Research On The Dilemmas And Countermeasures Of Traditional Chinese Medicine Services In Community Healthcare Centers Based On The Grounded Theory

Objective This study is based on the Grounded Theory and interviews the administrative executives and medical staff of the community healthcare center(CHC)in Hangzhou.Through the Grounded Theory coding analysis,the study identifies the existing problems and the models of traditional Chinese medicine(TCM)development in the CHC in Hangzhou.Additionally,the study collects relevant information about TCM services in the CHC in Hangzhou through a questionnaire survey.The study uses correlation analysis to verify the rationality of the model by selecting variables that reflect some elements mentioned in the model.Finally,the study proposes strategies to help the CHC to overcome the challenges in the development of TCM services from the perspective of structural functionalism theory.Methods This study employed multiple research methods,including literature review,Grounded Theory,in-depth interviews,and questionnaire surveys.Considering the resource and epidemic limitations of this study,the main urban areas of Hangzhou City(i.e.,Xihu,Shangcheng,Xiacheng,Binjiang,Gongshu,and Jianggan District)were selected as the sample area.A total of 43 CHCs were selected through cluster sampling as the research objects,and in-depth interviews and questionnaire surveys were conducted from October 2021 to May 2022.Firstly,the administrative directors and medical staff of CHCs were randomly selected for in-depth interviews using an information saturation approach.Interviews were terminated when no more new and useful information could be obtained.Ultimately,20 interviewees were included and the interview materials were analyzed using Nvivo 20.0 software.Secondly,a questionnaire survey was conducted to collect information on the development of TCM services in CHCs,and statistical analysis was conducted using SPSS 23.0.Results This study conducted interviews with administrative directors and medical staff from 8 community health service centers in the main urban area of Hangzhou from October to December 2021,obtaining 20 interview materials.The grounded theory method was used to code and analyze the interview materials,which revealed that the development of TCM services in community health service centers faces difficulties in policy and institutional systems,social environment,human resources,and innovation capabilities,forming a corresponding dilemma model.From December 2021 to May 2022,a questionnaire survey was conducted on 43 CHCs in the main urban area of Hangzhou,and bivariate correlation analysis was conducted using SPSS 23.0 to verify the positive correlation between TCM service staff,TCM cultural development factors,innovation capabilities,and TCM service volume.To a certain extent,this validates the scientific nature of the dilemma theoretical model proposed in this study.Based on this,this study proposed corresponding countermeasures from the perspective of structural-functionalism to promote community TCM services to overcome current development difficulties and achieve sustainable development.Conclusion Research on the development dilemma of community TCM services in Hangzhou city indicates that there are various obstacles hindering the full potential of TCM services.This study proposes a series of strategies based on the AGIL model to overcome the development challenges,including improving TCM policies and regulations,increasing investment in resources such as funds and talents,setting specific goals,optimizing the coordination mechanism among management entities,enhancing the innovation capability of CHCs,leveraging the efficiency of urban medical consortia,promoting inter-organizational communication and cooperation,optimizing the "three medical linkages" mechanism,improving the job satisfaction of medical staff,inheriting and developing TCM culture,strengthening TCM cultural promotion,and enhancing the cultural identity of medical staff towards TCM.