Objective To investigate the rebuilding status of community health service (CHS) system after Wenchuan earthquake in Mianzhu, improve service ability and provide data for better reconstruction of CHS system after natural disaster. Methods The interview was conducted with local health system officials, and self-designed questionnaire for face-to-face interview was distributed to 508 community residents in Mianzhu who were selected by convenience sampling. Data entry and statistical analysis were completed using Microsoft Office Excel 2007 and SPSS 16.0 respectively. Results A total of 508 questionnaires were distributed, and then 486 questionnaires were retrieved effectively (response rate 95.7%). The analysis on 486 respondents in CHS after rebuilding showed the rate of respondents with health files rose from 20.1% to 43.8%, the rate of having regular health check-up rose from 7.4% to 46.7%, the rate of health education rose from 20.1% to 39.7%, the rate of chronic disease monitoring rose from 0.9% to 35.4%, the rate of knowing referral pattern rose from 15.7% to 51.2%, the rate of propaganda for disaster relief rose from 33.6% to 58.6%, and the rate of doing disaster emergency response exercise was 21.8% currently. 62.3% of residents chose CHS on the first visit. The satisfactory degree to CHS rose from 45.4% to 76.1% after earthquake. Both popularization of regular health check-up and propaganda for disaster relief were major factors with influence on residents’ satisfaction to CHS (Plt;0.001, P=0.010, respectively). Conclusion The residents’ satisfactory degree to the rebuilding status of CHS system is encouraging. It is necessary to strengthen the popularization of regular health check-up and propaganda for disaster relief in order to improve the quality of community health service.
摘要:目的: 了解绵竹市社区卫生服务系统震后现状,同时分析社区医疗震后居民满意度和社区卫生服务机构震后灾害干预能力,以期为社区卫生服务体系地震应急恢复和重建提供参考意见。 方法 :采用随机抽样的方法,抽取绵竹市剑南社区卫生服务中心和天河社区卫生服务中心进行访谈,采取方便抽样的方法,抽取24‰的绵竹城区居民采用面对面访谈的方式用自制问卷进行调查,并用Epidata30 进行数据录入、SPSS130进行统计分析。 结果 :共发放问卷240份,收回有效问卷229份(有效回收率954%)。当地社区卫生服务系统在地震中受损严重。社区卫生服务系统灾后工作居民满意度为454%,社区卫生服务机构对居民进行抗灾/防灾知识教育的比例为336%,灾后是否有持续而足够的常见病药品供应及是否有持续而足够的慢性病药品供应是影响当地居民对当地社区卫生服务体系灾害应急工作的满意度的影响因素(P 值分别是0033,0001)。 结论 :震后社区卫生服务居民满意度较低,服务体系地震灾害干预能力不足。居民在在灾前接受抗灾教育的比例较低,加强药品储备能提高社区卫生机构灾害应急工作的效果。在社区卫生服务体系重建的过程中,应注重社区医疗基础工作的恢复,基础设施的重建和健全社区急救体系。Abstract: Objective: To investigate the reality of community health service system after earthquake in Mianzhu, the satisfaction of community residents to the community health service as well as the postdisaster emergency response capability of community hospital in order to provide decisionmaking suggestions on better reconstruction of community health service system. Methods : Jiannan and Tianhe community hospital were randomly selected for visiting and 24‰ of community residents in the city zone of Mianzhu were selected by convenience sampling for a facetoface interview using a questionnaire. Data entry and statistically analysis were completed by Epidata30 and SPSS130 respectively. Results :A total of 240 questionnaires were conducted to facetoface interviews, and 229 questionnaires were returned (response rate 954%).The community health service system was badly injured. Residents’ satisfactory degree of the community health service after earthquake was 454%. The proportions of disaster / disaster prevention education was 336%,medicine supply for familiar diseases and the chronic were the main factors which influenced judgements of residents to the emergency response capabilities of community hospitals(〖WTBX〗P =0033,P=0001,respectively). Conclusion :The community health services after earthquake had not been widely satisfied and the emergency response capability of community hospital was far from enough. The proportions of disaster / disaster prevention education were far from enough. The effectiveness of emergency response work of community hospitals can be enhanced by reinforcing medicine preparation.In the course of the reconstruction, community health service system should pay attention to the resumance of basic community health service,reconstruction of basic establishment and construction of firstaid system.
Objective To investigate the status of health condition and activities of daily living of “50630” retired cadres in Mianzhu, and analyze the related factors affecting their activities of daily living. Methods According to the registration information of Mianzhu administration of elderly cadres in Sichuan, the method of cluster sampling was adopted in March 2019 to select retired cadres who participated in work between October 1st, 1949 and June 30th, 1950 in urban and rural areas respectively. The survey and analysis were carried out using the self-designed general condition questionnaire, Berg balance scale, Hoffer walking ability rating scale, and modified Barthel Index, to understand the activities of daily living ability of retired cadres and analyze the relevant factors affecting their self-care ability of daily life. Results A total of 64 “50630” retired cadres were investigated, with an average age of (86.39±3.37) years. 64.06% of the patients with poor balance function needed wheelchair, 10.94% could not walk, and 56.25% were heavily dependent on activities of daily living. Age (r=−0.421, P=0.001) and underlying diseases (r=−0.060, P=0.032) were negatively correlated with activities of daily living. Balance ability (r=0.658, P<0.001), walking ability (r=0.393, P=0.001), spouse status (r=0.669, P<0.001), care status (r=0.830, P<0.001), place of residence (r=0.706, P<0.001) were positively correlated with activities of daily living. Education level (r=0.096, P=0.380) and gender (r=0.122, P=0.265) had no correlation with activities of daily living. Multiple linear regression analysis showed that the main influencing factors of daily living activities of “50630” retired cadres in Mianzhu were balance function, walking ability, spouse or not and type of care. Conclusions There are many related factors affecting the activities of daily living of “50630” retired cadres, which can be intervened according to basic diseases, balance function and walking ability. Through multi-disciplinary and multi-sectoral cooperation, integrating community health service resources, providing all-round health care services, formulating personalized rehabilitation measures, and organizing community group activities, it is possible to improve their social participation, psychological status, and ability of daily living activities, and reduce the disability, so as to further improve the quality of life of veteran cadres.