家庭医生在社区2型糖尿病健康管理及护理中的作用

The role of family doctors in community health management and nursing for type 2 diabetes

目的分析家庭医生在社区2型糖尿病患者健康管理中的作用。方法将深圳市碧海云天社区的220例2型糖尿病患者按社区居民的电子健康档案顺序,由电脑随机抽出110例患者作为干预组,抽取110例患者作为常规组。采用家庭医生模式对干预组患者实施健康管理,采用常规管理模式对常规组患者实施健康管理,健康管理实施周期为1年。分别于实施健康管理前、管理后6个月以及管理结束时对患者实施体检,并于管理结后调查患者的疾病控制行为的实施情况。具体检测项目包括FBG、2 hBG、HBA1c、BMI。结果实施健康管理前两组患者上述项目的检测结果比较均不存在明显差异(P>0.05),实施健康管理后6个月干预组上述各项指标的检测结果均优于常规组(P<0.05),健康管理结束干预组上述指标检测结果显著优于常规组(P<0.01)。实施健康管理后干预组遵医嘱用药行为、饮食控制行为、血糖检测行为、机体锻炼行为的实施状况均优于常规组(P<0.05)。结论家庭医生模式在社区2型糖尿病患者健康管理中的应用,能够有效提高患者的自我管理能力和疾病控制水平,有利于促进患者疾病康复。

Objective To analyze the role of family doctors in community health management of patients with type 2 diabetes. Methods 220 patients,with type 2 diabetes from Blue- sea Light- sky community in Shenzhen,were chose and divided into two groups according to the order of their health file,110 patients in the intervention group,and the other 110 patients drawn as a conventional group. Patients in the intervention group adopted family doctor mode for health management,however,conventional health management model was taken for health management in the conventional group,implementation period of health management lasted for one year.All the patients received physical examination three times respectively the time points before the implementation of health management,six months after health management and at the end of the management. Investigated the administration status about the implementation of disease control behavior in patients. Specific test items including FBG,2h BG,HBA1 c,BMI. Results Before the implementation of the health management,the difference of the levels of these projects between the two groups were not statistically significant（ P〉0. 05）. Six months after the implementation of health management, the indexes above in intervention group were better than those in conventional group（ P〈0.05）. At the end of the health management,above indexes in intervention group were significantly better than those in conventional group（ P〈0. 01）. After the implementation of health behavior management,the behavior of follow the doctor ＇ s advice,diet control behavior,the behavior of blood glucose testing,implementation status of the body exercising behaviors in the intervention group were better than the conventional group（ P〈0. 05）. Conclusions The application of family doctor model in community health management of patients with type 2 diabetes,can effectively improve the self-management skills and the disease control level of patients,and promoting the rehabilitation of patients with type 2 diabetes.