同伴教育对乡镇社区糖尿病和高血压患者自我管理行为的影响

The effect of peer health coaching on self-management behavior among patients with diabetes or hypertension in rural community

目的探讨基于"慢性病自我管理项目"的同伴教育对乡镇社区糖尿病和高血压患者自我管理行为的影响。方法采用方便取样的方法,在上海市金山区张堰镇的5个居(村)委组建糖尿病和高血压自我管理小组各5个,选取教育同伴各5例,经过专业培训并考核合格后,由教育同伴者对小组成员进行健康教育。结果干预12周后,糖尿病患者的饮食和运动行为得分显著高于干预前(P<0.05,P<0.01),血糖监测、足部护理、吸烟等行为得分无显著改变(均P>0.05);高血压患者的饮食、用药、情绪、作息、运动行为得分显著高于干预前(均P<0.01),病情监测行为得分无显著改变(P>0.05)。结论基于"慢性病自我管理项目"的同伴教育能提高乡镇社区糖尿病和高血压患者的部分自我管理行为。

Objective To explore the effect of peer health coaching based on the chronic disease self-management program on improving self management behavior among patients with diabetes or hypertension in rural community. Methods Using convenience sam pling method, patients with diabetes or hypertension were selected from 5 villages of Zhangyan town, Jinshan district of Shanghai city, and were assigned to build 10 self-management groups according to their disease type and the village where they lived in. Then l@ peer educators were chosen from each group to provide health education for their team members after specialized training. Results After 12 weeks of intervention, diet and exereise scores were significantly improved in diabetes patients （P〈0. 05, P〈0. 01）, whereas scores of blood glucose monitoring, foot care and smoking had no significant differences （P〉0.05 for all）. Scores of diet, medication, mood, daily schedule, and exercise in patients with hypertension were significantly improved after tbe intervention （P〈0.01 for all）, but disease management score had no significant improvement （P〉 0. 05）. Conclusion Peer health coaching based on the chronic disease self-management program can improve some self-management behaviors among patients with diabetes or hypertension in rural community.