行动者网络视域下“四介小”健康管理模式效果研究  

A study on the effectiveness of the“Si Jiexiao”health management model from the perspective of actor-network theory

作　　者：杨琪娇 樊金荣 王鑫 毕圣贤 彭馨怡 徐露 陈迎春[1,3] YANG Qijiao;FAN Jinrong;WANG Xin;BI Shengxian;PENG Xinyi;XU Lu;CHEN Yingchun(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China;Jiexiu City Medical Group,Jiexiu 032000,Shanxi,China;Research Center for Rural Health Services,Hubei Province Key Research Institute of Humanities and Social Sciences,Wuhan 430030,Hubei,China)

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030 [2]山西省介休市医疗集团,山西介休032000 [3]湖北省人文社科重点研究基地农村健康服务研究中心,湖北武汉430030

出　　处：《健康发展与政策研究》2024年第6期531-536,共6页Health Development and Policy Research

基　　金：国家社会科学基金重大项目(23&ZD188)。

摘　　要：目的评估“四介小”健康管理模式对慢性病患者行为改变的影响,为构建新时期基层健康管理模式提供科学依据与实践指导。方法以糖尿病患者为例开展研究,采用便利抽样,匹配问卷调查数据与县域公共卫生系统数据库信息,共纳入477例糖尿病患者作为研究样本,按照是否接受“四介小”健康管理模式管理,分为试验组(n=226)及对照组(n=251)。以患者2023年初次随访数据为基线,对比分析该年度患者末次血糖控制情况、定期随访依从性、运动频率、服药依从性、遵医行为、心理调整等指标。结果“四介小”健康管理模式在促进慢性病患者行为改变方面成效显著。试验组中血糖控制不佳的人数占比(58.85%)明显低于对照组(77.69%);定期随访依从性达到62.83%,显著高于对照组(51.79%),每周运动超过3次(52.21%)的患者比例明显高于对照组(29.08%)。试验组患者规律服药率显著提升,高达85.84%,相较于对照组(77.69%)有明显优势;遵医行为良好患者比例(46.46%)显著高于对照组(31.88%)。但在心理调整方面,组间比较未见统计学意义。结论“四介小”健康管理模式在改善慢性病患者行为上具有明显效果,尤其是在定期随访、运动频率、服药依从性、遵医行为等方面具有显著优势,对心理调节有积极的潜在影响趋势。Objective To evaluate the impact of the“Si Jiexiao”health management model on behavioral changes in chronic disease patients(using diabetes mellitus patients as an example),and to provide scientific evidence and practical guidance for developing grassroots health management model in the new era.Methods The study included a total of 477 diabetic patients as research subjects through convenience sampling.Data from a questionnaire survey were matched with a county-level public health system database information.Patients were divided into the experimental group(n=226)and the control group(n=251)according to whether they had received the“Si Jiexiao”health management model.The initial follow-up data in 2023 were taken as the baseline,and the follow-up results of glycemic control at the end of the year,adherence to regular follow-up,frequency of exercise,medication adherence,medical compliance,psychological adjustment,and other indicators were compared and analyzed.Results The“Si Jiexiao”health management model was found to be effective in promoting behavioral changes in chronic disease patients.Specifically,the proportion of patients with poor blood sugar control in the experimental group(58.85%)was significantly lower than the control group(77.69%);the compliance rate of regular follow-up reached 62.83%,which was remarkably higher than the control group(51.79%),and the proportion of patients who exercised more than three times a week in the experimental group(52.21%)was notably higher than the control group(29.08%).The rate of regular medication adherence in the experimental group was significantly improved,reaching as high as 85.84%,which had a vital advantage over the control group(77.69%);at the same time,the proportion of patients with good compliance to medical advice(46.46%)was significantly higher than the control group(31.88%).However,no statistically significant difference was observed in psychological adjustment between the two groups.Conclusions The“Si Jiexiao”health management model has obv

关 键 词：行动者网络理论 四介小 健康管理 效果分析 

分 类 号：R19[医药卫生—卫生事业管理]