家庭医生双签约服务对社区老年房颤患者管理的影响

Impact of family-doctor dual contract services on the management of elderly atrial fibrillation patients in community

目的探讨家庭医生双签约服务在社区老年房颤患者中的管理效果。方法选择2020年1月—2021年12月社区老年房颤患者100例为研究对象,根据管理方法不同分为观察组和对照组,每组各50例。对照组接受常规家庭医生签约服务管理模式,观察组联合家庭医生—专家双签约服务管理模式,2组均干预12个月,比较2组心率、血压、自我管理水平、抗凝治疗比例、满意度及依从性。结果2组管理12个月后心率和血压达标率得到提高;观察组心率、SBP及DBP达标率高于对照组(P<0.05);观察组管理12个月后的自我管理水平各维度评分高于对照组(P<0.05);观察组抗凝治疗比例高于对照组(P<0.05);满意度、定期复查、遵医嘱用药及饮食指导高于对照组(P<0.05);手术治疗率低于对照组(P<0.05)。结论家庭医生双签约服务用于社区老年房颤患者管理中,有助于降低其心率、SBP及DBP水平,提高患者自我管理水平,提高抗凝治疗占比,可获得较高的满意度及依从性,值得进一步推广。

Objective To explore the management effect of family-doctor dual contract services on elderly atrial fibrillation patients in community.Methods 100 elderly patients with atrial fibrillation in the community from January 2020 to December 2021 were selected as the research subjects.They were divided into observation group and control group based on different management methods,with 50 cases in each group.The control group received a routine family doctor contract service management model,while the observation group received a joint family doctor-expert dual contract service management model.Both groups were intervened for 12 months.The heart rate,blood pressure,self-management level,proportion of anticoagulant treatment,satisfaction,and compliance were compared between the two groups.Results After 12 months of management,the compliance rates of heart rate and blood pressure of both groups increased,while the compliance rates of the heart rate,SBP,and DBP of the observation group were higher than those of the control group(P<0.05).After 12 months of management,the self-management level scores in all dimensions of the observation group were higher than those of the control group(P<0.05);the proportion of anticoagulant treatment in the observation group was higher than that in the control group(P<0.05);the satisfaction,regular follow-up,medication adherence,and dietary guidance of the observation group were higher than those of the control group(P<0.05);the surgical treatment rate was lower than that of the control group(P<0.05).Conclusion The application of family-doctor dual contract services in the management of elderly atrial fibrillation patients in the community is help to reduce patients'heart rate,SBP and DBP,improve their self-management level,improve the proportion of anticoagulation therapy,and obtain higher satisfaction and compliance.It is worth of further promotion.