社区中老年居民骨质疏松健康促进效果分析

Analysis on the effects of health education and promotion on osteoporosis in middle-aged and elderly residents in Jiangsu province

目的研究骨质疏松社区综合干预模式的作用，从而为开展社区骨质疏松健康教育工作提供参考依据。方法采用多阶段分层随机整群抽样的方法，先按照经济水平和地理位置把江苏省13个省辖市分为苏南、苏中和苏北3个区域，在苏南、苏中和苏北各抽取1个省辖市南京市、南通市和徐州市，然后在每个省辖市抽取1个城区，在每个城区抽取3个街道。基线调查共抽取1500名社区居民作为调查对象进行筛查，共筛查出619名骨质疏松高危人群作为干预对象进行干预，然后依据相同社区、相同性别和年龄相差不超过5岁选择对照590名，对干预组居民开展健康管理和综合干预，干预半年前后，使用自行设计问卷进行调查。结果干预半年后，干预组与对照组比较发现，干预组居民对骨质疏松症对人体的最严重危害是什么（χ^2=24．27）、骨质疏松的特征性表现（χ^2=11．05）、有助于骨健康的基本补充剂包括哪些（χ^2=60．65）、绝经后妇女和老年人每日钙摄入推荐量是多少（χ^2=26．80）的知识知晓率明显提高，差异有统计学意义（P〈0．05）；干预组居民影响骨质疏松症的日常行为中每周饮用奶类及制品少于3d（χ^2=25．83）、每周食用豆类及制品少于3d（χ^2=19．20）、每周饮用咖啡超过3d（χ^2=7．77）、不经常户外活动（χ^2=18．55）、每天有氧运动6千步当量以下（χ^2=29．81）、饮食口味较重（χ^2=8．26）、未测量过骨密度行为有明显改善（χ^2=121．23），差异有统计学意义（P〈0．05），但其他行为如现在吸烟率、每周饮酒3d以上等行为无明显改善；干预组居民骨质疏松相关疾病和症状中骨折（χ^2=15．15）、身体疼痛（χ^2=21．33）和脚抽筋的发生率减少（χ^2=73．68），差异有统计学意义（P〈0．001）。结论在社区老年居民中开展骨质疏松健康知识普及和高危人群健康管理效果较好，可以进一步推广和应用。

Objective To study the effects of community comprehensive intervention model on osteoporosis, in order to provides a reference for osteoporosis health education work. Methods A multistage stratified random cluster sampling was applied to conduct a survey in Jiangsu province, in accordance with the economic level and geographic location. Nanjing, Nantong and Xuzhou cities were sampled, three urban streets were sampled in every district , respectively. A total of 1 500 40-69 years old community residents were screened, 619 high-risk participants for osteoporosis were arranged into the intervention group, and a total of 590 residents from the same communities were chosen as control group, who were gender- and age-matched with the intervention group. The intervention group residents received health management and comprehensive intervention, after half a year, a self-designed questionnaire was used to investigate the effects. Results Compared with control group, after six months, knowledge of intervention group related to osteoporosis awareness was improved significantly, such as the most serious harm to human body for osteoporosis （χ^2=24.27）, characteristic of osteoporosis （χ^2=11.05）, basic supplements to improve bone health （χ^2=60.65） , the recommended daily calcium intake to postmenopausal women and the elderly （χ^2=26.80）, the difference was statistically significant （P〈0.05）; daily behavior related to diet and exercise of intervention group has improved significantly, such as drinking milk or itsproducts less than 3 days a week （χ^2=25.83）, eating beans and products for less than 3 days a week （χ^2=19.20）, drinking coffee for more than three days a week （χ^2=7.77）, not often taking outdoor activities （χ^2= 18.55）, （P〈0.05）; Diseases and symptoms related to osteoporosis in intervention group was significantly reduced （P〈0.001）. Conclusions The osteoporosis is one of the most important public health problem for Jiangsu province, the work for osteoporosis prevention and control should be emphasized in community.