社区-家庭保健员-居民健康教育模式的效果评价

Effect evaluation of community-family health worker-resident education model

目的通过对比家庭保健员培训前后的基本生理指标,家庭保健员及其家庭成员的生活行为习惯的改善效果,探索家庭保健员在社区卫生健康教育中的作用。方法通过门诊筛选、自愿报名、入户筛选等途径,由石景山区某社区卫生中心及其下属2010—2013年6个社区卫生服务站在辖区内选择符合相关条件的居民进行家庭保健员培训。家庭保健员在培训前、培训结束一年后分别以问卷形式进行健康信息收集采样,对家庭保健员培训前后基本生理指标变化和家庭保健员及其家庭成员生活行为习惯变化、健康知识水平进行统计分析。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果家庭保健员培训前的BMI、收缩压、舒张压、空腹血糖、糖化血红蛋白[(24.70±2.08)kg/m2、(146.35±24.34)、(84.32±10.91)mmHg(1mmHg=0.133kPa)、(7.03±1.55)mmol/L、(6.55±1.28)%]较培训后[(23.10±1.74)kg/m2、(124.72±10.09)、(76.19±7.10)mmHg、(5.64±0.90)mmol/L、(5.60±0.89)%]差异均有统计学意义(均P<0.05)。家庭保健康员及其家庭成员在培训前、后的生活习惯中,吸烟、体育运动、食盐摄入的差异有统计学意义(P<0.05)。家庭保健员及其家庭成员的健康知识水平培训前后的差异有统计学意义(P<0.05)。结论社区-家庭保健员-居民健康教育模式可以改善慢性病患者的生理指标、改善家庭成员生活习惯、提高健康知识知晓率的作用,值得推广。

Objective To discuss the role of family health workers（FHWs） in community health education by comparing basic physiological indicators of family health workers before and after training,as well as the improvement of living behaviors of family health workers and family members.Methods Community family health workers were recruited for training from a community health center of Shijingshan district and its 6 community health service stations in 2010- 2013,mainly in the following ways,such as outpatient- selection,voluntary registration,or household screening.Survey was conducted in the form of questionnaires among FHWs before training and 1 year after training.The data of physiological indicators of family health workers,the improvements of daily habits and health knowledge of family health workers and their families were analyzed statistically.Measurement data were processed by t- test,count data by χ2 test,the result of P〈0.05 indicated the difference was statistically significant.Results After training,the physiological indicators of FHWs such as body mass index（BMI）,systolic blood pressure,diastolic blood pressure,fasting blood glucose and glycated hemoglobin [（24.70±2.08）kg/m^2、（146.35±24.34）、（84.32±10.91）mmHg、（7.03±1.55）mmol/L、（6.55±1.28）%] showed statistically significant difference from those before training[（23.10±1.74）kg/m2、（124.72±10.09）、（76.19±7.10）mmHg、（5.64±0.90）mmol/L、（5.60±0.89）%]（all P〈0.05）.After training,daily living habits,smoking,sports and salt intake of FHWs and family members showed statistically significant difference from those before training（P〈0.05）.After training,the level of health knowledge among FHWs and family members was significant improved（P〈0.05）.Conclusion Community- family health worker- resident health education model may improve the physiological indicators of chronic patients,living habits of family memebers,as well as the awareness of health knowledge,which is worthy of being widely applied.