社区糖尿病患者自我管理项目实施效果评价
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摘要
目的评价社区糖尿病患者自我管理项目实施效果,提高基层医务人员的慢性病防治知识和技能,为项目推广积累经验和提供科学依据。方法于2014年4月以广西2个社区卫生服务中心为基础,采用自身干预前后对照研究方法,对295名自愿参加自我管理活动的社区糖尿病患者进行项目干预,干预期为1年。在干预前后进行问卷调查和血糖检测,对干预前后患者在糖尿病核心知识知晓、生活方式、自我管理行为和血糖控制等方面的情况进行比较,对干预效果进行评价。用SPSS 18.0软件进行配对t检验、χ~2检验和秩和检验。结果干预后,糖尿病患者在糖尿病诊断标准、糖尿病症状、发生糖尿病的高危因素、发生低血糖的高危因素、糖尿病的危害及并发症和糖尿病的防治措施6项核心知识方面的得分比干预前均有较大提高,差异均有统计学意义(P<0.05);干预后,糖尿病患者在吸烟,饮酒,摄入油、盐情况以及饮食习惯方面均较干预前得到了改善,健康生活行为方式增加,差异均有统计学意义(P<0.05);干预后,糖尿病患者遵医嘱服药率、进行眼底检查和足部检查的比例、血糖监测频率较干预前有了明显提高,对血糖控制和自身健康状况满意度较干预前高,差异均有统计学意义(P<0.05)。随机血糖值正常比例由干预前的49.83%上升至干预后的58.64%,差异有统计学意义(P<0.05)。结论社区糖尿病患者自我管理项目能改变社区糖尿病患者生活行为方式,提高自我管理意识和管理效能,在控制血糖方面起到一定效果,值得在社区推广。
Objective To evaluate the implementation effects of self-management project of community diabetics patients, and to improve the knowledge and skill of chronic disease prevention and control of medical staff at the grassroots level, and to accumulate experience and to provide scientific basis for project promotion. Methods In April of 2014, on the basis of 2 community health service centers in Guangxi, a self-intervention and cross-reference study method was used to investigate the self-management activities of 295 community diabetic patients for one year intervention project. Before and after intervention, the questionnaires(the situations of diabetes in core knowledge, lifestyle, self-management behavior and blood glucose control and so on) and blood glucose test were conducted to compare. The effect of intervention was evaluated. The t test, χ~2 test and rank sum test were used to analyze the data, the used software was SPSS 18.0. Results After the intervention, patients with diabetes scored significantly higher than before the intervention in the 6 core knowledge aspects of diabetes diagnosis standard, diabetes symptoms, high risk factors of diabetes, risk factors of hypoglycemia, hazards and complications of diabetes, and prevention and treatment measures of diabetes(P <0.05). After the intervention, the smoking,drinking, oil and salt intake and dietary habits of diabetic patients were improved and their healthy lifestyles increased significantly(P<0.05). After intervention, the proportions of taking medications, fundus examination and foot examination of patients with diabetes according to the doctor's suggestion significantly increased(P<0.05). The frequency of blood glucose monitoring increased significantly,and the satisfaction of blood glucose control and health significantly increased(P <0.05). After the intervention, the normal value proportion of random blood glucose increased from 49.83% to 58.64%(P <0.05). Conclusion Community diabetes self-management project could change the lifestyles of diabetic patients in the communities, and improve the self-management consciousness and management effectiveness, and play the roles in the control of blood glucose. It is worth promoting in the communities.
Objective To evaluate the implementation effects of self-management project of community diabetics patients, and to improve the knowledge and skill of chronic disease prevention and control of medical staff at the grassroots level, and to accumulate experience and to provide scientific basis for project promotion. Methods In April of 2014, on the basis of 2 community health service centers in Guangxi, a self-intervention and cross-reference study method was used to investigate the self-management activities of 295 community diabetic patients for one year intervention project. Before and after intervention, the questionnaires(the situations of diabetes in core knowledge, lifestyle, self-management behavior and blood glucose control and so on) and blood glucose test were conducted to compare. The effect of intervention was evaluated. The t test, χ~2 test and rank sum test were used to analyze the data, the used software was SPSS 18.0. Results After the intervention, patients with diabetes scored significantly higher than before the intervention in the 6 core knowledge aspects of diabetes diagnosis standard, diabetes symptoms, high risk factors of diabetes, risk factors of hypoglycemia, hazards and complications of diabetes, and prevention and treatment measures of diabetes(P <0.05). After the intervention, the smoking,drinking, oil and salt intake and dietary habits of diabetic patients were improved and their healthy lifestyles increased significantly(P<0.05). After intervention, the proportions of taking medications, fundus examination and foot examination of patients with diabetes according to the doctor's suggestion significantly increased(P<0.05). The frequency of blood glucose monitoring increased significantly,and the satisfaction of blood glucose control and health significantly increased(P <0.05). After the intervention, the normal value proportion of random blood glucose increased from 49.83% to 58.64%(P <0.05). Conclusion Community diabetes self-management project could change the lifestyles of diabetic patients in the communities, and improve the self-management consciousness and management effectiveness, and play the roles in the control of blood glucose. It is worth promoting in the communities.
引文
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[8]刘付东,孙晓凯,许晓庆,等.社区糖尿病患者自我管理小组活动效能评价[J].中国慢性病预防与控制,2015,23(11):879-880.
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[10]王建华.糖尿病自我管理全书[M].北京:科学出版社,2010:22-23.
[11]张惺惺,董文兰,姜莹莹,等.我国六省(市)医务人员糖尿病自我管理知识技能水平及影响因素分析[J].中国慢性病预防与控制,2015,23(5):359-361.
[2]董建群.慢性病患者自我管理实践—糖尿病[M].北京:人民卫生出版社,2014:3.
[3]国家慢性非传染性疾病综合防控示范区办公室.国家慢性非传染性疾病综合防控示范区考核评价工作手册(修订版)[M].2012.
[4]苏宁,王亚东,陈琦,等.北京市城区高血压和糖尿病患者社区管理现状[J].中国公共卫生,2010,26(7):900-901.
[5]张萍,于宝柱,李欣欣,等.糖尿病患者饮食治疗依从性及影响因素分析[J].中国公共卫生,2010,26(12):1563-1564.
[6]王镭.生活方式疾病防治[M].北京:北京大学出版社,2014:55-59.
[7]黄砚萍,董建群.慢性病患者自我管理的政策发展[J].中国慢性病预防与控制,2012,20(2):222-225.
[8]刘付东,孙晓凯,许晓庆,等.社区糖尿病患者自我管理小组活动效能评价[J].中国慢性病预防与控制,2015,23(11):879-880.
[9]朱百琼,王俊,吴苏君.自我管理小组活动对糖尿病患者的效果评估[J].浙江临床医学,2014,16(9):1506-1507.
[10]王建华.糖尿病自我管理全书[M].北京:科学出版社,2010:22-23.
[11]张惺惺,董文兰,姜莹莹,等.我国六省(市)医务人员糖尿病自我管理知识技能水平及影响因素分析[J].中国慢性病预防与控制,2015,23(5):359-361.