医共体模式下专家参与社区慢病管理对老年社区糖尿病患者疾病认知和健康行为及血糖控制的影响  

Effects of expert participation in community chronic diseases management under medical alliance model on disease cognition,health behaviors and blood glucose control in elderly community patients with T2DM

作　　者：许烨萍 龚学军 陈梦霞 何莉颖[1] XU Ye-ping;GONG Xue-jun;CHEN Meng-xia;HE Li-ying(Yiwu Central Hospital Medical Alliance Zhoujiang Branch,Yiwu,Zhejiang 322000,China)

机构地区：[1]义乌市中心医院医共体稠江院区,浙江义乌322000

出　　处：《环境与健康杂志》2024年第12期1071-1075,共5页Journal of Environment and Health

基　　金：义乌市科研计划项目(20-3-175)。

摘　　要：目的探讨医共体模式下专家参与社区慢病管理对社区2型糖尿病(T2DM)老年患者疾病认知、健康行为及血糖控制的影响。方法研究对象为2020年9月至2022年7月社区T2DM老年患者220例,根据2021年7月推行医共体模式下专家参与社区慢病管理模式为分界,将2020年9月至2021年6月给予社区常规策略管理的110例患者纳入常规管理组,将2021年7月至2022年7月给予医共体模式下专家参与社区慢病管理的110例患者纳入强化管理组,对比两组患者干预前、后的疾病认知[疾病感知问卷(CIPQ-R)]、健康行为[糖尿病自我管理行为量表(SDSCA)、糖尿病管理自我效能量表(DMSES)]、血糖控制情况[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]及睡眠情况[匹兹堡睡眠质量量表(PSQI)]。结果干预后,两组患者疾病CIPQ-R各维度评分均明显提高(P<0.05),且强化管理组干预后评分明显高于常规管理组(P<0.05)。干预后,两组患者SDSCA和DMSES评分均明显提高(P<0.05),且强化管理组干预后评分明显高于常规管理组(P<0.05)。干预后,两组患者FPG、2hPG、HbA1c水平均明显降低(P<0.05),且强化管理组干预后水平明显低于常规管理组(P<0.05)。干预后,两组患者PSQI各维度评分均明显降低(P<0.05),且强化管理组干预后评分明显低于常规管理组(P<0.05)。结论医共体模式下专家参与社区慢病管理可有效改善社区T2DM老年患者对疾病的认知水平,提升健康行为强化自我保健能力,进而利于血糖控制和睡眠改善,值得应用。Objective To understand the effects of community chronic disease management with expert participation under medical alliance model on disease cognition,health behaviors and blood glucose control in elderly community patients with T2DM.Methods The research subjects were 220 elderly patients with type 2 diabetes mellitus(T2DM)in the community from September 2020 to July 2022.According to the implementation of expert participation in community chronic disease management under medical alliance model in the hospital in July 2021,110 patients who were given routine strategic management in the community from September 2020 to June 2021 were included in routine management group,and another110 patients who were given community chronic disease management with expert participation under medical alliance model between July 2021 and July 2022 were enrolled as intensive management group.The disease cognition[Chinese Illness Perception Questionnaire Revised Edition(CIPQ-R)],health behaviors[Summary of Diabetes Self-Care Activities(SDSCA),Chinese Version of Diabetes Management Self-efficacy Scale(DMSES)],blood glucose control[fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG),glycated hemoglobin(HbA1c)]and sleep status[Pittsburgh Sleep Quality Index(PSQI)]were compared between the two groups before and after intervention.Results After intervention,the scores of dimensions of CIPQ-R in the two groups were significantly enhanced(P<0.05),and the scores in intensive management group after intervention were significantly higher than those in routine management group(P<0.05).The scores of SDSCA and DMSES were significantly increased in the two groups after intervention(P<0.05),and the scores in intensive management group were significantly higher compared with those in routine management group after intervention(P<0.05).After intervention,the levels of FPG,2 h PG and HbA1c in the two groups significantly decreased(P<0.05),and the intensive management group had significantly higher levels after intervention than routine

关 键 词：医共体模式 社区慢病管理 T2DM 疾病认知 健康行为 血糖控制 

分 类 号：R181.3[医药卫生—流行病学]