武汉市社区脑卒中高危人群的健康促进行为现状调查

Investigation on health promotion behavior among high-risk population of stroke in Wuhan community

目的调查武汉市社区脑卒中高危人群一般资料以及生活方式和饮食习惯方面的健康促进行为状况,以便针对性制定相关干预措施及医疗建议。方法于2020年6—12月采用整群抽样法在武汉市13个行政区中随机选取1个常驻人口≥5 000人的社区,对该社区内的≥40岁常住居民进行脑卒中高危人群筛查,筛查出的高危人群进一步完成健康促进行为的问卷调查。采用描述流行病学分析方法对调查结果进行分析。结果共对2 315名武汉市社区≥40岁常住居民进行脑卒中筛查,共筛查出脑卒中高危人群239例,占比10.32%。危险因素≥3项者183例,8项危险因素筛查比例依次为:缺乏运动122例(66.67%)、血脂异常118例(64.48%)、超重或肥胖106例(57.92%)、高血压103例(56.28%)、脑卒中家族史74例(40.44%)、吸烟史66例(36.07%)、糖尿病34例(18.58%)、心房颤动或瓣膜性心脏病5例(2.73%),满足既往短暂性脑缺血发作(TIA)/脑卒中史的高危人群为56例,其中既往脑卒中史49例(87.50%),既往TIA史7例(12.50%)。不同年龄、婚姻状况、职业情况、经济状况(月收入)、医保类型的社区脑卒中高危人群的健康促进生活方式量表Ⅱ(HPLP-Ⅱ)评分差异均有统计学意义(均P<0.01)。脑卒中高危人群HPLPⅡ总评分为(116.01±18.13)分,各维度得分率从高到低依次为:人际间关系(64.42%)、营养(59.28%)、压力管理(58.08%)、健康职责(53.14%)、自我实现(57.13%)、运动锻炼(47.70%)。结论脑卒中高危人群生活方式和饮食习惯状况不容乐观,缺乏运动以及高糖高脂饮食是主要的不良生活方式和饮食习惯,应针对以上要素制定更加有效的干预措施,建立健康的生活方式和饮食习惯。

Objective To investigate the general information,health promotion behavior in lifestyle and dietary habits among high-risk population of stroke in Wuhan community,so as to formulate relevant intervention measures and medical suggestions.Methods From June to December 2020,a community with a resident population ≥ 5 000 was randomly selected from 13 boroughs of Wuhan by cluster sampling method. The permanent residents aged ≥ 40 years in the community were screened for high-risk of stroke,and the health promotion behavior of the residents who were assessed as high-risk population of stroke were investigated by questionnaire. Descriptive epidemiological analysis method was used to analyze the survey results.Results A total of 2 315 permanent residents aged ≥ 40 years in Wuhan community were screened for stroke,and 239 high-risk population were screened,accounting for 10.32%. There were 183 cases had ≥ 3 risk factors,and the screening ratios for 8 risk factors were as follows:122 cases of lack of exercise(66.67%),118 cases with dyslipidemia(64.48%),106 cases with overweight or obesity(57.92%),103 cases with hypertension(56.28%),74 cases had family history of stroke(40.44%),66 cases had history of smoking(36.07%),34 cases with diabetes(18.58%),5 cases of atrial fibrillation or valvular heart disease(2.73%). The high-risk population meeting the history of previous transient ischemic attack(TIA)/stroke was 56 cases,including 49 cases of previous stroke(87.50%)and 7 cases of previous TIA(12.50%). There were statistically significant differences in the health promoting lifestyle profile-Ⅱ(HPLP Ⅱ)scores among high-risk population of stroke in different age,marital status,occupation,economic status(monthly income)and medical insurance type(all P < 0.01). The total score of HPLP Ⅱ was(116.01 ± 18.13),the level of lifestyle and dietary habits were poor,and the score rate of each dimension from high to low was interpersonal relationship(64.42%),nutrition(59.28%),stress management(58.08%),health responsibility(53.14%),self-actualization(57.13%)and physical activity(47.70%).Conclusion The life style and dietary habits of the high-risk population of stroke are not optimistic. Lack of exercise and high sugar and high fat diet are the main bad lifestyle and dietary habits.More effective intervention measures should be formulated according to the above factors to establish healthy lifestyle and dietary habits.