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1.
长期护理需求评估是长期护理保险筹资与给付的联结点,直接决定了保险给付,并对长期护理保险筹资有重要影响.当前我国试点地方在长期护理需求评估制度的设计上分歧较大,虽积累了差异化的经验与案例,但地区分割不利于社会公平与社会流动.应立足于长期护理保险的社会保险属性,结合社会实际与试点效果,适当借鉴德国经验,统筹设计长期护理需求评估体系,通过"法律+行政法规+部门规章"的规范形式,精准定位评估对象,明确独立的评估主体、科学设计评估指标与评估工具、严格规范评估程序等确保评估结果的科学、客观与公正,并根据评估结果进行分级分类给付,实现长期护理保险资源流向精准.  相似文献   
2.
以往有关汉语从综合到分析的研究中,有两组概念未能得到足够的重视:词汇型综合和语用型综合、区别性语义和范畴性语义。《左传》《战国策》中“派遣”义“使”的用法变化证明了区分这两组概念的必要性。“使”的用法变化显示:(1)古汉语的综合性不但表现在词汇层面,也表现在语用层面。(2)汉语史上既存在区别性语义的从综合到分析,也存在范畴性语义的从综合到分析。(3)《左传》的语言面貌表现出守旧存古的特点,且不同形式之间在使用上存在语体差异。(4)从综合到分析的转变至迟在上古后期的《战国策》时代(公元前1世纪以前)就已显现出来。要之,区分不同类型的综合和分析,对进一步揭示汉语词汇系统演变的规律具有重要意义,对进一步认识上古汉语和中古汉语的分期也有一定的启示。  相似文献   
3.
BackgroundHaving a positive childbirth experience is an increasingly valued outcome. Few studies evaluated the women’s satisfaction with childbirth through face-to-face interviews out of the health service environment. The objective of this study was to identify factors associated with a higher level of satisfaction with the childbirth experience among Brazilian women.MethodsThis cross-sectional study involved 287 women giving birth in two hospitals in southern Brazil. Women who gave birth to healthy newborns at term were randomly selected. Face-to-face interviews were conducted 31–37 days after delivery, at the mothers’ homes, using a structured questionnaire. Satisfaction with the childbirth experience was measured using a Likert-type scale ranging from very satisfied to very dissatisfied. Prevalence ratios (PR) were estimated using Poisson regression with robust variance.ResultsFollowing hierarchical multivariate analysis, the following factors remained associated with a higher level of satisfaction with the childbirth experience: being satisfied with antenatal care (PR = 1.30; 95% confidence interval [95%CI] = 1.06−1.59), understanding the information provided by health professionals during labor and delivery (PR = 1.40; 95%CI = 1.01−1.95), not having reported disrespect and abuse (PR = 1.53; 95%CI = 1.01−2.31), and having had the baby put to the breast within the first hour of life (PR = 1.63; 95%CI = 1.26−2.11). No association was observed with type of delivery or hospital status (public or private).ConclusionsA higher level of satisfaction with the childbirth experience is related to satisfactory antenatal care, a non-abusive, respectful, and informative environment during childbirth, and to the opportunity to breastfeed the baby within the first hour of life. In clinical practice, greater attention to these basic principles of care during pregnancy and delivery could provide more positive experiences during birth.  相似文献   
4.
Although the party‐state has embarked on a mission to increase elder care services, evaluating this development according to different sectors demonstrates certain challenges. Official statistics do not include sector‐specific information, and while provider websites suggest that elder care services are largely in public hands, Chinese experts argue that they are mostly “civilian‐run.” How can we explain these discrepancies in data on Chinese elder care? Drawing on the concept of hybridization and triangulating quantitative and qualitative data, I argue that the party‐state's efforts to “socialize” elder care provision has resulted in hybridization within the industry which blurs the line between care providers and obfuscates the stark role of the state in elder care service provision. During the implementation of state‐initiated hybridization, providers misclassify their ownership type to benefit from financial incentives or circumvent political control, resulting in even greater hybridization and fragmentation on the ground.  相似文献   
5.
BackgroundMidwife-led continuity of care has substantial benefits for women and infants and positive outcomes for midwives, yet access to these models remains limited. Caseload midwifery is associated with professional satisfaction and lower burnout, but also impacts on work-life boundaries. Few studies have explored caseload midwifery from the perspective of midwives working in caseload models compared to those in standard care models, understanding this is critical to sustainability and upscaling.AimTo compare views of caseload midwifery – those working in caseload models and those in standard care models in hospitals with and without caseload.MethodsA national cross-sectional survey of midwives working in Australian public hospitals providing birthing services.FindingsResponses were received from 542/3850 (14%) midwives from 111 hospitals – 20% worked in caseload, 39% worked in hospitals with caseload but did not work in the model, and 41% worked in hospitals without caseload. Regardless of exposure, midwives expressed support for caseload models, and for increased access to all women regardless of risk. Fifty percent of midwives not working in caseload expressed willingness to work in the model in the future. Flexibility, autonomy and building relationships were positive influencing factors, with on-call work the most common reason midwives did not want to work in caseload.ConclusionsThere was widespread support for and willingness to work in caseload. The findings suggest that the workforce could support increasing access to caseload models at existing and new caseload sites. Exposure to the model provides insight into understanding how the model works, which can positively or negatively influence midwives’ views.  相似文献   
6.
BackgroundPre-registration midwifery students in Australia undertake a minimum of ten continuity of care experiences with childbearing women. However, women are rarely asked to formally evaluate this care by students.AimTo evaluate data from a routine, web-based survey of women about having a midwifery student provide a continuity of care experience.MethodsAll women (n = 886) recruited by a midwifery student for a continuity of care experience during a 12 month period received an email inviting them to complete an online survey. The survey included personal details, experiences of care, and two scales on Respect and Satisfaction.ResultsA response rate of 57% (n = 501) was achieved. On average students attended six antenatal visits (mean = 5.83) and had six postnatal contacts with women. Most students attended labour and birth (92.6% n = 464). Most women rated overall satisfaction with care by their student as ‘better than they had hoped’. Positive correlations were found between number of antenatal visits and postnatal contact with students on both levels of satisfaction and respect felt by women. Women felt more satisfied when their midwifery student attended labour and birth.ConclusionsThe online survey was feasible and provided valid and reliable feedback from women about their student during a continuity of care experience. Women valued having an ongoing relationship with a student during pregnancy, labour and birth, and postpartum. Pre-registration midwifery education programs should continue to privilege relationship-based care and national standards should support the effective integration of continuity of care experiences.  相似文献   
7.
BackgroundThe experience of labour and birth is complex, multidimensional and subjective and has the potential to affect the women and their families physically and emotionally. However, there is a lack of research around maternal satisfaction in Italy.AimTo evaluate mothers’ satisfaction with their childbirth experience in relation to socio-demographic characteristics, obstetric history and intrapartum care variables.MethodsA cross-sectional study involving 277 women who had given birth in a low risk maternity unit in Northern Italy was undertaken. Satisfaction with birth was measured using the Italian version of the Birth Satisfaction Scale-Revised (I-BSS-R). The scale comprises three Sub-Scales: quality of care provided, personal attributes of women and stress experienced during childbirth.FindingsNo socio-demographic variables were related to maternal satisfaction. Multiparous women had a higher satisfaction score (p = 0.020; CI:0.23;2.75). Antenatal class attendance was negatively associated with maternal satisfaction (p = 0.038; CI:−2.58; −0.07). Intrapartum variables that significantly reduced maternal satisfaction were: epidural usage (p = 0.000; CI:−4.66; −2.07), active phase >12 h (p = 0.000; CI:−6.01; −2.63), oxytocin administration (p = 0.000; CI:−5.08; −2.29) and vacuum assisted birth (p = 0.001; CI:−6.50; −1.58). Women with an intact perineum were more likely to be satisfied (p = 0.008; CI:−4.60; −0.69).DiscussionIn accordance with other research, we showed that intrapartum interventions are negatively associated with maternal outcomes and therefore also with maternal satisfaction with birth. The sub-scale that measured Quality of Care provided scored higher than the other two Sub-Scales.ConclusionFurther studies on maternal satisfaction in Italy should be conducted, using the I-BSS-R with the aim to compare outcomes and understand what matters to women during childbirth.  相似文献   
8.
ABSTRACT

The severe mental health problems of many of the young people living in residential settings pose a great challenge and demand on child protection and mental care (MC) services. Drawing on comparative research and debates from six European countries, this study examines demands for integrated care and interprofessional collaboration practices between residential child care (RCC) and MC. In this article, research data will be brought together from Denmark, Finland, Germany, Lithuania, the UK (Scotland) and Spain. In total, 61 practitioners from RCC and MC were interviewed. Given the complexity of the residential care service context and service system differences across national contexts, the original hypothesis was that this would differentiate the collaboration practices. However, the similarity between the countries is greater than anticipated. The concluding findings are organised by matrix technique into a content-analytic summary table. The main finding was that in spite of encouragement for integrated RCC, obstacles for collaboration and lack of coordination between systems remain, often related to understanding the professional role and tasks, lack of shared knowledge, attitudes and ways of communication. One significant finding in the cross-country comparison was the evident and unrealistic expectations for the ‘other’ provider to help and care.  相似文献   
9.
ABSTRACT

Huge advances have been made in deepening and expanding our knowledge of gendered migration over the last decades in both theoretical and methodological terms. Empirically it is, however, still the case that North–South migration is at the basis of most theorisations, leaving the characteristics of South–South migration at the margins. In this paper we, therefore, shift the focus to intra- and trans-regional migration in a South–South context in exploring what this means for women migrants. While feminist scholars have highlighted care and the ways in which migration challenges social reproduction as an important issue, mainstream approaches continue to focus predominantly on the ‘productive’ lives of migrant workers. With migration theories still largely drawing on the experience of South–North migration, there continues to be relatively little understanding of South–South migration’s gender dynamics, despite the fact that many of the highly feminised, yet hyper-precarious, migration flows occur intra-regionally.  相似文献   
10.
农村互助型社会养老是具有中国特色的社会养老的发展形式,是对农村传统家庭养老的重要补充。它扎根于农村传统的亲邻互助网络,其本质在于经济互助,表现为有组织地发动邻里、志愿等社会力量,充分利用以老年人为主的各类人力资源的闲置时间、资源低成本地相互帮助和服务。社会各界应将其作为重要实施方略,纳入积极应对人口老龄化战略和乡村振兴战略之中。其发展路径可以概括为:以资金互助为基础,以组织动员为抓手,以服务互助为重点,以社区居家养老为主要阵地,创新各类互助养老模式,着力形成稳定多元的资金来源,培育互助队伍,增加互助内容,从无偿到无偿、低偿相结合,探索建立标准规范的服务管理评估制度,机构养老与社区居家养老互联互通,最终尝试建立圈层化、整合化、网络化、制度化的农村互助型社会养老体系。  相似文献   
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