以社区为基础的健康促进和自我管理对居民骨质疏松防治知信行及骨量减低的影响  

Influencing on knowledge,belief,behavior associated with osteoporosis and osteopenia due to health promotion and selfmanagement based on the communities

作　　者：丁贤彬[1] 陈婷[1] 许杰 毛德强[1] 杨弦弦 DING Xian-hin;CHEN Ting;XU Jie;MAO De-qiang;YANG Xian-xian(Imtitute of Non-communicable Disease Prevention and Control,Chongqing Center for Disease Prevention cmd Control,Chongqing 400042,China)

机构地区：[1]重庆市疾病预防控制中心慢病所,重庆400042

出　　处：《中国慢性病预防与控制》2022年第3期176-180,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：重庆市科卫联合医学科研项目(2020FYYX013)。

摘　　要：目的 评估以社区为基础的健康促进与自我管理干预前后40岁及以上居民骨质疏松防治知识、健康相关行为和骨密度变化情况,为完善骨质疏松防治措施提供建议。方法 于2016—2017年,在重庆市4个试点区随机抽取2 100名调查对象,依据纳入、排除标准,干预前共纳入2 028人。以社区为依托组织开展健康教育、自我管理、新媒体干预等,干预时间为6个月,评估干预前后居民骨质疏松防治知识、健康相关行为和骨密度的变化情况。采用SPSS 25.0统计软件进行χ^(2)检验和条件logistic回归分析。结果 1 944人全程参加干预和干预后评估,失访率为4.14%,平均年龄(56.7±12.1)岁。干预后,调查对象对骨质疏松的特征性表现(64.87%)、骨质疏松易患人群(65.53%)、预防骨质疏松均衡膳食内容(59.62%)和骨健康基本补充剂主要内容(59.83%)的知晓率均高于干预前(分别为47.94%、53.76%、48.71%和50.46%),差异均有统计学意义(P<0.01)。干预后,食用油摄入过多的比例(71.14%)低于干预前(74.13%),差异有统计学意义(P<0.05)。干预后,过去3个月饮用奶类及制品(33.33%)、食用豆类及制品(14.51%)、服用钙和维生素D营养补充剂的频率≥5 d/周的比例(17.39%)高于干预前(分别为25.62%、10.49%和13.01%),差异均有统计学意义(P<0.01)。干预后过去3个月内进行户外活动每天接受日照的平均时间≥30 min的比例(64.30%)高于干预前(59.21%),干预后骨量减低的比例(46.30%)低于干预前(55.30%),差异均有统计学意义(P<0.01)。条件logistic回归分析结果显示,干预是骨量减低的保护因素(OR=0.65,95%CI:0.56~0.74)。结论 以社区为基础的综合干预可以提高居民骨质疏松防治知识的认知水平,促进健康行为的形成,降低骨量减低患病率,该干预措施是可行和值得推广的。Objective To assess the change of knowledge,behavior associated with osteoporosis and bone mineral density among residents (≥40 years old) before and after the health promotion and self-management based on the communities,and provide the suggestion for improving the intervention and treatment measures of osteoporosis. Methods From 2016-2017,in four pilot districts of Chongqing,2 100 residents (≥40 years old) were selected for the study,only 2 028 residents were included before intervention according to the criteria of inclusion and exclusion. All subjects received the intervention measures including health education,self-management and new media intervention from the communities for six months.The change of prevention and treatment knowledge and health behavior associated with osteoporosis and bone mineral density before and after the intervention were evaluated. The χ^(2)test and conditional logistic regression were used to analyze the data. The used software was SPSS 25.0. Results Total 1 944 cases finished the intervention course and evaluation,the rate of loss to follow up was 4.14%,average age was(56.7±12.1) years old. After the intervention,the awareness rates about the features of osteoporosis(64.87%),sensitive population of osteoporosis(65.53%),balanced diet to prevent osteoporosis(59.62%),bone health supplements(59.83%) were significantly higher than those(47.94%,53.76%,48.71% and 50.46%) before the intervention,P <0.01. The proportion of oil excessive intake after the intervention was 71.14% which was significantly lower than that(74.13%) before the intervention(P<0.05);the proportions of drinking milk and its products,beans and their products intake,calcium and vitamin D supplements intake over five days per week after the intervention for 3 months were 33.33%,14.51% and 17.39% which were significantly higher than those(25.62%,10.49% and 13.01%) before the intervention,P<0.05. The proportion of average daily outdoor activity time with sunlight ≥30 minutes after intervention for 3 months was 64.

关 键 词：骨质疏松 骨量减低 健康教育 综合干预 

分 类 号：R681[医药卫生—骨科学]