不同模式的社区健康管理对更年期妇女知信行的影响

Impacts of Different Health Management Modes on Knowledge,Attitude,Practice of Menopausal Women in Community

目的通过对更年期妇女实施不同模式的社区健康管理,探索出适合更年期妇女的社区健康管理模式。方法选取在月坛社区卫生服务中心及下属社区卫生服务站就诊的40～60岁更年期妇女355例为研究对象。其中干预组160例,给予以全科医师为主导、通过双向转诊与妇科医师共同管理的健康管理模式;对照组195例,维持目前的全科医师慢性病管理模式。管理时间为1年。于干预前后对两组更年期妇女进行问卷调查,比较不同健康管理模式对其知、信、行的影响;采用kupperman评分法测量两组更年期妇女的更年期症状评分,评估干预效果。结果干预后,干预组妇科相关知识的知晓率、慢性病相关知识的知晓率、健康生活方式的采纳率、疾病定期筛查率较对照组提高,差异均有统计学意义(P<0.05)。干预前,干预组、对照组的更年期症状评分分别为(10.18±1.06)分、(10.48±0.97)分,差异无统计学意义(P>0.05);干预后,两组评分分别为(6.20±0.76)分、(9.50±0.88)分,差异有统计学意义(P<0.05)。结论对更年期妇女实施以全科医师为主导、通过双向转诊与妇科医师共同管理的健康管理模式,可以提高其健康知识的知晓率,促进健康行为的采纳,减轻更年期症状,最终改善其健康水平。

Objective To explore and find a suitable mode of health management for menopausal women in community through implementing different modes of community health management for menopausal women. Methods Totally 355 women aged between 40 and 60 were enrolled from the Yuetan Community Health Service Center and its affiliating stations. The trial group includes 160 women whose health was jointly managed through two - way referral and gynecologists under the guidance of general practitioners （GP）. The contrast group includes 195 women whose health was maintained by the current GP management of chronic diseases. The duration of intervention was one year. The information was collected by questionnaire survey before and after the intervention. The impacts of different health management modes on knowledge, attitude, practice （KAP） between the two groups were compared. And Kupperman Scoring was taken to measure their menopausal symptoms and evaluate the intervention effect. Results After one year intervention the awareness rates of gynecological knowledge and chronic diseases, the rate of adopting health living style, and the rate of regularly screening diseases were higher in the trial group than in the control group （ P 〈0. 05）. Before the intervention the score of menopausal symptoms was （ 10. 18 ± 1.06） in the trial group and （ 10. 48 ±0.97） in the control group, with no significant difference （P 〉0.05）. After the intervention, however, it was （6. 20 ±0.76） in the former and （9. 50 ± 0. 88 ） in the latter, with a significant difference （ P 〈 0. 05 ） . Conclusion The new community health management of menopausal women jointly managed through two - way referral and gynecologists under the guidance of GP can raise the awareness rate of health knowledge, promote the adoption of healthy behaviors, and reduce the menopausal symptoms, and thus improve health level for the menopausal women.