社区推行慢性病人自我管理课程效果的评估  

Evaluation of chronic disease self-management program in an urban community

作　　者：钱云[1] 董美华[1] 董昀球[1] 沈冲[2] 沈洪兵[2] 

机构地区：[1]无锡市疾病预防控制中心健康促进部,江苏无锡214023 [2]南京医科大学公共卫生学院,江苏南京211166

出　　处：《中华疾病控制杂志》2014年第5期439-442,共4页Chinese Journal of Disease Control & Prevention

基　　金：江苏省科技支撑计划(社会发展)(BE2009 681);无锡市卫生局重大项目(Z201304);江苏省预防医学科研项目(Y2012079)

摘　　要：目的探讨在我国城市社区中推行慢性病人自我管理课程(chronic disease self-management program,CDSMP)的有效性和可行性。方法以社区卫生服务中心登记管理的高血压病和(或)2型糖尿病患者为干预对象,分别在干预前和干预后4个月进行问卷调查。运用无结构式调查问卷就CDSMP在社区推行的内容和形式调查社区卫生服务中心主任、课程组长和组员。结果电话通知200例患者,99例自愿参加,应答率49.50%;93例(占93.94%)上完6节课程并完成基线和干预后4个月两份调查问卷。4个月后,93例对象4个症状指标(健康担忧、疲劳、气短、疼痛)分值均下降,每周运动时间增加,自我管理效能提高,最近4个月住院次数和住院天数下降。在传播过程中可适当调整课程内容和形式;政策和基金支持可促使CDSMP传播在社区初级卫生保健中可持续性推行。结论在中国城市社区传播CDSMP可提高慢性病患者的健康行为、改善其健康状况、提高自我管理效能;在传播过程中适当调整课程内容和形式可增强其可行性。Objective To evaluate the effectiveness and feasibility of chronic disease self-management program （CDSMP） in a urban community. Methods Patients with hypertension and/or type 2 diabetes managed in the community health service center were recruited. Baseline and 4-month post-interviews were conducted respectively. The contents and forms were evaluated using non-structured interviews among directors, course leaders and participants. Results A total of 200 subjects were informed and 99 agreed to enter the 6-session program, with the response rate being 49.50%. Of the 99, 93 （with retention rate being 93.94% ） completed 6 sessions and completed pre-post interviews. At 4 months post-inter- views, statistically significant improvements were found for 4 symptom variables, excise, and self-efficacy. Hospitalization and days in hospital reduced significantly. The contents and forms may be appropriately adjusted. CDSMP could be sustain- ably embedded into primary health care with policy support and funding. Conclusions CDSMP proved to be effective in improving chronic disease patients＇ health behaviors, health status and self-efficacy in the urban community. In order to make CDSMP more feasible, the contents and forms may be appropriately adjusted during dissemination.

关 键 词：慢性病 评价研究 流行病学 

分 类 号：R19[医药卫生—卫生事业管理] R181[医药卫生—公共卫生与预防医学]