PRECEDE-PROCEED模式在社区慢性肾脏疾病患者健康管理中的应用效果

Effects of PRECEDE-PROCEED model on community health management of chronic kidney disease patients

目的探讨PRECEDE-PROCEED模式应用于社区慢性肾脏疾病(CKD)患者健康管理中的效果,为提升社区CKD综合防治提供帮助。方法采用便利抽样法,于2017年9月,在新乡市中心医院合作的社区医院选取CKD 3~4期患者共105例,给予为期6个月的PRECEDE-PROCEED模式管理,采用四川大学华西医院肾内科疾病知识调查问卷于入组、干预1个月、3个月及6个月时分别评价患者对疾病的认知情况,并检查同时间点相关的临床和生化指标变化情况。结果研究对象入组、干预1个月、3个月及6个月时对疾病认知程度评分分别为(31.40±8.79)、(45.32±10.51)、(56.57±12.16)、(72.83±14.75)分,随干预时间的延长,研究对象对疾病认知程度逐渐加深(F=233.574,P<0.01)。随干预时间延长,收缩压、舒张压、血清蛋白、血尿素氮、血肌酐、尿酸、血钙、血磷及肾小球滤过率逐渐降低,差异有统计学意义(P<0.01)。结论PRECEDE-PROCEED模式能有效提高社区CKD患者对疾病的认知,并能延缓CKD的进展,健康管理效果显著。

ObjectiveTo explore the effects of PRECEDE-PROCEED model on the health management of community patients with chronic kidney disease(CKD)and to improve the comprehensive prevention and control of CKD.MethodsTotally 105 patients with stage 3 or stage 4 CKD from community hospitals in partnership with Xinxiang Central Hospital were selected by convenient sampling in September 2017,who received management with PRECEDE-PROCEED model for 6 months.The Disease Knowledge Questionnaire developed by the Department of Nephrology,West China Hospital,Sichuan University was used to evaluate the patients'illness perception at inclusion as well as 1 month,3 months and 6 months after intervention,and the changes of relevant clinical and biochemical indicators were examined at the same time points.ResultsThe subjects'illness perception scores at inclusion as well as 1 month,3 months and 6 months after intervention were(31.40±8.79),(45.32±10.51),(56.57±12.16)and(72.83±14.75),respectively.The longer the intervention,the deeper the illness perception was(F=233.574,P<0.01).The subjects'systolic pressure,diastolic pressure,serum protein,blood urea nitrogen,serum creatinine,uric acid,blood calcium,blood phosphate and glomerular filtration rate decreased gradually as the duration of intervention became longer(P<0.01).ConclusionsPRECEDE-PROCEED model can effectively improve the illness perception of community patients with CKD,retard the progress of CKD,and bring better health management effects.