社区慢性病管理模式在老年糖尿病患者管理中的应用效果分析  

Analysis on Application Effect of Community Chronic Disease Management Mode in Management of Elderly Patient with Diabetes

作　　者：温娟 邵华 李艳杰 Wen Juan;Shao Hua;Li Yan-jie(Beijing Chaoyang District Jiangtai Community Health Service Center,Beijing 100016,China)

机构地区：[1]北京市朝阳区将台社区卫生服务中心,北京100016

出　　处：《中国社区医师》2023年第9期158-160,共3页Chinese Community Doctors

摘　　要：目的:探讨老年糖尿病患者应用社区慢性病管理模式的价值。方法:选取2021年1月—2022年7月北京市朝阳区将台社区卫生服务中心收治的84例规律就诊的老年2型糖尿病患者作为研究对象,根据管理方式的不同分为常规管理组与优质管理组,各42例。常规管理组实施常规管理模式,优质管理组在常规管理组基础上采用社区慢性病管理模式。对比两组疾病控制情况、知信行的效果及血糖指标变化情况。结果:优质管理组疾病总控制率高于常规管理组,差异有统计学意义(P<0.05)。管理后,优质管理组患者知识层面、态度层面、行为层面评分均高于常规管理组,差异有统计学意义(P<0.05)。管理后,优质管理组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于常规管理组,差异有统计学意义(P<0.05)。结论:老年糖尿病患者应用社区慢性病管理模式的效果显著,可全方位调节患者血糖指标,提高患者知信行评估分数。Objective:To explore the value of community chronic disease management mode in the elderly patients with diabetes.Methods:From January 2021 to July 2022,84 elderly patients with type 2 diabetes mellitus who had regular visits in Jiangtai Community Health Service Center of Chaoyang District of Beijing were selected as the study subjects.The patients were divided into routine management group and high-quality management group according to the difference of management mode,with 42 cases in each group.The routine management group implemented the routine management mode,and the high-quality management group implemented the community chronic disease management mode on the basis of the routine management group.The disease control,the effect of knowledge,attitude and practice,and the changes of blood glucose indexes were compared between the two groups.Results:The total disease control rate in the high-quality management group was higher than that in the routine management group,and the difference was statistically significant(P<0.05).After management,the scores of knowledge,attitude and behavior levels in the high-quality management group were higher than those in the routine management group,and the differences were statistically significant(P<0.05).After management,the fasting blood glucose,2 h postprandial blood glucose and glycated hemoglobin levels in the high-quality management group were lower than those in the routine management group,and the differences were statistically significant(P<0.05).Conclusion:The community chronic disease management mode in the elderly patients with diabetes has significant effects,it can comprehensively regulate the blood glucose index of patients,and improve the scores of patients'knowledge,attitude and practice assessment.

关 键 词：社区管理 慢性病管理 老年人 糖尿病 

分 类 号：R587.1[医药卫生—内分泌]