慢性病保健模型在社区高血压管理中的应用研究  

Application of the chronic care model in hypertension management in community health services

作　　者：高超[1] 郭岸英[2] 刘盼盼[3] 缪艳瑶[1] 吕伊然[1] 王红妹[1] 

机构地区：[1]浙江大学社会医学与全科医学研究所,杭州310058 [2]宁波市妇女儿童医院 [3]浙江医学高等专科学校

出　　处：《中华医院管理杂志》2012年第12期921-924,共4页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金资助项目（70603024）;“十一五”国家科技支撑计划项目（2007BAl07A06）

摘　　要：目的评价慢性病保健模型在社区高血压管理中应用的效果。方法采用实验对照研究方法，在杭州市朝晖社区选取高血压患者300名，分为实验组和对照组。实验组按照慢性病保健模型设计干预措施，对照组仍按社区原有方法管理，9个月后比较两组患者干预前后相关指标变化。结果干预前后，实验组在饮酒习惯、每日用盐量（降低0．78g）、舒张压（降低2mmHg）、体质指数（降低0．4）和SF-36生理得分（降低1．7）上有改善（P〈0．05），实验组在体重指数和SF-36生理总分上的变化值高于对照组。结论慢性病保健模型通过对患者饮食、运动及其他健康相关危险因素的引导干预达到提高健康产出的目的，对我国的社区高血压管理有一定借鉴意义。Objective To evaluate the effectiveness of Chronic Care Model in hypertension managnentin community health services. Methods Three hundred patients diagnosed with hypertension participated in this study and were divided into intervention and control groups In the following 9 months, intervention measures based on the Chronic Care Model were delivered to intervention group, while the conventional measures to control group. Data collected before and after the intervention were analyzed using descriptive statistics, t-test, 3（2-test and analysis of covariance by SPSS 16. 0 for Windows. Results The intervention group bad statistically significant positive effectiveness in drinking habit, daily salt intake（decreased 0. 78g）, diastolic blood pressure （decreased 2mmHg）, BMI （decreased 0. 4） and SF-36 physical component summary score （decreased 1.7） （P〈0. 05）. The intervention group bad better improvement in BMI and SF-36 physical component summary score than the control group. Conclusion The health outcomes of patients with hypertension could be improved by applying the Chronic Care Model featured diet, exercise habits and other health related factors management.

关 键 词：慢性病保健模型 疾病管理 高血压 

分 类 号：R473.2[医药卫生—护理学]