RESUMO
Objective:To find the preferences of nursing staff when they provide " Internet + nursing service" for elderly patients.Methods:By means of the discrete choice experiment, a questionnaire was designed to investigate the preferences of nursing staff when they provide " Internet + nursing services" for elderly patients. In-service nursing staff from 8 medical and health institutions in Ningbo city and Wenzhou city were selected by random sampling, for an online questionnaire survey conducted from May to June 2022. The preferences of nursing staff on their service income, service content, service distance, service continuity and residence status of elderly patients when providing " Internet + nursing service" were analyzed by mixed logit regression.Results:A total of 420 valid questionnaires were collected. Compared to 50 yuan/order, nursing staff preferred to a price of 150 yuan/order ( β= 1.22, P<0.001) nursing services; Compared to specialized nursing services, nursing staff preferred to the routine care ( β= 0.86, P<0.001) and health promotion ( β= 0.86, P<0.05) service; Compared to<5 km, nursing staff were unwilling to provide nursing services for elderly patients at distances of 5-10 km and 11-15 km ( β=-0.66, P<0.05; β=-0.95, P<0.001) ; Compared to 1-2 visits per month, nursing staff preferred not to provide continuing care services ( β=-0.70, P<0.05); Compared to homestay with the patient family, nursing staff preferred to provide nursing services for elderly patients residing in nursing homes ( β= 1.21, P<0.001) . Conclusions:Considering the preference of nursing staff tend to provide " Internet + nursing service" for the elderly patients with services featuring appropriate price, non-specialist care, close distance, low continuity (moderate intensity used as the reference) and security assurance for practice.
RESUMO
Objective:To investigate the current situation of the " Internet plus nursing services" for the elderly in Ningbo, and evaluate the promotion effect of the pilot policy, for reference to further optimize such service policy of China nationwide.Methods:The data came from the orders for " Internet plus nursing services" by elderly users over 60 years on the " cloud hospital" platform in Ningbo from 2016 to 2021. Descriptive analysis was used to study major demographic information, types of service items and number of person-times of the elderly users; The promotion effect of the pilot policy on " Internet plus nursing services" for the elderly in 2019 was analysed by Chow test.Results:The number of elderly users increased from 76 person-times in 2016 to 5 923 person-times in 2021, accumulating up to 12 209 person-times. The number of nursing service items increased from 18 in 2016 to 36 in 2021. The person-times of users of common clinical nursing and specialized nursing service items were 11 850 and 359 respectively. After the pilot policy was issued, the number of service items and the number of users were significantly increased in 2020( P<0.05). Conclusions:The development of " Internet plus nursing services" for the elderly in Ningbo had achieved certain results, especially with the promotion of the pilot policy in 2019, the types of service items and the number of elderly users had increased year by year. In the future, we should continue to focus on the elderly living alone and other special elderly groups with the support of relevant policies, further expand the scale of elderly users, improve the types of service items, and optimize the charging standards to help China′s healthy aging process.
RESUMO
Objective It is thought that environmental agents, especially the diet, play an important role in the processes of gastric cancer. The study was designed to investigate the relationship between dietary factors and the risk of gastric cancer in residents of islands so as to offer the evidence for effective measures of prevention and control. Methods A frequency matched design of case control study was used. 103 cases of gastric cancer newly diagnosed in 2001 and 133 controls were randomly selected among the residents of islands. And dietary factors were further investigated. Adjusted odds ratios (OR) and 95% confidence intervals (CI) of dietary factors on the processes of gastric cancer were estimated using unconditional logistic regression models. Results After the correction of the effects of some non diet factors, increased risks of gastric cancer were associated with hot diet (OR=1.48,95%CI:1.03 2.14) and pickled food (OR=2.63,95%CI:1.74 3.98). An inversed association with the risk of gastric cancer was seen in sauting (OR=0.33,95%CI:0.13 0.83 ), food eaten at regular time (OR=0.29,95%CI:0.19 0.44), allium vegetables (OR=0.43,95%CI:0.22 0.82) and carrot (OR=0.10,95%CI:0.02 0.41). Furthermore, PARc% of hot diet and pickled food were 11.8% and 57.8% respectively, which suggested that the carcinogenic effect of hot diet and pickled food on stomach in the population reached about 70% after the correction of the effect of other factors.Conclusions Pickled food and hot diet as the habits of residents in Zhoushan islands are important risk factors for gastric cancer, while decreased risk effect is found in sauting food, having regular dietary time and frequently eating allium vegetables and carrot.