摘要
目的探讨农村地区家庭医生团队管理对脑卒中高危人群的干预效果。方法选择在上海市浦东新区大团镇社区卫生服务中心慢性病登记管理在册的脑卒中高危患者280例,将其随机分为干预组和对照组,干预组在家庭医生团队的管理下采取社区综合健康教育措施和随访,对照组采取传统的健康教育方法,分析干预前后两组患者临床指标变化情况。结果干预组在干预前后自身比较,吸烟比例、饮酒比例均有所下降(P<0.05),血压正常比例和BMI正常比例均有提高(P<0.05);干预组与对照组比较,吸烟比例和饮酒比例下降更为明显(P<0.05);干预组干预后患者遵从医护计划、寻求健康促进行为和对疾病认识的比例比干预前有所提高,同时体育锻炼次数≥4次/周的比例从9.29%提高到54.29%(P<0.01),与对照组比较,干预组遵从医护计划、寻求健康促进行为和体育锻炼次数≥4次/周的比例更高(P<0.05);干预组患者干预后SBP、DBP、TC、TG、LDL-C和Hcy水平均有下降(P<0.01或P<0.05),HDL-C较干预前有所升高(P<0.01)。干预组患者干预后评分和10年卒中风险较干预前明显降低(P<0.01),干预组患者干预后评分和10年卒中风险低于对照组(P<0.01或P<0.05)。结论家庭医生团队对脑卒中高危人群采用社区综合健康教育干预改变了患者健康相关行为,促进了患者临床指标的改善。
OBJECTIVE To explore the intervention effect of family doctor team management in rural areas on high-risk stroke patients.METHODS 280 patients with hypertension(high risk)with carotid plaques registered in the chronic disease registration management of Daqing Town Community Health Service Center in Pudong New Area,Shanghai were randomly divided into intervention group and control group.The management team adopted community comprehensive health education measures and follow-up under the management of the family doctor team.The parameters of the two groups were analyzed before and after the intervention.RESULTS Before and after the intervention,the management group decreased the proportion of smoking and drinking(P<0.05),and the normal proportion of blood pressure and the normal proportion of BMI increased(P<0.05).Compared with the control group before and after the intervention,the proportion of smokingand drinking also decreased(P>0.05).Compared with the control group,the proportion of smoking and drinking decreased more significantly in the management group(P<0.05).There was also a statistically significant difference between the normal ratio of blood pressure and the normal proportion of BMI(P<0.05).The proportion of patients who followed the health care plan,sought health promotion behavior,and recognized the disease was higher than thatbefore the intervention.At the same time,the proportion of physical exercise times≥4 times/week increased from 9.29%to 54.29%(P<0.01).Compared with the control group,the management group had a higher rate of compliance with the health care plan,seeking health promotion behaviors and physical exercise times≥4 times/week(P<0.05).The levels of SBP,DBP,TC,TG,LDL-C and Hcy were decreased in the management group(P<0.01 orP<0.05),and HDL-C was higher than before the intervention(P<0.01).The scores of patients in the management group and the risk of 10-year stroke were significantly lower than those before the intervention(P<0.01).The scores of the intervention group and the 10-year stroke were lower in the management group than in the control group(P<0.01 orP<0.05).CONCLUSION The use of community-based comprehensive health education interventions in patients with hypertension and carotid plaque under the management of family doctors can better affect the main risk factors of stroke in patients,change the health-related behaviors of patients,and promote the improvement of relevant laboratory test indicators.
作者
汤红伟
侯进
TANG Hongwei;HOU Jin(Datuan Community Health Service Center,Pudong New Area,Pudong,Shanghai,201311,China)
出处
《中国初级卫生保健》
2020年第3期11-15,共5页
Chinese Primary Health Care
基金
上海市浦东新区卫生系统学科带头人培养项目(PWRd2016-14)。
