心脑血管病高危人群自我管理能力的影响因素及健康教育效果

Influence factors of self-management ability of high risk population of cardiovascular and cerbrovascular disease and effect of health education

目的探讨心脑血管病高危人群自我管理能力及其影响因素，并探讨健康教育的效果。方法选取2400例脑血管病高危人群为研究对象，并进行2年健康干预。2年间通过调查问卷的方法对其生活方式与自我管理能力状况进行4次调查并相互比较。结果高危人群自我管理能力女性（11303例）高于男性（850例）、文化程度高的人群高于文化程度低的人群、经济收入高的人群（1073例）高于经济收入低的人群（780例），差异具有统计学意义（χ^2=202．76，35．65，179．84；P〈0．05）；随着就诊次数的增加，自我管理能力也不断增加，差异具有统计学意义（χ^2=29．36，P〈0．05）；干预管理后高危人群的空腹血糖值（5．32±0．63）mmol／L、餐后2h血糖值（6．35±2．48）mmol／L、HbAl。（4．8±1．4）％、TC（3．2±1．4）mmol／L、TG（1．5±0．7）mmol／L、LDL-C（1．7±0．6）mmol／L，均低于干预前（7．24±2．18）mmol／L，（11．17±3．44）mmol／L，（9．1±3．4）％，（4．1±1．2）mmol／L，（4．1±1．2）mmol／L，（3．1±1．2）mmol／L，差异均有统计学意义（F=1．535，2．124，1．191，Q298，5．073，1．282；P〈n05）。结论心脑血管病高危人群自我管理能力较差，强化干预可以提高高危人群的自我管理能力，促进其健康。

Objective To understand lifestyle and self-management ability of high risk population of cardiovascular and cerebrovascular disease, and explore the effect of health education. Methods 2 400 high-risk in cardiovascular and cerebrovascular disease, 35 -85 years old, were selected and underway health intervention. Lifestyle and self-management ability were surveyed by questionnaire four times in two years. The heath status was compared. Results Self management ability was different in different populations： female （1 003 cases） was significantly higher in males （850 cases） ; higher degree of education ranked above the lower education level; higher income ranked above the lower income persons. The Chi square values were 134.69, 155.86, 85.90, respectively and the all P values were less than 0.05. Self-management ability was positively correlated with the number of visits （ ~2 = 69.55, P 〈 0. 05）. Fasting blood glucose level was （5.32 ± 0.63 ） mmol/L, 2 h blood glucose after meal was （6.35 ± 2.48） retool/L, HbAlc was （4.8 ± 1.4） %, TC was （3.2 ± 1.4） mmol/L, TG was （ 1.5 ± 0.7 ） mmol/L, and LDL-C was （ 1.7 ± 0.6） mmol/L, respectively after intervention, and those index before intervention were （7.24 ±2.18） mmol/L, （11.17 ± 3.44） mmol/L, （9. 1 ±3.4）%, （4.1 ± 1.2） mmol/L, （4.1 ± 1.2）mmol/L, （3.1 ± 1.2）mmol/L, respectively, and the differences were statistically significant （F = 1. 535, 2. 124, 1. 191, 0. 298, 5. 073, 1. 282 ; P 〈 0. 05）. Conclusions Population at high risk of cardiovascular and cerebrovascular diseases has low self-management ability. Reinforcement of health intervention could improve their self-management ability and promote their health status.