北京市糖尿病患者社区综合干预的效果评价研究  

Effect Evaluation of Comprehensive Community Intervention in Patients with Diabetes in Beijing

作　　者：杨世兵[1] 苏宁 刘威[1] 陈琦[1] 王亚东[1] 梁万年[2] 

机构地区：[1]首都医科大学卫生管理与教育学院,首都卫生管理与政策研究基地,北京市100069 [2]中国卫生部应急办公室

出　　处：《中国全科医学》2010年第10期1084-1087,共4页Chinese General Practice

基　　金：北京市政府2006年第118号折子工程

摘　　要：目的了解"慢病管理和费用控制项目"对北京市糖尿病患者社区综合干预的效果,为制定下一步干预方案提供依据。方法在北京市城区遴选20家社区卫生服务站作为干预组,选择12家社区卫生服务站作为对照组,从中选择4家干预站和4家对照站作为本评价研究的研究现场。于项目实施前(2006年初,基线调查)和项目实施后(2007年中,终期调查)采取偶遇抽样的方法抽取在8家社区卫生服务站就诊的糖尿病患者作为调查对象。基线调查中,共调查干预组糖尿病患者136人,对照组147人;终期调查中,共调查干预组糖尿病患者93人,对照组108人。比较干预前后糖尿病患者知识掌握、自我管理以及对服务满意度的变化。结果干预组在干预措施实施前后,在糖尿病知识掌握情况方面,遗传因素、肥胖、高热量饮食等危险因素的知晓情况间差异有统计学意义(χ2=6.430,P=0.011;χ2=6.318,P=0.012;χ2=4.587,P=0.032);在自我健康管理行为方面,调整饮食、加强锻炼间差异有统计学意义(χ2=4.316,P=0.038;χ2=6.020,P=0.014);满意度方面,对医生诊疗技术的满意度增加(χ2=6.612,P=0.010)。结论社区综合干预对糖尿病患者的管理效果令人满意,值得在社区慢病管理中推广。Objective To find out the effect of comprehensive community intervention on patients with diabetes melli- tus in Beijing after the implementation of a project called ＂ Chronic Disease Management and Expense Control＂ so as to provide basis for further establishment of invitation plan. Methods The urban community health service （CHS） institutions in Beijing were selected as interventional group （n = 20） and control group （n = 12）, and 4 institutions were selected form each group as the study locales. The patients with diabetes mellitus visiting in the 7 institutions were randomly sampled. The baseline question- naire survey was conducted before the implementation of the project （early 2006） including 136 diabetic patients in the interven- tion group and 147 in the control group, and the terminal survey was conducted after the implementation of the project （ mid 2007） including 93 diabetic patients in the intervention group and 108 in the control group. The changes were compared in knowledge, self - management and degree of satisfaction between the two groups. Results After comprehensive community in- tervention, the knowledge awareness of high risk factors including hereditary element, obesity and high caloric diet in the interventional group was raised （χ2= 6. 430, P = 0. 011 ; χ2 = 6. 318, P = 0. 012 ;χ2= 4. 587, P = 0. 032 ）. The proportion of patients that control their diet and exercise regularly was improved significantly （χ2 = 4. 316, P = 0.038; χ2 = 6.020, P = 0. 014）. The satisfaction rate about the doctors＇ skill was also increased （ χ2 = 6. 612, P =0. 010）. Conclusion The comprehensive community intervention for diabetes patients is satisfactory in effect, and worth to be popularized for chronic disease management in CHS.

关 键 词：糖尿病 社区 干预性研究 效果评价 

分 类 号：R587.1[医药卫生—内分泌] R197[医药卫生—内科学]