衡阳市社区高血压合并糖尿病患者个体化健康教育效果评价

Evaluation of individual health education and home visiting intervention effect for patients with hypertension combined with diabetes from community in Hengyang

目的评价个体化健康教育对社区高血压合并糖尿病患者进行综合防治的效果。方法采用随机抽样方法,抽取衡阳市雁峰区860例高血压合并糖尿病患者为研究对象,分为对照组和干预组各430例,对照组予以常规慢性病随访管理,干预组在对照组的基础上由同组社区全科责任医护团队全程予以口头教育、电话咨询及知识竞赛等模式进行个体化干预,比较2组的防治效果。结果经个体化健康教育后,社区高血压合并糖尿病患者在高盐饮食(52.32%)、饮酒(20.46%)等膳食方面改变最大,但吸烟(62.56%)无显著变化;干预24个月后,干预组血压[收缩压(130.89±8.70)mm Hg,舒张压(78.29±4.75)mm Hg]、空腹血糖[(6.69±1.36)mmol/L]、餐后2 h血糖[(8.81±1.24)mmol/L]、糖化血红蛋白[(6.38±1.03)%]及甘油三酯[(1.23±0.68)mmol/L]均低于干预前和对照组同期水平,差异有统计学意义(P<0.05)。结论在社区高血压合并糖尿病患者中采用社区全科责任医护团队个体化健康教育家访效果更好,有助于患者病情维持稳定。

Objective To evaluate the effect of comprehensive prevention for health education on the community patients with hypertension and diabetes mellitus in Hengyang. Methods 860 patients with hypertension and diabetes were randomly selected as the research object from the pioneer community in Hengyang City. The controls were given the routine followup of chronic diseases management while the intervention group were given home visiting intervention of individual health education on the basis of the control group by the same group of community general duty medical team as the controls to improve the way of life and so on. The control efficacy of the two groups were compared. Results By individualized health education,in terms of diet about community patients with hypertension and diabetes mellitus,the greatest change are high salt intake（ 52. 32%） and drink（ 34. 88%）,but not smoking（ 62. 56%）. Compared to the controls and same period of before intervention,the intervention group related metabolic parameters such as blood pressure [SBP（ 130. 89 ± 8. 70） mm Hg,DBP（ 78. 29 ±4. 75） mm Hg],fasting blood glucose（ 6. 69 ± 1. 36） mmol/L,2- hour postprandial blood glucose（ 8. 81 ± 1. 24）mmol / L,glycosylated hemoglobin（ 6. 38 ± 1. 03） % and triglyceride（ 1. 23 ± 0. 68） mmol / L,blood lipid have decreased,the difference was statistically significant（ P〈 0. 05） the difference was statistically significant（ P 〈0. 05）. Conclusion Usingthe individualized health education to the community patients with hypertension and diabetes mellitus can obtain a better consequences,and can also make the state of illness patients maintain stability.