南虹社区慢性病健康管理服务模式的探讨

Health management of risk factors of chronic diseases in Nanhong community

目的探讨健康管理服务模式优化社区居民生活方式，有效控制慢性非传染性疾病（慢性病）的发生发展，提高生活质量的效果。方法对珠海市南虹社区231名29～65岁居民进行为期半年的健康调查、评估、干预，并进行健康管理前后效果评价，选择38名慢性病患者采用知己饮食、运动量化管理模式。结果231名居民生活方式得到明显优化，参加知己管理模式的38名慢性病患者6个月后平均体重下降1．3kg，体重指数下降0．5，腰围减少1．8cm，健康管理前后比较差异均有统计学意义（均P〈0．05）。结论在社区进行居民健康管理是十分可行和有效的，尤其是对慢性病患者实施知己饮食、运动量化管理服务模式。

ObJective Chronic diseases are recognized as a major health problem in the 21st century. This project was to assess the effects of self-awareness health management service on optimization of life-style of community residents so as to effectively control the occurrence and development of chronic diseases. Method A survey of health information, an evaluation of health status, health intervention were conducted among 231 people aged between 29-65 years in a community for a half year, and the health management was effectively assessed. Of them, 38 subjects with chronic diseases were subjected to diet friends used and exercise quantitative management model. Results The way of life of the 231 people has been optimized, and in the 38 patients with chronic diseases who had adopted the management mode of friends six months later their average body weight dropped by 1.3 kg, body mass index dropped by 0.5, and waist circumference reduced by 1.8 cm （ P 〈 0. 05 ）. Conclusion It is feasible to conduct health management in residents of communities, especially in patients with chronic diseases, which conforms to the basic principles and requirements of prevention and treatment of chronic diseases advocated by WHO.