Analysis of influencing factors of community elderly health services by general practitioners from the perspective of social ecology / 中华医院管理杂志

Objective:To identify the influencing factors for community elderly health services provided by general practitioners (GPs) using the social ecological theory, for reference in improving their participation and satisfaction.Methods:According to the social ecological theory, an ecological model for GPs to carry out community elderly health services was constructed from four levels: public policy ecology, community health service ecology, interpersonal relationship ecology, and individual characteristics ecology of general practitioners. A survey questionnaire was designed with six latent variables: public health policy support, public health service and basic medical service supply, doctor-patient relationship, individual participation and individual satisfaction. The questionnaire was distributed to 220 GPs from 11 primary healthcare institutions in Jiangsu province, China, who were randomly selected between October and November 2021. Exploratory and confirmatory analyses of the model were conducted using AMOS 25.0.Results:A total of 207 valid questionnaires were collected, and all the KMO values of the six latent variables were greater than 0.7, while the composite reliability values and average variance extracted values greater than 0.7 and 0.5, respectively. Both the reliability and validity of the data met the analysis requirements. Exploratory analysis revealed that public health policy support had a direct positive effect on both public health service and basic medical service supply (both effect sizes being 0.37). Public health service had a direct positive effect on doctor-patient relationship, individual participation and individual satisfaction (effect sizes being 0.52, 0.22, and 0.31, respectively). The direct effect of basic medical service supply on doctor-patient relationship was not significant (effect size being 0.03), but it had a direct positive effect on public health service (effect size being 0.46). Doctor-patient relationship had a direct positive effect on individual participation (effect size being 0.51), but its direct effect on individual satisfaction was not significant (effect size being 0.06). Individual participation had a direct positive effect on individual satisfaction (effect size being 0.52). Conclusions:By optimizing the public policy ecosystem, community health service ecosystem, and interpersonal relationship ecosystem, the participation and satisfaction of general practitioners can be systematically improved.

Influencing factors of early activity in patients with acute ischemic stroke based on social ecological model: A qualitative study / 中南大学学报(医学版)

OBJECTIVES@#Acute ischemic stroke (AIS) is one of the main causes of disability in middle-aged and elderly people, and early activity plays an important role in functional recovery. This study aims to understand the factors that affect the implementation of early activity in patients with AIS and to provide reference for promoting early activity implementation and developing intervention strategies for AIS patients.@*METHODS@#Using purposive sampling, 19 AIS patients and their caregivers who visited at Stroke Center in the Third Xiangya Hospital of Central South University and the Third Hospital of Changsha from June to December 2021, as well as 19 medical staff, hospital administrators, or community workers providing medical health services to stroke patients, were selected as interviewes. A semi-structured interview was conducted based on the social ecological theory model, and the Colaizzi seven-step method was used to analyze the interview data.@*RESULTS@#According to qualitative interview results, the factors affecting early activity in AIS patients were summarized into 4 themes and 12 sub-themes: medical staff factors (insufficient knowledge and skills, insufficient knowledge of early activity, unclear division of responsibilities), patient factors (severity of the disease, lack of knowledge, psychological pressure, fear of falling), social environmental factors (lack of social support, shortage of human resources and rehabilitation equipment, insufficient medical insurance support), and evidence and norms (the evidence for early activity needs improvement, lack of standardized early activity procedures).@*CONCLUSIONS@#Early activity in AIS patients is impacted by factors at multiple levels, including medical staff, patients, social environment, and evidence and norms. Developing comprehensive intervention strategies to address these factors can promote early activity implementation in AIS patients.

A percepção da família sobre o nível de atividade física e o comportamento sedentário nos pré-escolares: consequências para o desenvolvimento físico e cognitivo / The family's perception about level of physical activity and sedentary behavior in preschoolers: consequences for physical and cognitive development

OBJETIVO: Verificar a percepção da família quanto à presença dos comportamentos sedentários e do nível de atividade física de pré-escolares em casa e na escola MÉTODO: Foi realizada uma pesquisa de campo (design ecológico) com 26 pais de pré-escolares. Os pais responderam dois questionários, um relacionado às atividades realizadas dentro e fora do ambiente escolar por seus filhos e outro sobre o nível de atividade física RESULTADOS: Evidencia-se a baixa frequência de atividades físicas oferecidas pelos pais nos dois principais microssistemas da criança, tanto em casa (13%) quanto na escola (9%), e mais de 50% das crianças foram classificadas como pouco ativas e com alta exposição à televisão CONCLUSÃO: Os agentes diretamente envolvidos com as crianças tendem a oferecer atividades sedentárias com maior frequência quando comparadas às atividades físicas, influenciando a quantidade de atividades ativas realizadas pelas crianças

OBJECTIVE: To verify the family's perception of the presence of sedentary behaviors and the level of physical activity of preschoolers at home and at school METHODS: A field research (ecological design) was carried out with 26 parents of preschoolers. Parents answered two questionnaires, one related to the activities carried out inside and outside the school environment by their children and the other on the level of physical activity RESULTS: The low frequency of physical activities offered by parents in the child's two main microsystems is evident, both at home (13%) and at school (9%) and more than 50% of children were classified as not much active and with high exposure to television CONCLUSION: Agents directly involved with children tend to offer sedentary activities more frequently when compared to physical activities, influencing the amount of active activities performed by children

De víctima a victimaría: la mujer en la crianza de los hijos / From victim to victimizer: women in parenting

Este artículo busca problematizar concepciones corrientes sobre las mujeres víctimas de violencia, pobreza y exclusión, quienes en el rol materno replican en sus hijos las conductas aprendidas en los diferentes sistemas que las afectaron, desde el macro hasta el microsistema, los cuales se perciben cargados de violencia y exclusión. El estudio se fundamentó en la teoría ecológica de Bronfenbrenner, teniendo una visión sistémica del problema y se analizó desde autores como Martín-Baró, Foucault y Wernicke, entre otros. Luego de reconocer las características sociodemográficas y las relaciones interpersonales, se estableció la correlación entre ser víctima de violencia y el moldeamiento de las características psicológicas que se observan en las mujeres transmutándose de víctimas a victimarias en perjuicio de sus hijos, reproduciéndose la violencia en una espiral que es vista como natural en distintos entornos sociales. Se encontró una diferencia entre la mujer del ámbito urbano y la desplazada proveniente del ámbito rural, en cuanto al uso de los servicios que proveen las instituciones y la relación con las demás personas, siendo estas últimas más desconfiadas y prevenidas.

This article seeks to problematize current views on women who are victims of violence, poverty and exclusion. Mothers learn these behaviors from diverse systems, from the macrosystem to the microsystem, which are perceived to be loaded with violence and exclusion; and they replicate these behaviors on their children. The study was based on Bronfenbrenner's ecological theory, taking a systemic approach to the problem and analyzed from authors such as Colombo, Martin-Baró, Foucault and Wernicke, among others. After recognizing the socio-demographic characteristics and interpersonal relationships, a correlation was established between being a victim of violence and the shaping of psychological characteristics observed in women, who transition from being victims to victimizers, to the detriment of their children. This suggests that violence is perpetuated in a spiral, which it is regarded as natural in different social environments. A difference between women of urban areas and displaced from the rural areas was found in the use of services provided by institutions and the relationship with others, the latter being more suspicious and prevented.

Fundamentos metodológicos y teóricos de la investigación: las relaciones existentes entre las prácticas educativas familiares, el clima social familiar de los padres y el desarrollo de Habilidades sociales en niños y niñas entre 2 y 3 años de edad de nivel socio-económico bajo, medio y alto de la ciudad de Medellín / Methodological and theoretical fundamentals of the research: relationships between family educational practices, parents ́s family social climate of and Development of social skills in children between 2 and 3 years of age in low, medium and high social ­ economic leven In Medellin city

Este artículo presenta una reflexión en torno a la metodología propia para una investigación cuyo objeto es la familia. Hace un análisis de diferentes enfoques epistemológicos que soportan tales metodologías a partir del concepto de paradigmas de Kuhn y de autores que permiten establecer los puntos de encuentro y desencuentro de las investigaciones frente a la familia, concretamente, de las prácticas educativas familiares y el clima social familiar, con base en el punto de vista psicológico. El texto muestra, como conclusión, que a partir de los dos principales enfoques del objeto de estudio, los problemas, los métodos y técnicas de investigación, tienen un punto que puede suponerse común: consideran que la interacción con distintos ambientes representa una influencia directa en el desarrollo de los niños. Estas dos variables se soportan en la teoría ecológica de Bronfenbrenner y en la teoría histórico-cultural de Vigotsky.

This paper aims to show a reflection on the convenient method to develop a research which has as object the family. It presents an analysis about the different epistemic approaches, starting from the concept of paradigm by Kuhn and several authors that allow establishing the meetings or disagreement points about this research, specifically, about parenting practices, and social - family weather, based on a psychological point of view. The text shows, as conclusion, that the two principal epistemic approaches have a common point of view: the interaction with different environments represents a direct influence to children's develope processes. These research variables can be supported by the ecologic theory, by Bronfelbrenner and the historical-cultural theory by Vigotsky.