沈阳市长白社区慢性病共病患病情况及老年患者积极度与健康结局的相关性研究  

Prevalence of Multiple Chronic Conditions and the Correlation between Patient Activation and Health Outcomes among the Elders in Changbai Community,Shenyang

作　　者：周玉刚[1] 王爽[1] 张陆 肖焕[1] 赫曙光 刘雪君[1] 于凯[1] 赵心[1] 于晓松[1] 

机构地区：[1]中国医科大学附属第一医院全科医学科,辽宁省沈阳市110001 [2]辽宁省沈阳市和平区长白社区卫生服务中心,110166

出　　处：《中国全科医学》2017年第4期465-471,共7页Chinese General Practice

基　　金：国家自然科学基金资助项目(71273279)--基于全科医生连续性服务的整合式健康管理服务模式的研究;辽宁省科技计划项目(2013225089)--基于全科医生签约服务的代谢综合征临床管理整合模式研究;沈阳市科学技术计划项目(F13-220-9-62)--社区代谢综合征患者临床管理适宜技术规范化研究

摘　　要：目的了解沈阳市长白社区全科医生签约成年居民慢性病及其共病(MCCs)患病情况,探讨老年MCCs患者积极度与健康结局的相关性。方法截止到2015年3月,沈阳市长白社区卫生服务中心辖区常住居民35 268例,已与全科医生团队建立签约服务关系的签约成年居民4 569例,其中60岁及以上的老年居民1 979例。依据自愿参加原则,选取于2014-10-09至2015-04-09到长白社区卫生服务中心就诊的60~80岁签约MCCs患者180例。于2015年3月,采用统一制定的调查表从签约成年居民个人健康档案中提取性别、年龄、受教育程度、慢性病患病情况等相关信息。采用患者积极度量表(PAM)、健康状况自评问卷、简明记忆症状评估量表(CMSAS)、健康调查量表(SF-36)等对180例60~80岁签约MCCs患者进行问卷调查。结果 4 569例签约成年居民中,慢性病患者2 268例,MCCs患者1 010例,慢性病、MCCs患病率分别为49.64%、22.11%。1 979例签约老年居民中,慢性病患者1 448例,MCCs患者792例,慢性病、MCCs患病率分别为73.17%、40.02%。1 855例60~80岁签约居民中,慢性病患者1 358例,MCCs患者748例,慢性病、MCCs患病率分别为73.21%、40.32%。不同性别的签约成年居民慢性病患病率比较,差异无统计学意义(P>0.05);不同年龄、受教育程度的签约成年居民慢性病患病率比较,差异均有统计学意义(P<0.05)。不同性别、年龄、受教育程度的签约成年居民MCCs患病率比较,差异均有统计学意义(P<0.05)。180例60~80岁MCCs患者积极度平均得分为(58.3±10.8)分;患者积极度第1、2、3、4水平患者数分别为24例(13.33%)、47例(26.11%)、79例(43.89%)、30例(16.67%);抑郁/焦虑阳性患者积极度总分与阴性患者比较,差异有统计学意义(P<0.05)。Spearman秩相关分析结果显示,患者积极度得分与自评健康状况呈正相关(rs=0.268,P<0.05)。Pearson相关分析结果显示,患者积极度得分与生活质量总分、生理健康�Objective To investigate the prevalence rates for chronic diseases and multiple chronic conditions（MCCs） among adults signing service contracts with general practitioners（GPs） and to study the correlation between patient activation and health outcomes among the elders in Changbai community,Shenyang. Methods Of the 35 268 residents in the community,we selected 4 569 adult residents including 1 979 aged 60 or over（the above numbers were counted as of March2015） who had signed the service contracts with GPs. The baseline characteristics of them, including types and number of chronic diseases and basic health information（gender, age, educational attainment） were investigated with the uniform questionnaire from contracted residents＇ health records in March 2015. Meanwhile,we also selected 180 MCCs patients aged 60～ 80 from the adult residents,who visited Changbai Community Health Service Center from October 9,2014 to April 9,2015 and voluntarily participated in the questionnaire survey with Patient Activation Measure（PAM）,Self-rated General Health,Condensed Memorial Symptom Assessment Scale（CMSAS） and Short Form 36 Questionnaire（SF-36）. Results The prevalence rate of chronic diseases was respectively 49. 64% in all adults（2 268 /4 569） and 73. 17% in the elders（1 448/1 979） in this community. The prevalence rate of MCCs was respectively 22. 11%（1 010 /4 569） and 40. 02%（792/1 979）. The prevalence rate for chronic diseases,MCCs among the 1 855 residents aged 60 ～ 80 was 73. 21%（1 358 /1 855）,and 40. 32%（748 /1 855）,respectively. No significant gender difference in the prevalence rate for chronic diseases existed between all the 4 569 adult residents（P〈0. 05）. Remarkable age and educational attainment differences were observed in the prevalence rate for chronic diseases between the 4 569 adult residents（P〈0. 05）. There were distinct gender, age and educational attainment differences in the prevalence rate for MCCs between the 4 569 adult residents（P

关 键 词：慢性病 慢性病共病 患病率 患者积极度 结果评价(卫生保健) 

分 类 号：R197[医药卫生—卫生事业管理]