CAJ | 학술논문

目的评价牛津健康联盟-社区健康干预(Community Interventions for Health,CIH)项目是否有利于提高杭州市社区医务人员对慢性病防治相关技能的掌握及操作情况.方法选取杭州市下城、拱墅和西湖区3个城区,采用平行对照、非随机分组的类实验设计设置干预区与对照区.在干预区开展为期2年的有关慢性病干预及管理技能的综合性干预,并对干预效果进行评价.基线调查获得有效问卷985份,随访调查获得有效问卷870份.结果经过2年干预后,干预区医务人员对接诊或服务患者进行血胆固醇、血压、空腹血糖检测的比例高于干预前,差异有统计学意义(x2=7.97,P=0.05;x2=27.21,P=0.00;x2=21.32,P=0.00),对照区的血糖测量比例(3119％)高于基线调查时比例(25.37％),差异有统计学意义(x2=15.29,P=0.00).在干预区,平衡膳食、合理营养重要性的医患交流高于干预前,差异有统计学意义(x2=8.64,P=0.03),如何增加体力活动、如何戒烟的交流无论干预区还是对照区干预前后均无统计学变化.多因素logistic回归分析显示,筛查常见慢性病的技能培训、管理慢性病患者的技能培训均与血胆固醇、血压和空腹血糖的检测相关联.慢性病咨询、建议的培训也在一定程度上影响着医患慢性病危险因素的交流.结论对社区医务人员实施一系列慢性病防治知识、技能的培训,能够在一定程度上推动医务人员慢性病相关检测的开展,并促进慢性病防治知识、技能的医患交流.
목적 평개우진건강련맹-사구건강간예(Community Interventions for Health,CIH)항목시부유리우제고항주시사구의무인원대만성병방치상관기능적장악급조작정황.방법 선취항주시하성、공서화서호구3개성구,채용평행대조、비수궤분조적류실험설계설치간예구여대조구.재간예구개전위기2년적유관만성병간예급관리기능적종합성간예,병대간예효과진행평개.기선조사획득유효문권985빈,수방조사획득유효문권870빈.결과 경과2년간예후,간예구의무인원대접진혹복무환자진행혈담고순、혈압、공복혈당검측적비례고우간예전,차이유통계학의의(x2=7.97,P=0.05;x2=27.21,P=0.00;x2=21.32,P=0.00),대조구적혈당측량비례(3119％)고우기선조사시비례(25.37％),차이유통계학의의(x2=15.29,P=0.00).재간예구,평형선식、합리영양중요성적의환교류고우간예전,차이유통계학의의(x2=8.64,P=0.03),여하증가체력활동、여하계연적교류무론간예구환시대조구간예전후균무통계학변화.다인소logistic회귀분석현시,사사상견만성병적기능배훈、관리만성병환자적기능배훈균여혈담고순、혈압화공복혈당적검측상관련.만성병자순、건의적배훈야재일정정도상영향착의환만성병위험인소적교류.결론 대사구의무인원실시일계렬만성병방치지식、기능적배훈,능구재일정정도상추동의무인원만성병상관검측적개전,병촉진만성병방치지식、기능적의환교류.
Objective To evaluate the effect of the Oxford Health Alliance-Community Interventions for Health on chronic diseases prevention and control capacity in community medical staff in Hangzhou.Methods A two year comprehensive intervention on chronic disease prevention and control capacity was conducted in the medical staff in Xiacheng district and Gongshu district,Xihu district was used as control according to the study design principal of parallel comparison and non-random grouping.The intervention effect was evaluated with Cochran-Mantel-Haenszel test.A total of 985 questionnaires were completed in the baseline survey and 870 questionnaires were completed in the follow-up survey.Results After 2 year intervention, the detection rates of blood cholesterol, blood pressure and fasting blood glucose by community medical staff significantly increased compared with the rates before the intervention (x2 =7.97, P =0.05;x2 =27.21, P =0.00;x2=21.32, P=0.00).While, in the control district, the fasting blood glucose detection rate increased from 25.37％ to 31.19％, the differences showed statistical significance (x2=15.29, P=0.00).The communication between community medical staff and patients about healthy diet pattern was improved after the intervention, the difference was statistical significant (x2=8.64, P=0.03).However, no significant differences in communication about increasing physical activity and smoking cessation between community medical staff and patients was found before and after intervention both in intervention districts and in control district.Furthermore, multivariate logistic regression analysis indicated that the interventions on screening of common chronic diseases and management of chronic diseases patients were related with the detections of blood cholesterol, blood pressure and fasting blood glucose.Moreover, the intervention on counsel and suggestion for chronic disease prevention and control had some influence on the communication about chronic disease risk factors between community medical staff and patients.Conclusion The intervention on chronic disease prevention and control capacity in community medical staff was effective to improve the detection of chronic diseases in community and the communication between the medical staff and patients.