社区老年人慢性病与生活方式调查及分层护理模式构想

Survey on Chronic Diseases and Lifestyle of the Elders in Community and Stratified Nursing Model Envisioning

目的了解社区老年人慢性病患病与生活方式的关系,为发展老年人的社区医疗保健服务工作提供参考。方法 2011年3—4月采用方便抽样、集中调查和入户调查相结合方法对社区500名≥60岁老年人进行问卷调查。调查内容为躯体疾病及生活方式,并对两者关系进行分析。结果调查的老年人年龄60～94岁,平均(68.8±6.9)岁,年龄为60～69岁者296例(59.2%)。患慢性病者333例,患病率为66.6%;患病率较高的6种慢性病为高血压(43.0%,215/500)、心脏病(23.6%,118/500)、偏头痛(16.8%,84/500)、高胆固醇血症(15.8%,79/500)、慢性支气管炎(14.4%,72/500)、糖尿病(12.6%,63/500),6种慢性病患病率比较,差异有统计学意义(χ2=195.539,P=0.000)。吸烟与高血压、心脏病和慢性支气管炎患病率有关,饮酒与慢性支气管炎、糖尿病患病率有关,食用大蒜与高胆固醇血症患病率有关,食盐口味与高血压、心脏病患病率有关,独居与心脏病患病率有关,爱看电视与心脏病、偏头痛患病率有关,经常下棋与高血压患病率有关,经常体育锻炼与偏头痛患病率有关,差异均有统计学意义(P<0.05)。对影响患慢性病的相关因素进行多因素Logistic回归分析,结果显示吸烟〔OR=2.820,95%CI(1.378,5.774),P=0.005〕、饮酒〔OR=2.606,95%CI(1.266,5.363),P=0.009〕、经常下棋〔OR=0.402,95%CI(0.207,0.782),P=0.007〕进入回归方程。结论吸烟、饮酒是患慢性病的危险因素,经常下棋是其保护因素。结合研究结果,构想慢性病社区分层护理模式。

Objective Investigate the relationship between chronic diseases and lifestyle of the elders community, so as to provide basis for developing community health service for the elders. Methods A total of 500 elders （ age I〉 60） from the community were investigated by adopting convenience sampling, centralized investigation and household survey with questionnaires during March and April in 2011. The investigation were their chronic diseases and lifestyle, and then analyzed their rela-tionship. Results The age of the eiders investigated was 60 ± 94 years old, the average age was （68.8±6.9） years old. 296 cases （59.2%） were 60 - 69 years old. 66. 6% of the elderly suffered from chronic diseases; the high prevalence of chronic diseases can be ordered as： hypertension （43.0%, 215/500） , heart disease （23.6%, 118/500） , migraine （ 16. 8%, 84/ 500）, high cholesterol （ 15.8%, 79/500 ）, chronic bronchitis （ 14. 4%, 72/500 ） and diabetes （ 12. 6%, 63/500 ）, differences between these chronic diseases were statistically significant （X^2 = 195. 539, P = 0. 000） . The prevalence of hyper- tension, heart disease and chronic bronchitis were associated with smoking, and the prevalence of chronic bronchitis and diabetes were associated with drinking, the prevalence of hypercholesterolemia was concerned with eating garlic, the prevalence of hyper- tension and heart disease were concerned with salt flavor, the prevalence of heart disease was concerned with living a/one, the prevalence of heart disease and hemicrania was concerned with enjoying watching television, the prevalence of hypertension was concerned with often playing chess, the hemicrania was concerned with doing physical training, differences were all statistically significant （ P 〈 0.05 ） . Multiple Logistic regression analysis showed that smoking （ OR = 2. 820, 95% CI （ 1. 378, 5. 774 ）, P = 0. 005] , drinking [ OR = 2. 606, 95% CI （ 1. 266, 5. 363 ） , P = 0. 009] and often playing chess [ OR = 0. 402, 95 % CI （0. 207, 0. 782） , P = 0. 007 ] entered the regression equation. Condusion Smoking, drinking were risk factors for chronic disease, but often playing chess was protective one. According to research and learning from the foreign and domestic idea, strati-fied nursing model was envisioned.