提高糖尿病患者健康素养对其社区卫生服务利用的影响研究  

Influence of the Utilization of Community Health Service on Improving the Health Literacy of Patients With Diabetes Mellitus

作　　者：温秀芹[1] 韩琤琤[1] 刘菊红[1] 赵洁[1] 常春[2] 曾庆奇[2] 郑韵婷[2] 

机构地区：[1]首都医科大学全科医学系德胜社区卫生服务中心,北京市100120 [2]北京大学医学部公共卫生学院社会医学与健康教育系

出　　处：《中国全科医学》2015年第33期4025-4029,4033,共6页Chinese General Practice

基　　金：教育部博士点基金资助项目(20110001110018)

摘　　要：目的探讨提高糖尿病患者健康素养对其社区卫生服务利用的影响。方法 2013年7月—2014年7月采用两阶段整群随机抽样方法抽取北京市西城区德胜社区糖尿病患者(干预前534例、干预后413例)作为研究对象,在德胜社区卫生服务中心实施团队式个体化健康管理干预。比较干预前后患者一般情况、健康素养、基本医疗服务利用、基本公共卫生服务利用、健康状况。结果干预前后患者年龄、性别、民族、婚姻状况、家庭人口数、家庭月收入、医疗保险类型比较,差异无统计学意义(P>0.05);而患者的文化程度、退休前职业分布情况比较,差异有统计学意义(P<0.05)。干预前153例(28.7%)患者具备基本健康素养,381例(71.3%)为低健康素养;干预后147例(35.6%)患者具备基本健康素养,266例(64.4%)为低健康素养。干预后糖尿病患者健康素养水平高于干预前(χ2=5.185,P<0.05)。干预前后糖尿病患者首选医疗机构、两周就诊、签约全科医生情况比较,差异有统计学意义(P<0.05);过去1年住院情况比较,差异无统计学意义(P>0.05)。干预前后糖尿病患者建立健康档案、利用社区健康教育、参加社区免费体检、接种流感疫苗、接受生活方式指导情况比较,差异有统计学意义(P<0.05)。干预前后糖尿病患者自评健康状况、自评糖尿病控制情况比较,差异无统计学意义(P>0.05);干预前后糖尿病患者血糖水平情况比较,差异有统计学意义(P<0.05)。结论提高糖尿病患者的健康素养可增加其对社区卫生服务的有效利用,促进其健康状况改善。Objective To investigate the influence of the utilization of community health service on improving the health literacy of patients with diabetes mellitus. Methods From July 2013 to July 2014, we selected diabetes patients from Desheng Community in the Xicheng District in Beijing using cluster random sampling method by two stages （534 patients beforeintervention and 413 patients after intervention） . Team - based individualized health management intervention was carried out in Desheng Community Health Service Center. Comparison was made in general information, health literacy, the utilization of basic medical services, the utilization of basic public health services and health status between before and after intervention. Results After intervention, patients＇ age, gender, nationality, marital status, number of family members, family monthly income and insurance type were not significantly different from those before intervention （P 〉 0. 05 ） , while patients＇ educational level and the occupation distribution were significantly different from those before intervention （P 〈 0.05 ） . Before intervention, 153 （28.7%） patients had basic health literacy and 381 （71.3%） had low- level health literacy; after intervention, 147 （35.6%） patients had basic health literacy and 266 （64. 4% ） patients had low - level health literacy. After intervention, the health literacy level of the subjects was higher than that before intervention （ x^2 = 5. 185, P 〈 0. 05 ） . After intervention, preferred medical settings, visits to doctors within two weeks and contracts signed with general practitioners were significantly different from those before intervention （ P 〈 0.05 ）, and hospitalization in the last year was not significantly different from that before intervention （ P 〉 0. 05 ） . After intervention, the establishment of health records, the utilization of social health education, the participation of physical examination free of charge in community, the inoculation of influenza

关 键 词：糖尿病 社区卫生服务 健康管理 健康素养 健康状况 

分 类 号：R587.1[医药卫生—内分泌]