家庭医生特色签约服务对老年2型糖尿病患者自我管理的效果

Effect of Family Doctor Contract Service on Self-management of Elderly Patients with Type 2 Diabetes

目的:探讨家庭医生特色签约服务对社区老年2型糖尿病患者自我管理情况的干预效果。方法:选取2019年1月-2020年1月北京市朝阳区豆各庄社区卫生服务中心就诊的接受家庭医生特色签约服务的老年2型糖尿病患者230例作为观察组,选取同期就诊未签约患者230例作为对照组。比较两组患者自我管理行为情况、健康指标、服务满意度。结果:管理后,观察组糖尿病自我管理行为总分、饮食、运动治疗、血糖监测、足部护理及用药情况评分均高于对照组,差异有统计学意义(P<0.05)。管理后,观察组患者腰围、空腹血糖、餐后2 h血糖、糖化血红蛋白、收缩压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇均低于对照组,差异有统计学意义(P<0.05)。观察组服务满意度高于对照组,差异有统计学意义(P=0.035)。结论:家庭医生特色签约服务适合在家庭医生制度较成熟地区推广,可改善老年糖尿病患者自我管理行为,改善健康指标,提高服务满意度。

Objective:To explore the intervention effect of family doctor contract service on self-management of elderly patients with type 2 diabetes in the community.Methods:A total of two hundred and thirty elderly patients with type 2 diabetes who received family doctor contract service in Dougezhuang Community Health Service Center of Chaoyang District of Beijing from January 2019 to January 2020 were selected as the observation group,and two hundred and thirty patients who received no contract service during the same period were selected as the control group.Self-management behavior,health indicators and service satisfaction were compared between the two groups.Results:After management,the total score of diabetes self-management behavior,diet,exercise therapy,blood glucose monitoring,foot care and medication in the observation group were higher than those in the control group,with statistically significant difference(P<0.05).After management,waist circumference,fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,systolic blood pressure,triglyceride,total cholesterol and low density lipoprotein cholesterol in observation group were lower than those in control group,with statistically significant difference(P<0.05).The service satisfaction in observation group was higher than that in control group,and the difference was statistically significant(P=0.035).Conclusion:The family doctor contract service is suitable for promotion in areas with mature family doctor system,which can improve the selfmanagement behavior of elderly patients with diabetes mellitus,improve health indicators,and increase service satisfaction.