CAJ | 학술논문

目的：探讨提高糖尿病患者健康素养对其社区卫生服务利用的影响。方法2013年7月—2014年7月采用两阶段整群随机抽样方法抽取北京市西城区德胜社区糖尿病患者（干预前534例、干预后413例）作为研究对象，在德胜社区卫生服务中心实施团队式个体化健康管理干预。比较干预前后患者一般情况、健康素养、基本医疗服务利用、基本公共卫生服务利用、健康状况。结果干预前后患者年龄、性别、民族、婚姻状况、家庭人口数、家庭月收入、医疗保险类型比较，差异无统计学意义（P ＞0.05）；而患者的文化程度、退休前职业分布情况比较，差异有统计学意义（P ＜0.05）。干预前153例（28.7％）患者具备基本健康素养，381例（71.3％）为低健康素养；干预后147例（35.6％）患者具备基本健康素养，266例（64.4％）为低健康素养。干预后糖尿病患者健康素养水平高于干预前（χ2＝5.185，P ＜0.05）。干预前后糖尿病患者首选医疗机构、两周就诊、签约全科医生情况比较，差异有统计学意义（P ＜0.05）；过去1年住院情况比较，差异无统计学意义（P ＞0.05）。干预前后糖尿病患者建立健康档案、利用社区健康教育、参加社区免费体检、接种流感疫苗、接受生活方式指导情况比较，差异有统计学意义（P ＜0.05）。干预前后糖尿病患者自评健康状况、自评糖尿病控制情况比较，差异无统计学意义（P ＞0.05）；干预前后糖尿病患者血糖水平情况比较，差异有统计学意义（P ＜0.05）。结论提高糖尿病患者的健康素养可增加其对社区卫生服务的有效利用，促进其健康状况改善。
목적：탐토제고당뇨병환자건강소양대기사구위생복무이용적영향。방법2013년7월—2014년7월채용량계단정군수궤추양방법추취북경시서성구덕성사구당뇨병환자（간예전534례、간예후413례）작위연구대상，재덕성사구위생복무중심실시단대식개체화건강관리간예。비교간예전후환자일반정황、건강소양、기본의료복무이용、기본공공위생복무이용、건강상황。결과간예전후환자년령、성별、민족、혼인상황、가정인구수、가정월수입、의료보험류형비교，차이무통계학의의（P ＞0.05）；이환자적문화정도、퇴휴전직업분포정황비교，차이유통계학의의（P ＜0.05）。간예전153례（28.7％）환자구비기본건강소양，381례（71.3％）위저건강소양；간예후147례（35.6％）환자구비기본건강소양，266례（64.4％）위저건강소양。간예후당뇨병환자건강소양수평고우간예전（χ2＝5.185，P ＜0.05）。간예전후당뇨병환자수선의료궤구、량주취진、첨약전과의생정황비교，차이유통계학의의（P ＜0.05）；과거1년주원정황비교，차이무통계학의의（P ＞0.05）。간예전후당뇨병환자건립건강당안、이용사구건강교육、삼가사구면비체검、접충류감역묘、접수생활방식지도정황비교，차이유통계학의의（P ＜0.05）。간예전후당뇨병환자자평건강상황、자평당뇨병공제정황비교，차이무통계학의의（P ＞0.05）；간예전후당뇨병환자혈당수평정황비교，차이유통계학의의（P ＜0.05）。결론제고당뇨병환자적건강소양가증가기대사구위생복무적유효이용，촉진기건강상황개선。
Objective To investigate the influence of the utilization of community health service on improving the health literacy of patients with diabetes mellitus. Methods From July 2013 to July 2014,we selected diabetes patients from Desheng Community in the Xicheng District in Beijing using cluster random sampling method by two stages(534 patients before intervention and 413 patients after intervention). Team - based individualized health management intervention was carried out in Desheng Community Health Service Center. Comparison was made in general information,health literacy,the utilization of basic medical services,the utilization of basic public health services and health status between before and after intervention. Results After intervention,patients' age,gender,nationality,marital status,number of family members,family monthly income and insurance type were not significantly different from those before intervention(P > 0. 05),while patients' educational level and the occupation distribution were significantly different from those before intervention( P < 0. 05 ) . Before intervention,153 (28. 7% )patients had basic health literacy and 381 ( 71. 3% ) had low - level health literacy;after intervention,147 (35. 6% )patients had basic health literacy and 266(64. 4% )patients had low - level health literacy. After intervention,the health literacy level of the subjects was higher than that before intervention( χ2 = 5. 185,P < 0. 05) . After intervention, preferred medical settings,visits to doctors within two weeks and contracts signed with general practitioners were significantly different from those before intervention(P < 0. 05),and hospitalization in the last year was not significantly different from that before intervention( P > 0. 05 ) . After intervention,the establishment of health records,the utilization of social health education,the participation of physical examination free of charge in community,the inoculation of influenza vaccine and the accepted guidance of life style were significantly different from those before intervention(P < 0. 05). After intervention,self -evaluated health status and self - evaluated diabetes control were not significantly different from those before intervention(P >0. 05);blood glucose level was significantly different from that before intervention(P < 0. 05). Conclusion The improvement of the health literacy of diabetes patients could promote their effective utilization of community health service and improve their health status.