健康管理对欠发达地区农村高血压患者生活质量的干预效果评价

Effect of health management on quality of life of hypertensive patients living in underdeveloped rural regions

目的 评价健康管理对改善欠发达地区农村高血压患者生活质量的干预效果.方法 以甘肃省民勤县作为研究现场,采用类试验流行病学设计方法,对患者采取全人群的健康教育和个性化随访管理,并以8条目简明（SF-8）最表评价患者的生活质量变化情况,分别对基线期和随访结束期患者的生命质量评分进行比较.结果 试验组结局期生活质量各项维度得分较基线期均有显著提高（P〈0.05）,其中一般健康状况较基线提高10.92分,躯体活动功能对角色功能影响较基线提高9.59分,而社会功能状况较基线提高4.61分.经协方差分析校正了基线水平不均衡后,结果提示试验组结局期生活质量各维度得分较对照组均差异有统计学意义（P〈0.05）,试验组生活质量各维度得分均显著高于对照组.结论 在欠发达地区农村,以乡镇卫生院医务人员为主导的初级卫生保健力量在健康管理理念的指导下,通过对高血压患者开展主动的筛查、随访和健康教育,可以有效改善患者的生活质量.

Objective To evaluate the effectiveness of health management on quality of life of hypertensive patients living in underdeveloped rural regions. Methods Minqin County of Gansu Province was taken as research field, and health education covered all the population. Individual follow-up was adopted by quasi-experiment,and SF-8 scale was used to evaluate the change of scores of quality of life at baseline and the end of the study. Results The score of various dimension of quality life of interventive group showed a significant decrease at the end of follow-up （ P 〈 0. 05） , and the net score of general health status was 10. 92,the net score of impact to social role exerted by physical function was 9. 59,and the net score of social function was 4.61. Moreover, there was statistical difference between the intervention group and the control group for their quality of life（P 〈0. 05） , which showed in detail that each dimension of quality of life of the intervention group had higher score than that of the control group, after adjusting baseline difference by analysis of covariance. Conclusions All these results suggest that the active screening, following up and health education, conducted by the primary health care staff of township hospitals, under the idea of health management, can improve the quality of life of hypertension patients effectively in the rural area of underdeveloped region.