家庭保健员在社区慢性病防治中的作用

Investigation of Community Family Health Workers′ Function in Prevention and Treatment of Chronic Disease

目的通过对比培训家庭保健员前后社区居民生活习惯及基本生理指标的变化,探索家庭保健员在社区慢性病防治中的作用。方法通过自愿报名、社区百姓推选、现场筛选等途径,在社区内选择符合相关条件的居民入选家庭保健员并进行培训。在培训前、培训结束1年后两个时间点以问卷形式进行健康信息收集采样,并进行统计学分析。结果培训前健康信息收集采样调查家庭保健员5 400人,家庭成员3 600人,共收回有效问卷7 236份(80.4%)。培训结束后1年,再次发放问卷进行调查,部分失访,收回有效问卷6 729份,回收率为92.99%,其中家庭保健员4 018份,家庭成员2 711份。两次收回有效问卷中家庭保健员均以35～59岁为主,家庭成员均以≥60岁为主;家庭保健员和家庭成员均以初中文化程度为主。培训结束后1年家庭保健员和家庭成员吸烟、饮酒、体育锻炼、日常生活心态的调整、吃早餐、食用蔬菜、水果、豆、奶及豆奶制品情况、炒菜用油、食盐摄入量等情况较培训前均明显改善,差异有统计学意义(P<0.05)。培训结束后1年初中、高中、大专及以上文化程度被调查者的吸烟和饮酒情况较培训前均明显改善,差异有统计学意义(P<0.05)。培训结束后1年被调查人员的收缩压、舒张压及空腹血糖水平较培训前均明显下降,差异有统计学意义(P<0.05)。结论家庭保健员在社区慢性病防治工作中起到了积极的作用,值得推广。

Objective To find out the role of Family Health workers（FHW） in prevention and treatment of chronic disease by observing the changes of daily habits and physical signs of residents in Beijing community before and after FHW training.Methods Community family health workers were recruited in many ways,such as voluntary registration,residents′ recommendation and screening on the spot,ect.They were assigned to take part in a training program.Survey was conducted in the form of questionnaires among FHWs and their family members at four time points：before-training,end of training,half-year after training,and one year after training and the health information collected was analyzed statistically.Results Before training,5 400 FHWs and 3 600 family members signed up for the survey,but only 7 326（80.4%） of the questionnaires were effective.When the training came to an end one year later,the then effective questionnaires turned to 6 729,accounting for 92.99%,including 4 018 FHWs′ and 3 600 family members′.Among the effective returned questionnaires,FHWs were between 35 and 59 years old and family members were all above 60 years old;both of them mainly had middle school educational background.One year after training,they had bigger improvement in the daily habits such as smoking,drinking,physical education,state of mind adjustment,breakfast,vegetables,fruits,beans,milk and soy bean products,edible oil and salt intake,and so on and the difference was significant（P〈0.05）.One year after training,the subjects with middle school education and above had obvious improvement in smoking and drinking and the difference was also significant（P〈0.05）.One year after training,their systolic blood pressure,diastolic blood pressure and fasting blood-glucose had an obvious decrease and the difference was significant as well（P0.05）.Conclusion Family Health Workers play an important role in prevention and treatment of chronic disease,and it is well worth popularizing.