医院-社区-家庭三位一体老年慢性病管理模式的构建——以帕金森病为例

Construction of the Hospital-Community-Family Trinity Management Model for Chronic Diseases of the Elderly——Taking Parkinson’s Disease as an Example

目的以帕金森病为例,构建“医院-社区-家庭”三位一体老年慢性病管理模式,探讨其对慢病管理的应用价值。方法选择96例帕金森病患者,随机分为观察组和对照组,对照组给予常规药物治疗+专科指导及宣教,观察组在此基础上给予“医院-社区-家庭”三位一体管理模式干预,比较两组患者的认知功能及生活质量情况。结果干预后,对照组患者的蒙特利尔认知评估量表(MoCA)评分无改变(P>0.05),观察组评分改善(P<0.05)。干预后,对照组统一帕金森病评定量表(UPDRS)评分在日常生活能力、运动检查和治疗并发症方面有所改善(P<0.05),而精神、行为及感情方面无明显变化(P>0.05);观察组在运动检查、治疗并发症方面均有改善,在日常生活能力,精神、行为及感情方面明显改善(P<0.05)。结论“医院-社区-家庭”三位一体老年慢性病管理模式可显著提高帕金森病患者的认知功能及生活质量,是适合我国国情的慢病管理模式,值得推广。

Objective Taking Parkinson’s disease as an example,a trinity chronic disease management model of“hospitalcommunity-family”was constructed to explore its application value in chronic disease management.Methods A total of 96 patients with Parkinson’s disease admitted to Yueyang Hospital of Traditional Chinese Medicine were randomly divided into the observation group and the control group.The control group received routine drug treatment,specialized guidance and education.On this basis,the observation group conducted the“hospital-community-family”trinity management mode intervention.The cognitive function and quality of life of the two groups of patients was compared.Results The score of MoCA in the control group was not statistically signifi-cant before and after the intervention(P>0.05),while the score in the observation group was improved(P<0.05).Before and after inter-vention,the scores of UPDRS in the control group were improved in daily living ability,motor examination and treatment complica-tions(P>0.05).After intervention,the observation group improved in sports examination and sports complications,and significantly im-proved in daily living ability and emotional state(P<0.05).Conclusion The“hospital-community-family”trinity chronic disease man-agement model for the elderly can significantly improve the cognitive function and quality of life of Parkinson’s patients.It is a chronic disease management model suitable for China’s national conditions and worth promoting.