CAJ | 학술논문

目的探讨强化培训对提高社区医生规范化管理慢性心力衰竭(心衰)患者的影响.方法将49个社区卫生服务中心分为两组:医院社区联合组(25个),社区对照组(24个).医院社区联合组:对社区医生进行慢性心衰规范化管理的强化培训和实施患者强化管理计划;社区对照组:对社区医师不进行培训,仅对患者进行常规门诊管理.结果医院社区联合组医生的慢性心衰防治理论知识和实践技能操作水平较社区对照组提高(P<0.05);医院社区联合组医生经管的患者服药依从性、生活质量改善比社区对照组提高(P<0.05),一级终点事件发生率[总死亡率(4.44%vs 22.12%)、心血管死亡率(3.97%vs 19.91%)、心衰再住院率(21.43%vs 40.92%)、心衰急诊率(5.71%vs 23.54%)]均明显下降(均P<0.01).结论强化培训可提高社区医生对慢性心衰患者的规范化管理水平,改善患者的依从性和生活质量,降低一级终点事件的发生率.
목적탐토강화배훈대제고사구의생규범화관리만성심력쇠갈(심쇠)환자적영향.방법장49개사구위생복무중심분위량조:의원사구연합조(25개),사구대조조(24개).의원사구연합조:대사구의생진행만성심쇠규범화관리적강화배훈화실시환자강화관리계화;사구대조조:대사구의사불진행배훈,부대환자진행상규문진관리.결과의원사구연합조의생적만성심쇠방치이론지식화실천기능조작수평교사구대조조제고(P<0.05);의원사구연합조의생경관적환자복약의종성、생활질량개선비사구대조조제고(P<0.05),일급종점사건발생솔[총사망솔(4.44%vs 22.12%)、심혈관사망솔(3.97%vs 19.91%)、심쇠재주원솔(21.43%vs 40.92%)、심쇠급진솔(5.71%vs 23.54%)]균명현하강(균P<0.01).결론강화배훈가제고사구의생대만성심쇠환자적규범화관리수평,개선환자적의종성화생활질량,강저일급종점사건적발생솔.
Objective To investigate whether strengthening community doctor training could improve the standardized management of patients with chronic heart failure. Methods Forty nine community health service centers were included in the study, in 25 centers with united hospital-community model (united group), community doctor received intensive training for stan-dardization management of chronic heart failure and strengthened management of patients plan was implemented; in other 24 centers patients were managed with regular outpatient service (control group). Results The knowledge of chronic heart failure and practical skil in doctors of united group was improved significantly (P<0.05). The compliance and the quality of life of pa-tients in united group was significantly higher than control group(P<0.05). The overal mortality rate (4.44%vs 22.12%), cardio-vascular mortality (3.97%vs 19.91%), heart failure readmission rate(21.43%vs 40.92%),the heart failure emergency rate(5.71%vs 23.54%) in united group were significantly lower than those in controp group (P<0.05). Conclusion Strengthening training of community doctor can improve the level of the standardized management of chronic heart failure, and improve the compliance and quality of life of patients and reduce the incidence of the primary end point events.