The deployment of advanced practice nurses in the French health system: From clinics to professional networks.

AIM: The aim of this study is to contribute to an understanding of the role deployment of advanced practice nurses (APNs) in French healthcare settings. INTRODUCTION: The introduction of APNs was formalised in France by the decrees issued on 18 July 2018, which described the areas, activities and training of APNs. BACKGROUND: A qualitative study on the role implementation of APNs was conducted between July 2021 and May 2022 following a call for projects launched by the Île-de-France Regional Health Agency to evaluate the deployment of APNs in the area. METHODS: Data were collected through field observations and semi-structured interviews in order to explore both the APNs deployment processes in nine healthcare structures and the roles played by APN networks and associations with regard to the deployment of APN activities in their working environments. RESULTS: The projects proved to be evolutionary, and their development was marked by various forms of APN isolation and multiple obstacles that were specific to their professional practice settings. Some APNs relied on a variety of forms of mutual assistance and advocacy deployed throughout APN networks and associations. DISCUSSION: The deployment of APNs' role was impacted by diverse configurations of professional power relations and the nature of the obstacles that were structural for APNs in primary care. Their experience of isolation derived from the novelty of their role, the challenge they posed to the cohesion of the nursing profession and a lack of supportive policies for their deployment. Their participation in APN networks and associations enabled them to access advocacy and manage the uncertainties and unknowns related to the deployment of their activities. CONCLUSION: The results suggest that the formalisation of schemes for mutual assistance among APNs and advocacy should be integrated into the guidelines for the implementation of their role. IMPLICATIONS FOR NURSING POLICY: APN policy should strengthen a bottom-up approach, relying in particular on the development of different forms of collaboration and communication between APN networks and associations on the one hand and the public authorities on the other.

"Too Many Jobs and Not Enough Hands": Immigrant and Refugee Community Health Workers at the Frontlines of the COVID-19 Pandemic.

Refugees and immigrants have experienced heightened health inequities related to COVID-19. As community-embedded frontline health personnel, refugee and immigrant community health workers (riCHWs) played essential roles in the provision of informational, instrumental, and emotional support during the unprecedented first year of the pandemic. Despite the importance of this workforce, riCHWs are at high risk for burnout due to low recognition and demanding workloads. This was exacerbated as riCHWs navigated a new and uncertain health delivery landscape. We sought to glean insight into riCHWs' stressors, coping strategies and resources, and self-efficacy to identify ways to support their work and wellbeing. Using a narrative inquiry approach, we conducted semi-structured, in-depth interviews with 11 riCHWs working in a midsized city in the midwestern United States. We generated three distinct yet interrelated themes: (1) Rapid and trustworthy information is key, (2) Creativity and perseverance are good … structural support is better, and (3) Integrating riCHW expertise into health promotion programming and decision-making. Although riCHWs were deeply committed to enhancing community wellbeing, quickly shifting responsibilities in tandem with structural-level health inequities diminished their self-efficacy and mental health. riCHWs relied on work-based friends/colleagues for informational and emotional support to enhance their capacity to deliver services. Findings suggest increasing opportunities for peer support and idea-exchange, professional development, and integration of riCHW expertise in health promotion decision-making are effective strategies to enhance riCHWs' professional self-efficacy and personal wellbeing.

The application of MOOC combined with peer mutual assistance in cardiopulmonary resuscitation teaching / 中华医学教育探索杂志

Objective:To explore the application effect of massive open online course (MOOC) combined with peer mutual assistance in cardiopulmonary resuscitation teaching.Methods:A total of 140 students in the same class of Batch 2015 were divided into the experimental group and the control group. In the teaching of cardiopulmonary resuscitation, the experimental group was based on the MOOC teaching platform, watched videos and topic tests before class, and used the peer mutual assistance in class. While the control group adopted traditional classroom teaching mode. The teaching effect of the two groups were evaluated by comparing the operation assessment scores and questionnaire survey of students' satisfaction with teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The operating assessment score of the experimental group was (82.20±2.31), and the operating assessment score of the control group was (75.80±1.72). The difference was statistically significant ( t=3.27, P<0.05). The questionnaire survey showed that the course satisfaction and learning motivation of the experimental group were better than those of the control group. In learning burden, the two groups had similar results ( P=0.739). Conclusion:MOOC combined with peer mutual assistance in cardiopulmonary resuscitation teaching can help students better master skills, improve students' course satisfaction and learning motivation, without increasing their learning burden.

[Public health nurses' activities during normal times and factors associated with their promotion of residents' mutual support during disasters].

Objective　To clarify the actual state of activities conducted by public health nurses (PHNs) during normal times and assess factors related to the implementation of such activities for the promotion of residents' mutual support during disasters, across different municipalities in Japan.Methods　We conducted a nationwide cross-sectional self-report questionnaire survey of PHNs in 1,463 municipalities. The questionnaires included descriptions of municipalities, activities related to disaster prevention and the rationale for them, and the details of activities that were being conducted to promote residents' mutual support in times of disaster. We conducted multiple logistic analyses to examine the associated factors.Results　We analyzed 535 responses (valid response rate of 36.6%). The proportion of municipalities in which oriented district activity systems and oriented business activity systems were used jointly by PHNs was 81.7%. The proportion of municipalities in which PHNs participated in the formulation of regional disaster prevention plans was 31.6%. "Individual support" would be implemented for persons requiring support in evacuation activities in 41.7% of municipalities; "cooperative support for community organizations," in 34.8%; and other "activities for the purpose of residents' mutual support," in 29.9%. Reasons for not implementing such measures included "outside the division of duties" and "having no contact with residents' organizations." Logistic regression analyses showed that the oriented district activity system, participation of PHNs in the formulation of regional disaster prevention plans, and preparation of an activity manual on disaster countermeasures for PHNs were significantly associated with the performance of activities during normal times for promotion of residents' mutual support during disasters.Conclusion　Our findings clarified that the PHNs' activities during normal times for the promotion of residents' mutual support during disasters were not carried out sufficiently. It is important to review activities according to the district, to ensure supervisory PHNs play a greater role, to provide external support to municipalities for the participation of PHNs in the formulation of regional disaster prevention plans, and to prepare an activity manual on disaster countermeasures for PHNs.

Social Capital and the Realization of Mutual Assistance for the Elderly in Rural Areas-Based on the Intermediary Role of Psychological Capital.

BACKGROUND: Mutual assistance for the elderly is a new pension model that has been widely valued and discussed in China, especially in rural areas. The social and psychological capital owned by the elderly in rural areas promotes their participation and affects the realization of mutual assistance for the elderly. Based on this, this paper proposes the following hypotheses: H1: Bonding social capital positively affects the realization of mutual assistance for the elderly in rural areas; H2: bridging social capital positively affects the realization of mutual assistance for the elderly in rural areas; H3: linking social capital positively affects the realization of mutual assistance for the elderly in rural areas; and H4: psychological capital plays an intermediary role in the process of social capital influencing the realization of mutual assistance for the elderly in rural areas. The empirical research is carried out around these hypotheses. METHODS: In this paper, the 2019 China General Survey of Social Conditions (CSS) database was used as the data source for empirical analysis. Social capital can be divided into bonding social capital, bridging social capital, and linking social capital, while psychological capital can be divided into four dimensions: self-efficacy, optimism, hope, and resilience. Our evaluation was performed using LOGIT regression analysis with STATA16 software. First, the correlation of social capital to the realization of mutual assistance for the elderly in rural areas was verified. Next, the mediation effect was verified using the KHB regression method, and the influence of psychological capital as an intermediary variable on the realization of mutual assistance for the elderly in rural areas was demonstrated. RESULTS: Social capital had a significant positive effect on mutual assistance for the elderly in rural areas. Psychological capital played an intermediary role in the relationship between the three types of social capital and rural mutual assistance for the elderly. Among the four dimensions of psychological capital, self-efficacy, optimism, and tenacity played a partial mediating role in the relationship between social capital and mutual assistance for the elderly in rural areas, while the mediating role of hope was not significant. CONCLUSIONS: (1) All three types of social capital have a significant promoting effect on the realization of mutual assistance for the elderly in rural areas, among which bridging social capital has the most significant effect. (2) Psychological capital plays a partial mediating role in the three kinds of social capital's influence on the realization of mutual assistance for the elderly in rural areas, and the intermediary role is the strongest in the effect of linking social capital on the realization of mutual assistance for the elderly in rural areas, but the overall effect is not high. (3) Among the four dimensions of psychological capital, self-efficacy, optimism, and tenacity all have certain intermediary effects, but the intermediary effect of hope is not significant. (4) There are significant gender and regional differences in the impact of social capital and psychological capital on the realization of mutual assistance for the elderly in rural areas.

On the Cultivation and Promotion of the Concept of "Mutual Assistance" during the COVID-19 Prevention and Control Period / 中国医学伦理学

"Mutual assistance" with profound moral significance, is a traditional social moral code and way of life, inherits the essence of ancient philosophers, is gradually regarded as a principle of dealing with neighborhood and social relations, which embodies the organic unity of social value and individual value. Actively carrying forward the ethical idea of "mutual assistance" is of great practical significance for preventing and controlling COVID-19, winning the prevention and control war, and promoting the construction of community of human health. Therefore, it is necessary to cultivate and practice "mutual assistance" vigorously to strengthen the moral consciousness of "life first", stimulate individual moral consciousness, and construct social benign moral relations.

Reconsideration on "Mutual Assistance" under the Public Health Emergencies / 中国医学伦理学

With increasingly being used in the field of public health, "mutual assistance" is in line with the realistic ethical demands of public health, and has become a new safety product provided by China for global public health security governance. To ensure "mutual assistance" under public health emergencies, it is crucial to fundamentally follow "protecting the lives and health of the people", take "building a community of health for mankind" as a long-term version, and take "solidarity and mutual assistance" as the action direction. "Mutual assistance" is of great practical value, and it is important to seek common ground while reserving differences in resolving the practical dilemma of public health emergencies.

A Methodology of Workshops to Explore Mutual Assistance Activities for Earthquake Disaster Mitigation.

To minimize the damage caused by large earthquakes, mutual assistance activities between residents and rescue victims (i.e., to support residents who cannot evacuate individually) are important. To enhance these activities, the technologies and methods for creating a Community Disaster Management Plan (CDMP), based on the quantitative evaluation of mutual assistance abilities, are required. However, the lack of a method for it is a key issue. This study aims to develop a methodology of workshops for making CDMPs by using the developed support tool by the authors to explore and promote mutual assistance activities. Through the demonstration and examination of a Community Disaster Management Plan on actual districts, the findings mentioned in this article were obtained. Moreover, the usability of this method is shown. In particular, this method is effective at revising CDMPs, and raising resident awareness on the importance of mutual assistance. The suggested method can also improve the lack of techniques involved in promoting mutual assistance.

Research on the awareness of disaster prevention and the ability of self-rescue and mutual aid among children in Mianyang Area / 中国小儿急救医学

Objective:To investigate the current situation of children′s awareness of disaster prevention and self-rescue ability in Mianyang area, provide reference for the development of scientific training programs on children′s disaster knowledge, and improve children′s survival ability during the disaster occurence.Methods:Through literature review and expert consultation, the questionnaire was designed by ourselves.Multi-stage sampling method was used to investigate 2 162 cases from county (city) high school, junior high school and primary school in Mianyang area.Results:8.3% of children had weak disaster awareness.Children had a good understanding of disaster related knowledge, with the highest alarm call awareness rate of 91.8%, fire, flood, earthquake escape and earthquake warning score of 86.5%, 84.2%, 84.2%, 83.0%.Cardiopulmonary resuscitation and fire hydrant operation awareness rate was very low (58.8%, 57.4%). Even some children still chose improper escape behavior.The scores of early warning knowledge and first aid skill were correlated with gender and age.In knowledge of disaster precursors, using of fire extinguishers and hydrants, and first aid skills, the scores of boys were significantly higher than those of girls ( P<0.001). Except for fire-related knowledge, gas leakage escape and shelter awareness rate, the older the children were, the higher the scores were ( P<0.05). The scores of early warning, escape knowledge and first aid skills were correlated with the location of home, and the differences were significant ( P>0.001). More than 80.0% of children chose flashlights, food and water, and emergency kits, while 65.0% to 75.0% children thought it was not necessary to prepare a radio, telephone directory, and cash. Conclusion:Children′s awareness of disaster reduction and self-rescue ability are generally good, but there are still insufficient first-aid skills and improper choice of escape behavior.The education of disaster awareness and self-rescue ability should be strengthened in children′s basic education so as to reduce the casualties of children caused by disasters.

Influence Of Narrative Medicine-Based Health Education Combined With An Online Patient Mutual Assistance Group On The Health Of Patients With Inflammatory Bowel Disease and Arthritis.

BACKGROUND: Inflammatory bowel disease arthritis (IBDA) threatens patients' physical and mental health. Therefore, patients need not only physical therapy, but also adequate health education and psychological support. This study was designed to explore the effect of health education based on narrative medicine combined with an online patient mutual assistance group that was based on the physical and mental health of patients with IBDA. METHODS: A total of 120 patients with IBDA were randomly divided into four groups (30 patients per group). Patients in the control group were given routine health education on the premise of routine treatment. The three treatment groups were given health education based on narrative medicine, online patient mutual assistance group intervention, or combined intervention. Depression, sleep, arthralgia, irritable bowel syndrome (IBS) symptoms, and inflammatory factors were measured and compared before and 1 month after the intervention. RESULTS: Before the intervention, no significant differences were observed in baseline data between the four groups. However, after the intervention, the physical and mental health of patients who received health education based on narrative medicine or online patient mutual assistance groups was improved. Our data showed that patients in the combined intervention group experienced a better outcome. CONCLUSION: Narrative medicine-based health education combined with an online patient mutual assistance group is beneficial to the physical and mental health of IBDA patients. Taken together, this model needs to be further deepened and popularized in clinical practice.

Why some donors are more willing to donate platelets? ----a qualitative study on 25 regular platelet donors in Guangzhou, China.

BACKGROUND: Since 1998, China has gradually moved toward voluntary uncompensated blood donation. In some cities, the shortage of platelets has been noticeably severe. Mutual assistance that collects blood from one's family and social networks is a potential solution. The measure, however, turned out problematic. There are donors who choose to donate platelets over whole blood without compensations, and donate platelets directly to blood banks instead of via the mutual assistance system. This study explores reasons behind their choices qualitatively. METHODS: This report is based on data conducted from January to February 2018; 25 uncompensated regular platelet donors were interviewed. The blood component donation service team in Guangzhou facilitated the data collection process and referred prospectively eligible blood donors to our research team. The interviews took about 30 min to two hours to complete. The qualitative data were analyzed by using the software ATLAS.ti 8. RESULTS: Platelet donation takes a much long time than whole blood donation and requires complicated processes. It may also cause discomfort as the other blood components are returned to the body, causing physical and psychological distress due to worries about contamination. Thus, platelet donation tends to involve higher time and psychological costs than whole blood donation. Yet, it has short collection intervals that allows for more frequent donations, and urgency of a severer shortage than whole blood. Hence, regular platelet donors may feel higher significance in platelet donation than whole blood donation, with the belief that more lives would be saved. Some whole blood donors thus switched to become platelet donors. Mutual assistance blood donation was not chosen by the participants for platelet donation, because such donations may exert moral pressure to both the donors and recipients. Furthermore, "acquaintance" has been loosely defined; the system has sometimes been manipulated to become profit-making monetary transactions. It hence failed. CONCLUSIONS: The practice of platelet donation reinforces the understanding that blood donation is a gift giving process performed among strangers. A safe and sustainable voluntary blood supply can only be secured in the absence of monetary transactions and moral pressure.

Delivering development? Evidence on self-help groups as development intermediaries in South Asia and Africa.

Donors and governments increasingly seek to deliver development projects through community-based organizations such as self-help groups (SHGs), but little is known about the effectiveness of such arrangements. This article briefly summarizes hypotheses regarding the effectiveness of interventions using SHGs and presents the results of an evidence review on the impacts of interventions delivered through SHGs on health, finance, agriculture and empowerment outcomes in South Asia and sub-Saharan Africa. Though the impacts of SHG-based interventions are generally positive, the evidence base is limited and does not generally test whether alternative delivery mechanisms might be more effective.

Investigation of Requirements for Living in a Local Community on an Isolated Island in Shimane Prefecture / 日本プライマリ・ケア連合学会誌

<p><b>Introduction: </b>To determine the requirement (s) that enables the elderly living on an isolated island to continue living on their familiar island. </p><p><b>Methods: </b>The annual reports on the internal migration in Japan derived from the basic resident registers of the Ministry of Internal Affairs were organized. A questionnaire survey and interviews were conducted with members of the resident welfare division of the village office of Chibu Village, Oki-gun, Shimane Prefecture, and the answers were qualitatively analyzed.</p><p><b>Results: </b>A large number of persons of advanced age have moved out from Oki Island. The destinations have varied by year and included places outside Shimane Prefecture. There were no hospitalization facilities or nursing homes in Chibu Village. The only establishment that provided nursing services was the social welfare council. Available home care services were only home-visit care and visiting care. The most common place of death was hospitals outside the island. The communities were characterized by strong ties and mutual assistance among people in the neighborhood, which supported the lives of aged members.</p><p><b>Conclusions: </b>For persons of advanced age living on an isolated island to continue living in their familiar area, it was found necessary to improve the system for receiving people of advanced age who require nursing, and enhance the link between the government and residents to maintain mutual assistance activities among residents.</p>