社区综合管理对原发性骨质疏松症患者认知和行为的影响研究  

Effects of Community Comprehensive Management on Cognition and Behavior of Patients with Primary Osteoporosis

作　　者：陆霞芳[1] 夏长春[1] 王芷芊 邓伟 

机构地区：[1]上海市闸北区彭浦新村街道社区卫生服务中心,200435 [2]复旦大学公共卫生学院卫生统计与社会医学教研室,复旦大学公共卫生学院公共卫生安全教育部重点实验室

出　　处：《中国全科医学》2013年第8期842-846,共5页Chinese General Practice

摘　　要：目的探讨社区综合管理对原发性骨质疏松症患者认知和行为的影响。方法 2009年9月,选择上海市闸北区彭浦新村街道社区卫生服务中心门诊确诊的年龄>55岁的女性原发性骨质疏松症患者226例为研究对象,依据患者登记的社区卫生服务点将其分为对照组和干预组,每组113例。对照组进行常规药物治疗,干预组在常规药物治疗基础上进行社区综合管理。记录两组患者干预前后原发性骨质疏松症认知量表、饮食及生活习惯量表、运动自我效能量表、运动行为量表得分及变化,研究结束时对社区医师和干预组患者进行访谈。结果 (1)两组患者干预前原发性骨质疏松症认知量表4个方面得分及总分比较,差异均无统计学意义(P>0.05);干预后比较,在预防保健知识、危险因素方面得分及总分差异有统计学意义(P<0.05)。(2)两组患者干预前饮食及生活习惯量表各方面比较,除经常接受直射日照(≥4次/周)外,差异均无统计学意义(P>0.05);干预后比较,在经常食用鱼虾、虾皮,经常食用深绿色蔬菜,经常接受直射日照,经常服用钙剂方面差异有统计学意义(P<0.05)。(3)两组患者干预前运动自我效能量表各因素得分及总分比较,除物理环境因素得分外,差异均无统计学意义(P>0.05);干预后比较,仅物理环境因素得分及总分差异有统计学意义(P<0.05)。(4)两组患者干预前运动行为量表各方面比较,差异均无统计学意义(P>0.05);干预后比较,仅在过去1年经常进行锻炼、坚持锻炼时间≥3个月方面差异有统计学意义(P<0.05)。(5)干预组综合指导完成率为93.8%。结论对原发性骨质疏松症患者进行社区综合管理,能够提高其对疾病的认知水平,促进其采取促进健康行为。Objective To evaluate the effects of community comprehensive management on cognition and behavior of patients with primary osteoporosis.Methods A total of 226 patients(>55 years old,female) of primary osteoporosis identified at our community health center were divided into the intervention group and the control group(n=113 for each group) in September 2009.Patients in the control group were given routine medication,and patients in the intervention group were given routine medication plus community comprehensive management.The scores of primary osteoporosis scale(POS),diet and lifestyle change scale(DLCS),exercise self-efficacy scale(ESS),and exercise behavior scale(EBS) of patients in the two groups before and after the intervention were recorded.The community doctors and patients in the intervention group were interviewed after the intervention.Results Scores of each of the four dimensions and the total score of POS were not significantly different between the two groups before the intervention(P>0.05),while difference was observed in scores regarding healthcare knowledge and risk factors,as well as the total score after the intervention(P<0.05).No significant difference was observed between patients of the two groups in DLCS scores(except for direct sunshine for 4 times a week or more) before the intervention(P>0.05),while difference was observed in regular fishes and shrimps intake,dark green vegetables intake,sun bath,and calcium medication after the intervention(P<0.05).No significant difference was observed between patients of the two groups in ESS scores(except for physical environment factors) before the intervention(P>0.05),while difference was observed in score of physical environment factors as well as the total score after the intervention(P<0.05).Significant difference was observed in scores of regular exercise of the past year and consistent exercise for more than 3 months of the EBS between the two groups after the intervention(P<0.05).The completion rate of the intervention group was 93.8%.Conclus

关 键 词：社区卫生服务 社区综合管理 骨质疏松 认知 行为 干预 

分 类 号：R681.4[医药卫生—骨科学]