínica e diretrizes clínicas. Conclusão: A elaboração e implementação de um Protocolo de Enfermagem da Atenção Primária agrega não apenas conhecimento para a prática, vislumbra mais valorização profissional, onde possibilita o rompimento de uma barreira centrada na figura médica, ao atribuir à enfermagem papel relevante e conquistada, com protocolos de atendimento capazes de suprir as demandas existentes nas Unidades. Além de permitir o fortalecimento, visibilidade técnica, científica e a ampliação do acesso às pessoas à Atenção Primária à Saúde como parte significativa e resolutiva pela enfermagem. (AU)

Objective: To describe the experience of elaborating the Primary Care Nursing Protocol and the management of Basic Health Units in Rio Branco ­ Acre. Methods: This is an experience report on the elaboration of a Protocol, a powerful instrument for implementing improvements and managing Basic Health Units. The preparation of the protocol was carried out in stages: Stage 1: Composition of the Committee; Stage 2: Research and Construction; Stage 3: Public Consultation; Step 4: Completion of Construction. Results: A protocol drafting committee was set up. The implementation of improvements in the assistance provided to the population during the project execution period was observed. Ahead of the management of Basic Health Units, it was possible to experience the Primary Health Care scenario closely, (financing, composition of teams and attributes), to know the managerial and political capacity for the organization of health care, as well as to implement related improvements. clinic management and clinical guidelines. Conclusion: The elaboration and implementation of a Primary Care Nursing Protocol adds not only knowledge to practice, it envisions more professional appreciation, which makes it possible to break a barrier centered on the medical figure, by attributing a relevant and conquered role to nursing, with protocols services capable of meeting the existing demands in the Units. In addition to allowing the strengthening, technical and scientific visibility and the expansion of people's access to PHC as a significant and decisive part of nursing. (AU)

Objetivo: Describir la experiencia de elaboración del Protocolo de Enfermería de Atención Primaria y la gestión de Unidades Básicas de Salud en Rio Branco ­ Acre. Métodos: Este es un relato de experiencia sobre la elaboración de un Protocolo, un poderoso instrumento para implementar mejoras y gestionar Unidades Básicas de Salud. La elaboración del protocolo se realizó por etapas: Etapa 1: Composición del Comité; Etapa 2: Investigación y Construcción; Etapa 3: Consulta Pública; Paso 4: Finalización de la construcción. Resultados: Se constituyó una comisión de elaboración del protocolo. Se observó la implementación de mejoras en la asistencia prestada a la población durante el periodo de ejecución del proyecto. Frente a la gestión de las Unidades Básicas de Salud, fue posible vivir de cerca el cenário de la Atención Primaria de Salud (financiación, composición de equipos y atributos), conocer la capacidad gerencial y política para la organización de la asistencia a la salud, así como implementar mejoras relacionadas, con la gestión de la clínica y direcciones clínicas. Conclusión: La elaboración e implementación de un Protocolo de Enfermería de Atención Primaria aporta no sólo conocimiento a la práctica, sino que aporta mayor valorización profesional, al permitir el rompimiento de una barrera centrada en la figura médica, para atribuir a la enfermería un papel relevante y conquistado, con protocolos de atención capaces de superar las demandas existentes en las Unidades. Además de permitir el fortalecimiento, la visibilidad técnica y científica y la ampliación del acceso de las personas a la Atención Primaria de Salud como parte significativa y resolutiva por parte de la enfermería. (AU)

Atividades de educação permanente dos estudantes de graduação em enfermagem: um recorte temporal / Continuing education activities of undergraduate nursing students: a time frame / Actividades de educación continua de enfermería de pregrado: um marco de tiempo

Objetivo: Classificar atividades de educação permanente realizadas por estudantes de Graduação em Enfermagem segundo o Projeto Pedagógico do Curso. Métodos: Estudo documental, de abordagem quantitativa, com um recorte temporal circunscrito entre os anos de 1999 e 2010. Foram incluídos trabalhos produzidos por estudantes da quarta série do Curso de Graduação em Enfermagem de uma Instituição de Ensino Superior Federal localizada na zona sul do município de São Paulo, Brasil. Os arquivos estavam armazenados fisicamente numa das salas do departamento de Administração desta mesma instituição. Os documentos foram lidos e catalogados de acordo com as seguintes variáveis: ano, realização ou não do treinamento, grande área e unidades curriculares do Projeto Pedagógico do Curso e estratégia de ensino utilizada. Os dados foram organizados e armazenados eletronicamente, e submetidos à análise estatística descritiva. Resultados: Foram analisados 425 trabalhos, e 416 treinamentos foram realizados, correspondendo a 97,9%. Em relação às unidades curriculares 52,2% (n=217) pertenceu a "Fundamentos do cuidado em Enfermagem II". A estratégia mais utilizada foi aula expositiva com 36,1% (n=150). Conclusão: Conclui-se que é importante investir em metodologias ativas de ensino para a educação permanente desde a formação do estudante. (AU)

Objective: To classify continuing education activities carried out by Nursing Undergraduate students according to the Course's Pedagogical Project. Methods: Documentary, with a quantitative approach, with a time frame of one year from 1999 to 2010. from São Paulo, Brazil. Administration packages physically stored in one of the department rooms of this same institution. The documents were read and cataloged according to the following variables: year, training or not, large area and curricular units of the Pedagogical Project of the Course and use strategy. Data organized and stored electronically, and selected for descriptive statistical analysis. Results: 425 works were analyzed, and 416 training sessions were carried out, corresponding to 97.9%. Regarding the curricular units, 52.2% (n=217) belong to "Fundamentals of Nursing Care II". The most used strategy was lecture with 36.1% (n=150). Conclusion: It is concluded that it is important to invest in active teaching methodologies for permanent education since the student's formation. (AU)

Objetivo: Clasificar las actividades de formación continua realizadas por estudiantes de Graduación en Enfermería de acuerdo con el Proyecto Pedagógico del Curso. Métodos: Documental, con abordaje cuantitativo, con marco temporal de un año de 1999 a 2010. de São Paulo, Brasil. Paquetes de administración almacenados físicamente en una de las salas departamentales de esta misma institución. Los documentos fueron leídos y catalogados según las siguientes variables: año, formación o no, gran área y unidades curriculares del Proyecto Pedagógico del Curso y estrategia de uso. Datos organizados y almacenados electrónicamente, y seleccionados para análisis estadístico descriptivo. Resultados: Se analizaron 425 trabajos y se realizaron 416 capacitaciones, correspondiente al 97,9%. En cuanto a las unidades curriculares, el 52,2% (n=217) pertenecen a "Fundamentos del Cuidado de Enfermería II". La estrategia más utilizada fue la conferencia con 36,1% (n=150). Conclusión: Se concluye que es importante invertir en metodologías de enseñanza activa para la formación permanente desde la formación del estudiante. (AU)

Conhecimento de graduandos de uma universidade privada da Região Nordeste do Brasil sobre gestão de consultório odontológico: estudo observacional / Conocimientos de estudiantes de una universidad privada de la Región Nordeste de Brasil sobre la gestión del consultorio odontológico: estudio observacional / Knowledge of undergraduates from a private university in Northeast Brazil regarding dental office management: an observational study

Em um mercado de trabalho competitivo onde é vital que os profissionais se reinventem para agregar valor aos seus clientes, o grande desafio está na capacidade do cirurgião-dentista desenvolver tanto competências clínicas quanto técnicas de gestão para minimizar o risco de insucesso. Esta pesquisa teve como objetivo avaliar o conhecimento de estudantes do último ano do curso de Odontologia sobre gestão de consultório odontológico. Foi realizado estudo do tipo observacional, descritivo com abordagem quantitativa, que teve como cenário uma universidade privada na Região Nordeste do Brasil. A coleta de dados foi realizada por meio de questionário, abordando aspectos do conhecimento em gestão de consultório odontológico, mensurado por meio de Escala Likert. A partir de uma amostra censitária de 140 estudantes no ano de 2022, um total de 95 participaram da pesquisa. Mais de 50% dos participantes indicaram ter conhecimento sobre estruturação física do consultório. O nível de conhecimento mais elevado foi quanto à preservação dos prontuários (83,2%) e obrigatoriedade de ter um responsável técnico (81,1%). No entanto, 51,5% dos participantes não se sentem confortáveis para administrar uma empresa própria e apenas 12,6% julgam ter obtido o conhecimento necessário sobremarketingodontológico durante o curso.Conclui-se que alguns aspectos gerenciais são desconhecidos pelos estudantes. A inserção ou utilização de novas abordagens pedagógicas na estratégia de ensino pode facilitar um maior conhecimento dos estudantes sobre gestão de consultório (AU).

En un mercado laboral competitivo donde es vital que los profesionales se reinventen para aportar valor a sus clientes, el gran reto reside en la capacidad del odontólogo para desarrollar tanto habilidades clínicas como técnicas de gestión para minimizar el riesgo de fracaso. Esta investigación tuvo como objetivo evaluar el conocimiento de los estudiantes de último año de Odontología sobre la gestión del consultorio odontológico. Se realizó un estudio observacional, descriptivo, con enfoque cuantitativo, ambientado en una universidad privada de la Región Nordeste de Brasil. La recolección de datos se realizó mediante un cuestionario, que aborda aspectos del conocimiento en la gestión de la práctica odontológica, medidos mediante una escala Likert. Deuna muestra censal de 140 estudiantes en el año 2022, un total de 95 participaron en la investigación. Más del 50% de los participantes indicaron tener conocimiento sobre la estructura física de la oficina. El mayor nivel de conocimiento fue sobre la conservación de la historia clínica (83,2%) y la obligación de contar con un técnico responsable (81,1%). Sin embargo, el 51,5% de los participantes no se siente cómodo gestionando su propia empresa y sólo el 12,6% cree haber obtenido los conocimientos necesarios sobre marketing dental durante el curso. Se concluye que algunos aspectos de la gestión son desconocidos por los estudiantes. La inclusión o uso de nuevos enfoques pedagógicos en la estrategia de enseñanza puede facilitar un mayor conocimiento de los estudiantes sobre la gestión de la práctica (AU).

In a competitive job market in which professionals must reinvent themselves to add value to their clients, the major challenge lies in the ability of dentists to develop both clinical skills and management techniques to minimize the risk of failure. This study assessed the knowledge of final-year dental students regarding dental office management. An observational, descriptive study with a quantitative approach was conducted in a private university in the Northeast region of Brazil. Data collection was performed by a questionnaire addressing aspects of knowledge in dental office management, measured using a Likert scale. From a census sample of 140 students in the year 2022, a total of 95 participated in the research. More than 50% of participants had knowledge about the physical structure of the dental clinic. The highest level of knowledge concerned the maintenance of patient records (83.2%) and the requirement of a technical responsible person (81.1%). However, 51.5% of participants do not feel comfortable managing their own business, and only 12.6% believe they have acquired the necessary knowledge about dental marketing during the course. It is concluded that some management aspects are unknown to the students. The incorporation or utilization of new pedagogical approaches in the teaching strategy may facilitate greater knowledgeof students about dental office management (AU).

Early characterization of an adult population at an insurer's point of entry as an opportunity to identify hospitalization risk

Introduction: Health Benefit Plan Administrators must manage the health risk of their members. Therefore, health characterization is performed from enrollment to support decision-making and timely intervention. Objective: To analyze the historical results of characterizing the adult population on admission to the insurance company in relation to the demand for all-cause and psychiatric hospitalization services. Materials and Methods: An observational cross-sectional study with members over 18 years of age, in which an analysis was made of the characterization of the adult population of the insurer and its association with the use of medical consultation services in primary care and all-cause and psychiatric hospitalizations. Bivariate and multivariate analysis was made, and odds ratios (OR) were calculated in logistic regression. Results: Variables significantly associated with having an all-cause hospitalization were identified: having referred history of heart disease OR=1.71(95%CI: 1.33; 2.20), respiratory disease OR= 1. 30(95%CI: 1.04; 1.61), chronic kidney disease OR=1.66(95%CI: 1.13; 2.45), cancer OR=1.65(95%CI: 1.14; 2.40), taking any medication permanently OR=1.35(95%CI: 1.174; 1.56) and smoking OR=1.44(95%CI: 1.12; 1.85). For psychiatric hospitalizations, a history of discouragement, depression, or little hope was relevant with OR=5.12(95%CI: 1.89; 13.87). Discussion: The characterization of patients during enrolment allowed the identification of predictor variables of hospitalization, guiding management from the primary care level minimizing costs and catastrophic health events. Conclusion: The timely identification of specific patient profiles allows timely actions to minimize health costs and catastrophic health events.

Investigation and study of factors related to NCD health management of basic public health services in Chongqing and Guizhou Province / 重庆医学

Objective To analyze the health management situation of non-communicable chronic disease(NCD)in Chongqing City and Guizhou Province and its influencing factors.Methods A stratified random sampling method was used to select 16 representative primary medical and health institutions from Chongqing City and Guizhou Province as the research sites,and the data were collected through the combination method of qualitative and quantitative research.Results A total of 760 patients with NCD were surveyed,and the awareness rate,utilization rate and satisfaction rate of the NCD health management program all exceeded 84.2％,while the awareness rate,utilization rate and satisfaction rate of follow-up and categorical intervention were the lowest.The awareness rate of hypertension physical examination in the patients with＜60 years old was lower than that in the patients with 60-＜70 years old(OR=4.28,95％CI:1.43-12.81)and the pa-tients with ≥70 year sold(OR=3.16,95％CI:1.12-8.91);the utilization rate of diabetes screening in the patients with＜60 years-old was lower than that in the patients with ≥70 years old(OR=2.70,95％CI:1.08-6.76)and the awareness rate of hypertension physical examination was lower than that of the patients with 60-＜70 years old(OR=4.24,95％CI:1.01-17.75);the awareness rate of hypertension physical ex-amination in the patients in Chongqing City was higher than that in Guizhou Province(OR=0.15,95％CI:0.04-0.54)and the utilization situation was better than that in Guizhou Province(OR=0.13,95％CI:0.05-0.34).Conclusion The overall situation of NCD management services in Chongqing City and Guizhou Province is good,but the service quality of follow-up and classified intervention projects needs to be further improved.

Reflection on the discipline construction of medical care and health management of the elderly / 沈阳医学院学报

With the continuous deepening of aging in our country,the demand and importance of medical care and health management of the elderly are becoming more and more prominent,and the construction of discipline system of medical care and health management of the elderly provides powerful talent support for promoting the development of aging cause and the development of medical care and health industry.However,there are still many shortcomings in the professional construction and talent cultivation in the field of medical care and health management of the elderly in our country.Universities are still exploring and practicing in this area,and there is an urgent need to strengthen the construction of disciplinary systems and promote the development of the medical care and health industry.This paper introduces the construction of discipline system of medical care and health management of the elderly,analyzes the existing problems,looks forward to its future development direction,and elaborates the specific measures and characteristics in the construction of discipline system of medical care and health management of the elderly.

The role of home medical and nursing care team in the service system for home disabled elderly / 沈阳医学院学报

Objective:To analyze the role of home medical and nursing care team in the service system of home disabled elderly.Methods:A total of 100 home disabled elderly managed by our hospital from Jan to Dec 2022 were enrolled,and the home medical and nursing care teams strengthened home rehabilitation nursing services and guidance,health risk guidance,psychological support,and nutrition guidance and intervention.The management results before and after intervention was compared.Results:After intervention,the mastery of health risk management,psychological support and nutritional intervention,and the compliance rate of rehabilitation exercise were higher than those before intervention(P＜0.05).The incidence of pressure injury was lower than that before intervention(P＜0.05).After intervention,the satisfaction rate of the elderly to the work of the home medical and nursing care team was 95%.Conclusion:Home medical and nursing care team plays an important role in the nursing service system of the disabled elderly,and play an important role in the construction of a three-level service health management system of institution-community-home.

Implement quality control circle activities to improve customer satisfaction / 现代医院

Objective To study the application effect of quality control circle(QCC)in reducing the dissatisfaction rate of physical examination clients in health management center.Methods To establish QCC,selected the health check-up popula-tion in our hospital in September-2019 and March-2020,through the questionnaire investigation and analysis,compare the dis-satisfaction of the clients before and after the quality control circle.Results After carrying out QCC activities,the dissatisfaction of physical examination clients was significantly lower than that before QCC,and the difference was statistically significant(P＜0.05).Conclusion The activities of QCC in the health management center can effectively improve the quality of the physical examination work and reduce the dissatisfaction of the customers in the physical examination.It is of great significance to the health management.

Research progress on community health management models for elderly hypertensive patients / 现代医院

Objective Summarize domestic and international community health management models and characteristics for elderly hypertensive patients,providing references for the development of community health management in China.Methods Employ literature research to retrieve relevant documents on community health management models for elderly hypertensive pa-tients,and analyze the characteristics and applicability of different models through summarization and comparative analysis.Results In China,community health management models for elderly hypertensive patients include family doctor contracting serv-ices,Hospital-Community-Home health management model,traditional Chinese medicine health management model,"Internet+"health management model,PDCA cycle model,PRECEDE-PROCEED model,and comprehensive community management model.Foreign studies can be categorized into self-management model,Health Rise model,Community Health2(CH2)model,and community pharmacy management model.Conclusion Conducting hypertension health management for elderly patients at the community level is effective,serving as a widely applicable strategy for chronic disease prevention and control.Continued ex-ploration of the scientific and effective aspects of different management models,improving the efficiency and effectiveness of com-munity health management,can contribute more evidence for the formulation of scientific and effective strategies for chronic dis-ease prevention and control.

Clinical characteristics and management strategies of chronic obstructive pulmonary disease in high-altitude areas / 中华健康管理学杂志

Objective:To study the clinical characteristics and management strategies of patients with chronic obstructive pulmonary disease (COPD) in high-altitude areas.Methods:An observational cross-sectional study was conducted in 79 stable COPD patients who visited the outpatient of Respiratory Medicine at Tibet Autonomous Region People′s Hospital and Peking University Third Hospital from August 3 rd 2020 to November 30 th 2020. Patients were divided into Lhasa group ( n=44) and Beijing group ( n=35). The differences of clinical characteristics including demographic characteristics, risk factors, respiratory symptoms, comorbidities, medications and spirometry were analyzed. Further comparative analysis was conducted on the clinical characteristics of smokers ( n=15) and non-smokers ( n=29) in Lhasa group. Results:The proportion of female patients and biofuel exposure in Lhasa group was significantly higher than Beijing group (56.8% vs 0, 86.4% vs 0, both P<0.001). The proportion of smokers in Lhasa group was significantly lower than Beijing group (34.1% vs 100%, P<0.001). The mean score of COPD assessment test (CAT) in Lhasa group was significantly higher than Beijing group (21.27 vs 9.17, P<0.001). The proportion of acute exacerbations ≥2 in the past year in Lhasa group was significantly higher than Beijing group (31.8% vs 11.4%, P=0.032). The median percentage of forced vital capacity in the first second of predicted value (FEV 1%pred) of patients in Lhasa group was significantly higher than Beijing group (63% vs 38%, P<0.001). The proportion of patients treated by inhaled corticosteroid/long-acting β 2-agonist (ICS/LABA) and inhaled long-acting muscarinic antagonists (LAMA) in Lhasa group was significantly lower than Beijing group (4.5% vs 60.0%, 0 vs 65.7%, both P<0.001). There were no significant differences in CAT score, number of acute exacerbations in the past year and lung function between smokers and non-smokers in Lhasa group. Conclusions:Compared with those patients in Beijing, the majority of patients with COPD living in Lhasa are female, with a low proportion of smokers and a high proportion of biofuel exposure. Although their lung function is better, their respiratory symptoms are more severe with more acute exacerbations in the past year, and most patients do not receive standardized medication.

Construction of influencing factors model and policy recommendations for quality of primary traditional Chinese medicine health management services / 中华健康管理学杂志

Objective:To construct the impact factor model of primary traditional Chinese medicine (TCM) health management service quality, and put forward corresponding policy suggestions.Methods:In this cross-sectional study, the typical sampling and random sampling method were used to select 39 insiders of primary TCM health management service from 15 communities in Zhejiang Province from August to October in 2022. Interviews on service projects, implementation effects and impact factors were conducted, the three-level coding of interview record was carried out using the grounded theory research method, a model of impact factor for health management service quality of basic TCM was constructed, and the corresponding policy recommendations were put forward.Results:Based on the open coding of 39 original interview data, a total of 516 reference points were obtained, and 53 initial concepts related to the topic were formed and summarized into 17 first-level categories. Through the summary of main axis coding, 6 main categories of “policy environment”，“health literacy”，“community orientation”，“capacity building”，“health preference” and “conflict of interest” were extracted. The logical correlation between the six main categories were analyzed with selective coding, an impact factor model was constructed in accordance with the story line of factors affecting service quality. The story line of this model was as follows: first, the policy environment was the external guarantee of community TCM service quality; second, as the demand-side of the services, the health literacy and requirement of residents was the regulatory factor for service quality; in addition, the community played the role of the supply-side of the services, the service ability construction was the key factor, and the community functions and target orientation was the internal driving factor, meanwhile, the internal/external conflicts of interest had a negative constraint on the service quality.Conclusions:The guarantee intensity of external policy environment is limited, the service demand side pays insufficient attention, and the service supply side functions are absent at the present stage. It is necessary to improve the external policy environment, deepen the connection between supply and demand sides in the field of TCM health service, promote the capacity building of TCM service at the grass-roots level, balance the interests of relevant departments of TCM service, in order to improve the quality of TCM health management service at the grass-roots level.

Association of individual and area level socioeconomic status with depressive symptoms for older adults—evidence from China Health and Retirement Longitudinal Study / 中华健康管理学杂志

Objective:To analyze the impact of individual and regional level socioeconomic characteristics on the mental health of middle-aged and older adults based on data from the China Health and Retirement Longitudinal Study.Methods:This study was a cohort study. Using the data from the China Health and Retirement Longitudinal Study, subjects without depression were screened in the baseline survey, the depression status of the selected subjects was tracked and observed for seven years. Descriptive statistical analysis, multivariate logistic analysis, joint analysis were used to analyze the influence of factors such as gender, personal annual income, education level, urban and rural areas, and eastern, central, and western regions on the risk of depression among middle-aged and elderly people.Results:The 7-year follow-up results showed that the prevalence of depression symptoms in the study subjects was 42.24%; compared with men, women′s risk of developing depression symptoms was significantly increased ( OR=1.782); compared with junior college education and above, middle school (including technical secondary school), primary and lower education levels had a significantly increased risk of developing depression symptoms ( OR=1.476, 2.134); compared with annual income of more than 10 000 yuan, subjects with an annual income of 10 000 yuan or below had significantly increased risk of developing depression symptoms ( OR=1.251). At the same time, compared with the urban area, the risk of developing depression symptoms was significantly increased in the rural areas ( OR=1.389). Compared with the eastern area, the risk of developing depression symptoms was significantly higher in the central and western areas ( OR=1.342, 1.730). The joint analysis results showed that compared with high-income and high-education men, low-income low-education women, high-income low-education women, low-income middle-education women, and high-income middle-education women were at the top four odd ratios for developing depression symptoms ( OR=5.050, 3.662, 3.047, 2.641); compared with men in eastern cities, rural women in the west, rural women in the middle, women in the western cities, and rural women in the east ranked the first four odd ratios for developing depression symptoms ( OR=4.286, 3.216, 2.642, 2.158). Conclusion:Socioeconomic factors at the individual and regional levels have a significant impact on the risk of developing depressive symptoms in middle-aged and older adults, and mental health management of middle-aged and older adults with low socioeconomic status should be strengthened.

Current status of health management (physical examination) service capacity of medical institutions in Tianjin / 中华健康管理学杂志

Objective:To investigate and analyze the current status of health management (physical examination) service capabilities of medical institutions in Tianjin in 2021.Methods:It was a cross-sectional study. Using the census method, a questionnaire survey was conducted to obtain the health management (physical examination) service capabilities of 86 medical institutions in Tianjin in 2021. The questionnaire covered the basic information of the institution, human resources and equipment, physical examination items carried out, the annual number of people receiving physical examination, the degree of informatization, and the completion of quality control indicators. In this survey, a total of 86 questionnaires were distributed and 86 valid questionnaires were collected (100%). Mann-Whitney U test and χ2 test were used to compare the differences of health management (physical examination) indicators between public and private medical institutions, and to analyze the current health management (physical examination) service capabilities of medical institutions in Tianjin. Results:Among the 86 medical institutions included in the analysis, 53 (61.6%) were public institutions and 33 (38.4%) were private medical institutions. In terms of basic information, the proportion of comprehensive hospitals and level-3 medical institutions belonging to public institutions, as well as the time of health management (physical examination) business development, were significantly higher than those of private medical institutions [62.3% vs 30.3%, 62.3% vs 0, 11 (7, 5) years vs 7 (5, 10) years], and the proportion of independent setup of the physical examination center and the business area of health management (physical examination) were significantly lower than those of private institutions[33.3% vs 98.1%, 1 011 (600, 1 000) m 2 vs 2 000 (1 395, 2 782) m 2] (all P<0.05). In terms of practitioners, there were 2 964 health management (physical examination) practitioners in Tianjin in 2021, aged 43 (35, 56) years. The proportion of male practitioners, part-time practitioners, nurses, practitioners with intermediate professional title, chief inspection physician, health management specialist in public institutions and the time engaged in health management work of employees were all significantly higher than those in private medical institutions [20.6% vs 17.5%, 20.7% vs 8.1%, 33.8% vs 23.4%, 40.7% vs 27.3%, 7.1% vs 3.9%, 13.8% vs 4.7%, 6 (3, 11) years vs 5 (3, 8) years] (all P<0.05). In terms of business development, the implementation rates of preventive medical management, mental health management, hypertension risk management, health management contract service, pulmonary nodule management, health management intervention plan, health risk assessment, and health education programs in public institutions were significantly higher than those in private medical institutions (24.5% vs 0, 28.3% vs 0, 35.8% vs 15.2%, 39.6% vs 15.2%, 41.5% vs 12.1%, 50.9% vs 18.2%, 66.0% vs 36.4%, 83.0% vs 42.4%), and the annual health physical examination person-times, group and individual physical examination person-times in public institutions were significantly lower than those in private institutions [18 625 (11 844, 27 998) to 38 384 (10 832, 46 927), 14 818 (8 803, 23 915) to 28 663 (4 982, 41 927), 2 179 (1 221, 3 588) to 5 784 (1 461, 12 156)] (all P<0.05). Among the six quality control indicators of health examination, the completion rates of waist-hip circumference measurement in both types of institutions were low (<40%). Conclusion:Compared with public institutions, the talent echelon construction and service capability of health management (physical examination) in private medical institutions in Tianjin still needs to be improved.

Influence of IKAP health management model on nursing effect in elderly population with high cardiovascular risk in Baiyin city / 中华健康管理学杂志

Objective:To explore the influence of information-knowledge-attitude-practice (IKAP) health management model on nursing effect in elderly population with high cardiovascular risk in Baiyin city.Methods:In this non-randomized controlled trial, a total of 126 elderly population with high cardiovascular risk who received physical examination and nursing services from October 2021 to March 2022 in the Health Management Center of the First People′s Hospital of Baiyin were collected as the research subjects by cluster random sampling method. Using propensity score matching method to enroll patients in a 1∶1 ratio based on their preferred nursing methods, 63 patients receiving routine nursing were included in control group and were given routine health education and nursing (health education was given by explaining disease-related knowledge, diet and medication guidance, once a week), and 63 patients who received IKAP health management model were enrolled as IKAP group and were given IKAP health management on the basis of the control group once a week by collecting information, transmitting knowledge, changing ideas and behavior. Both groups were continuously intervened for 6 months. The psychological state [Chinese psychosomatic health scale (CPSHS)], self-efficacy [insight and treatment attitudes questionnaires (ITAQ)], quality of life [generic quality of life inventory-74 (GQOLI-74)], lifestyles (controlled diet, regular exercise, sleep difficulties, weight control) and physical health status [somatic self-rating scale (SSS)] were compared between groups before and after the intervention. The medication rate and compliance rates of blood pressure, blood glucose and blood lipid of the two groups were compared by chi-square test, and the influence of IKAP health management model on nursing effect in elderly population with high cardiovascular risk in Baiyin city was analyzed.Results:The CPSHS score, sleep difficulty rate and SSS score in both groups after intervention were all significantly lower than those before intervention [IKAP group, (19.29±4.96) vs (31.37±9.23) points, 31.75% vs 73.02%, (37.06±4.30) vs (60.16±79.83) points; control group, (22.93±7.39) vs (31.67±9.21) points, 52.38% vs 74.60%, (41.75±4.97) vs (60.04±9.95) points], and the above-mentioned indicators in IKAP group were all significantly lower than those in the control group (all P<0.05). The ITAQ score, GQOLI-74 score, diet control rate, regular exercise rate and weight control rate were all significantly higher in the two groups after intervention than those before [IKAP group, (17.65±3.65) vs (2.41±0.31) points, (83.91±6.04) vs (56.26±5.14) points, 76.19% vs 42.86%, 57.14% vs 30.16%, 71.43% vs 42.86%; control group, (14.35±3.36) vs (2.33±0.29) points, (75.25±5.78) vs (57.12±5.21) points, 57.14% vs 44.45%, 38.10% vs 28.57%, 53.97% vs 39.68%], and the above-mentioned indicators were all significantly higher in IKAP group when compared with those in the control group (all P<0.05). The compliance rates of blood pressure, blood glucose and blood lipid in IKAP group after intervention were all significantly higherthan those in the control group [(85.71% vs 68.25%, 90.48% vs 76.19%, 82.54% vs 66.67%)] (all P<0.05). Conclusion:IKAP health management model can effectively enhance the self-efficacy, correct the poor living habits, improve the psychological and physical states, help to control the blood pressure, glucose and lipid, and enhance the quality of life in elderly population with high cardiovascular risk.

Development and progress in the application of smart health technologies for older adults with mild cognitive impairment / 中华老年医学杂志

Under the backdrop of smart health management technology development, this article reviews research advances in smart monitoring, assessment and intervention technologies for older people with mild cognitive impairment, including the types, typical applications and results of monitoring, assessment and intervention technologies.In addition, from the perspective of community-dwelling older adults' cognitive health management, a model for innovative management of community-dwelling older adults' cognitive function taking advantage of smart health management technologies is proposed, aiming to enhance the acceptance of smart health technologies among older people with cognitive impairment and to provide policy advice on developing friendly communities for older people with cognitive impairment.

The importance and updated key point of ethical review in health management research： based on the Measures of Ethical Review of Life Sciences and Medical Research Involving Humans / 中国医学伦理学

The release of the Measures of Ethical Review of Life Sciences and Medical Research Involving Humans has brought new requirements to the field of ethical review in health management research. Based on the background of new regulations and combining the characteristics of the health management discipline， this paper explored the needs and necessity of ethical review in health management research. In the Measures， the ethical governance of health management research was updated， the concept of exemption from the ethical review was put forward， as well as the importance of protecting the rights and interests of research participants and the protection of personal information were emphasized. This paper also explored the ethical review framework for health management research， including the formulation of operational standards for exemption from ethical review， the refinement of standardized ethical review work systems and processes， and the clarification of information data source verification. These explorations aimed to provide an ethical guarantee for health management research， promote its healthy development， and ensure that the rights and interests of research participants are fully respected and protected. Through research， it is hoped that the ethical level of health management research can be further improved， promoting the development of the discipline and social progress.