CAJ | 학술논문

目的：探讨以家庭医生服务团队为主线，家庭医生工作室为平台，个体、群体相结合的社区卫生服务模式对城市社区空巢老人生活质量、社会支持、孤独水平、抑郁状况以及生化指标的影响，从而探讨建立适合城市社区空巢老人的卫生服务模式。方法2012年2月在上海市嘉定区真新街道整群抽取4个社区空巢老人，按社区随机分为干预组和对照组。干预组107例，对照组101例，对干预组进行干预，对照组仅作随访，不施加任何干预措施。干预前后对两组老人进行体检并应用简明健康状况调查表、社会支持评定量表、老年抑郁量表和孤独量表进行测量。结果经过1年的干预，两组老人生活质量、社会支持、孤独水平、抑郁状况在干预前后差异均有统计学意义（P ＜0.01），干预组老人上述量表得分均好于对照组老人；两组老人体质指数、腰围、臀围、腰臀比、收缩压、舒张压、血糖、糖化血红蛋白、血脂在干预前后差异亦有统计学意义（ P＜0.05），干预组老人上述指标水平均好于对照组老人。结论以家庭医生服务团队为主线，家庭医生工作室为平台，个体、群体相结合的社区卫生服务模式切实可行，能有效提高城市社区空巢老人的生活质量、社会支持，降低其孤独水平、抑郁状况，并能改善老人的健康状况。
목적：탐토이가정의생복무단대위주선，가정의생공작실위평태，개체、군체상결합적사구위생복무모식대성시사구공소노인생활질량、사회지지、고독수평、억욱상황이급생화지표적영향，종이탐토건립괄합성시사구공소노인적위생복무모식。방법2012년2월재상해시가정구진신가도정군추취4개사구공소노인，안사구수궤분위간예조화대조조。간예조107례，대조조101례，대간예조진행간예，대조조부작수방，불시가임하간예조시。간예전후대량조노인진행체검병응용간명건강상황조사표、사회지지평정량표、노년억욱량표화고독량표진행측량。결과경과1년적간예，량조노인생활질량、사회지지、고독수평、억욱상황재간예전후차이균유통계학의의（P ＜0.01），간예조노인상술량표득분균호우대조조노인；량조노인체질지수、요위、둔위、요둔비、수축압、서장압、혈당、당화혈홍단백、혈지재간예전후차이역유통계학의의（ P＜0.05），간예조노인상술지표수평균호우대조조노인。결론이가정의생복무단대위주선，가정의생공작실위평태，개체、군체상결합적사구위생복무모식절실가행，능유효제고성시사구공소노인적생활질량、사회지지，강저기고독수평、억욱상황，병능개선노인적건강상황。
Objective To study the effect of a health service model of urban community with a family doctor team as the main line and their clinics as the platform involving both individual and community on empty nest elderly in the quality of life, social support,loneliness,depression and biochemical indexes so as to explore a health service mode of urban community suit-able to empty nest elderly. Methods The voluntary participants of 4 community empty nest elderly were cluster sampling in Shanghai Jiading Zhenxin streets in February 2012,and were randomly divided into the experimental group(107) treated with the comprehensive intervention and the control group ( 101 ) with the traditional community follow -up without any interven-tion. A set of questionnaires including general information questionnaire,Social Support Rate Scale,Geriatric Depression Scale and Loneliness Scale were used in the study. Results After one year intervention,there were significant differences in quality of life,social support,loneliness scores and depression status between the two groups(P<0. 01);and the difference was also significant in body mass index,waste circumference,hip circumference,waist hip ratio,systolic pressure,diastolic pressure, blood glucose,glycosylated hemoglobin and blood lipid(P<0. 05);the conditions of the elderly in intervention group were bet-ter than those in control group in every aspect. Conclusion The health service model with a family doctor team as the main line and their clinics as the platform involving both individual and community is feasible. It can improve the quality of life,social sup-port,reduce depression,loneliness and promote health condition of urban community empty nest elderly.