个体化健康教育模式在签约家庭医生团队的社区老年慢性病患者中的应用

Application of Individualized Health Education Model in the Elderly Patients with Chronic Diseases in the Community Who Signed Up with Family Doctor Team

目的探讨个体化健康教育模式在签约家庭医生团队的社区老年慢性病患者中的应用价值。方法选取2018年1—12月在郑州市航海东路社区卫生中心登记签约的214例老年慢性病患者,根据建档顺序将其分为对照组和观察组,各107例。对照组接受首诊负责制常规社区健康教育,观察组接受个体化健康教育模式。比较两组患者治疗依从性(血糖控制达标、规律服药、危险行为改变)、健康知识掌握情况及临床相关指标(收缩压、舒张压、空腹血糖、餐后2 h血糖)。结果干预后,两组血糖控制达标、规律服药、危险行为改变、健康知识掌握比例均高于干预前,且观察组血糖控制达标、规律服药、危险行为改变、健康知识掌握比例均高于对照组(均P<0.05)。干预后,两组收缩压、舒张压、空腹血糖、餐后2 h血糖均低于干预前,且观察组收缩压、舒张压、空腹血糖、餐后2 h血糖均低于对照组(均P<0.05)。结论在签约家庭医生团队的社区老年慢性病患者中实施个体化健康教育模式,可有效提高患者的疾病认知,提高按时用药依从性及对家庭医生签约服务总体满意度,值得在基层社区卫生服务机构推广。

Objective To explore the application value of individualized health education model in the elderly patients with chronic diseases in the community who signed up with family doctor team.Methods A total of 214 elderly patients with chronic diseases who signed in Hanghai East Road Community Health Center,Zhengzhou from January to December 2018 were selected.They were divided into control group and observation group according to the filing order.Each group had 107 cases.Control group accepted routine community health education under the responsibility system of first diagnosis,and observation group accepted individualized health education model.The treatment compliance(blood glucose control standard,regular medication,risk behavior change),health knowledge and clinical related indexes(systolic blood pressure,diastolic blood pressure,fasting blood glucose and 2-hour postprandial blood glucose)were compared between the two groups.Results After intervention,the proportions of blood glucose control standard,regular medication,risk behavior change and health knowledge in the two groups were all higher than those before intervention,and the proportions of blood glucose control standard,regular medication,risk behavior change and health knowledge in observation group were all higher than those in control group(all P<0.05).After intervention,the systolic blood pressure,diastolic blood pressure,fasting blood glucose and 2-hour postprandial blood glucose in the two groups were all lower than those before intervention,and the systolic blood pressure,diastolic blood pressure,fasting blood glucose and 2-hour postprandial blood glucose in observation group were all lower than those in control group(all P<0.05).Conclusion The implementation of individualized health education model in elderly patients with chronic diseases in the community who signed up with family doctor team can effectively improve the patients’disease awareness,drug compliance on time and overall satisfaction with the contracted service of family doctors,which is worth promoting in the community health service institutions at the grass-roots level.