“快乐生活俱乐部”在社区糖尿病管理中的效果评价

Evaluation of "Happy Life Club" in Community Management of Type II Diabetics in Beijing

目的了解"快乐生活俱乐部"在社区糖尿病管理中的作用,为糖尿病自我管理的社区干预策略提供依据。方法在北京市丰台区方庄社区卫生服务中心的2型糖尿病患者中招募100名志愿者,参加"快乐生活俱乐部"活动,并将其随机分为两组。干预组在常规药物治疗的基础上,由健康教练按计划开展动机谈话;对照组仅采用常规药物进行治疗,干预期限为6个月。结果与对照组相比,干预组患者监测自我血糖的频率增加,更多地按照医生的建议服药;高密度脂蛋白、餐后2h血糖、糖化血红蛋白等指标的水平较干预前改善,差异有统计学意义(P<0.05)。结论 "快乐生活俱乐部"这一新的慢病管理模式,可以提高糖尿病患者的自我管理能力,并使患者具备不断增强改变行为的能力。

Objective To understand the effect of ＂Happy Life Club＂ on community diabetes management,and to provide a policy implication for the community intervention of diabetes self-management.Methods Totally 100 volunteers with type II diabetes in Fangzhuang Community in Beijing were recruited to participate in the activity in ＂Happy Life Club＂.They were randomly divided as intervention and control groups.The patients in the intervention group received motivational interviewing by ＂health coach＂ besides conventional medical treatment.Those in the control group received conventional medical treatment only.The term of intervention was six months.Results Compared with the control group the frequencies of blood glucose self-monitoring was higher in the intervention group;the compliance of medication was better;and the levels of high density lipoprotein-cholesterol （HDL-C）,2-hour postprandial blood glucose （2hPG） and glycosylated hemoglobin （HbA1c） were better（P0.05）.Conclusion As a new pattern of chronic disease management,＂Happy Life Club＂ improved patients′ self-management ability,and enabled them behavioral adaptive capacity.