CAJ | 학술논문

目的：了解重庆市高血压和糖尿病患者的社区健康管理现状，并探讨其影响因素。方法于2014年7月，采用方便抽样法，在重庆市沙坪坝区24个社区的社区卫生服务中心（站）中抽取居民1200名。采用自行设计的问卷对纳入居民进行调查，内容包括居民的一般情况、慢性病患病情况及社区健康管理利用情况。共发放问卷1200份，回收1036份，因问卷填写不合格剔除15份，最终获得有效问卷1021份。结果1021名居民的实际糖尿病患病率为11.9％〔122／1021，95％CI （10.0％，13.9％）〕，实际高血压患病率为29.3％〔299／1021，95％CI （26.5％，32.1％）〕。居民对社区健康管理的知晓率为77.8％（794／1021），不同患病情况居民的知晓率比较，差异有统计学意义（P＜0.05）。居民的社区健康管理接受率63.8％（651／1021），不同患病情况居民接受率比较，差异有统计学意义（P＜0.05）。不同患病情况居民对健康管理作用的认知、健康管理满意度、健康管理形式比较，差异无统计学意义（P＞0.05）。健康管理内容中，不同患病情况居民在测量／询问血压和血糖、生活指导、用药指导、体格检查、建立健康档案及其他方面比较，差异有统计学意义（ P＜0.05）；而在随访和健康教育讲座方面比较，差异无统计学意义（ P＞0.05）。多因素非条件Logistic逐步回归分析显示，性别、年龄、自测血糖和血压情况、最近卫生服务机构、患病情况对居民接受社区健康管理的影响有统计学意义（ P＜0.05）。结论居民的高血压和糖尿病患病率较高，而社区健康管理知晓率和接受率较低，高血压和糖尿病患者优于未患病居民。性别、年龄、自测血糖和血压情况、最近卫生服务机构、患病情况是居民接受社区健康管理的影响因素。
목적：료해중경시고혈압화당뇨병환자적사구건강관리현상，병탐토기영향인소。방법우2014년7월，채용방편추양법，재중경시사평패구24개사구적사구위생복무중심（참）중추취거민1200명。채용자행설계적문권대납입거민진행조사，내용포괄거민적일반정황、만성병환병정황급사구건강관리이용정황。공발방문권1200빈，회수1036빈，인문권전사불합격척제15빈，최종획득유효문권1021빈。결과1021명거민적실제당뇨병환병솔위11.9％〔122／1021，95％CI （10.0％，13.9％）〕，실제고혈압환병솔위29.3％〔299／1021，95％CI （26.5％，32.1％）〕。거민대사구건강관리적지효솔위77.8％（794／1021），불동환병정황거민적지효솔비교，차이유통계학의의（P＜0.05）。거민적사구건강관리접수솔63.8％（651／1021），불동환병정황거민접수솔비교，차이유통계학의의（P＜0.05）。불동환병정황거민대건강관리작용적인지、건강관리만의도、건강관리형식비교，차이무통계학의의（P＞0.05）。건강관리내용중，불동환병정황거민재측량／순문혈압화혈당、생활지도、용약지도、체격검사、건립건강당안급기타방면비교，차이유통계학의의（ P＜0.05）；이재수방화건강교육강좌방면비교，차이무통계학의의（ P＞0.05）。다인소비조건Logistic축보회귀분석현시，성별、년령、자측혈당화혈압정황、최근위생복무궤구、환병정황대거민접수사구건강관리적영향유통계학의의（ P＜0.05）。결론거민적고혈압화당뇨병환병솔교고，이사구건강관리지효솔화접수솔교저，고혈압화당뇨병환자우우미환병거민。성별、년령、자측혈당화혈압정황、최근위생복무궤구、환병정황시거민접수사구건강관리적영향인소。
Objective To investigate the status of community health management of hypertensive and diabetic patients in Chongqing and its influencing factors.Methods In July 2014, we sampled 1 200 residents from 24 community health service centers in Shapingba District of Chongqing using convenience sampling method.We used a self-designed questionnaire to conduct investigation on the enrolled residents.The questionnaire content included general information, the condition of chronic diseases and the utilization of community health management.A total of 1 200 questionnaires were distributed and 1 036 questionnaire were returned, and we at last obtained 1 021 effective questionnaires after the exclusion of 15 unqualified questionnaires.Results The actual diabetes prevalence among the 1 021 residents was 11.9% 〔122/1 021, 95%CI (10.0%, 13.9%)〕, and the actual hypertension prevalence was 29.3%〔299/1 021, 95%CI (26.5%, 32.1%)〕 .The residents′awareness rate of community health management was 77.8% (794/1 021), and residents with different diseases were significantly different ( P<0.05) in the awareness rate.The residents′acceptation rate of community health management was 63.8% (651/1 021), and residents with different diseases were significantly different (P<0.05) in the acceptation rate.Residents with different diseases were not significantly different (P>0.05) in the effect of health management, the satisfaction degree with health management and the form of health management.Among health management items, residents with different diseases were significantly different ( P <0.05 ) in blood pressure monitoring/consultation, life guidance, medication guidance, physical examination and the establishment of health record and other aspects; while residents with different diseases were not significantly different (P>0.05) in follow-up and lectures of health education.Multivariate non-conditional logistic regression analysis showed that gender, age, monitor of blood glucose and blood pressure, the nearest health service setting and the state of illness had significant influence on residents accepting community health management (P<0.05) .Conclusion Residents have higher prevalence of hypertension and diabetes mellitus, while the awareness rate and acceptation rate of community health management are low, and hypertensive patients and diabetic patients have higher awareness rate and acceptation rate.Gender, age, monitor of blood glucose and blood pressure, the nearest health service setting and the state of illness are influencing factors for residents accepting community health management.