CAJ | 학술논문

目的：探索医院-社区联动模式在农村糖尿病健康管理中的效果。方法在农村社区开设糖尿病专科门诊，比较门诊开设6个月后，糖尿病患者的代谢指标、知识知晓程度和自我管理水平的变化。结果6个月后，患者代谢指标中除体质指数外，空腹血糖、餐后血糖、糖化血红蛋白均下降；患者经糖尿病知识测试的得分改善明显；自我管理水平方面，除“药物治疗问题”外，其他因子得分均有改善，差异均有统计学意义（P＜0．05）。结论医院-社区联动模式是一种有效的健康管理模式。
목적：탐색의원-사구련동모식재농촌당뇨병건강관리중적효과。방법재농촌사구개설당뇨병전과문진，비교문진개설6개월후，당뇨병환자적대사지표、지식지효정도화자아관리수평적변화。결과6개월후，환자대사지표중제체질지수외，공복혈당、찬후혈당、당화혈홍단백균하강；환자경당뇨병지식측시적득분개선명현；자아관리수평방면，제“약물치료문제”외，기타인자득분균유개선，차이균유통계학의의（P＜0．05）。결론의원-사구련동모식시일충유효적건강관리모식。
Objective To evaluate a hospital-community collaboration model for the health management of diabetic patients from the rural regions.Methods A diabetes-specific clinic was first founded in a rural community.The metabolic factors, the rate of correct answer to diabetes-related questions and the level of self-management of the patients as observed 6 months after the clinic had been founded were compared with those obtained before the clinic was founded.Findings 6 months after the clinic was founded, the level of fasting and postprandial blood-glucose, hemoglobin A1C decreased significantly except the body mass index among the metabolic factors.The scores of DKT improved significantly.The scores of all the other factors improved on the level of self-management except the “drug therapy problems”.The difference was statistically significant (P<0.05).Conclusion The hospital-community collaboration model as formulated was found effective for the health management of diabetic patients from the rural regions.