| 刘庆敏,刘冰,任艳军,曹承建,吕筠,李立明.杭州市社区医务人员慢性病防治技能干预效果评价[J].Chinese journal of Epidemiology,2015,36(11):1226-1230 |
| 杭州市社区医务人员慢性病防治技能干预效果评价 |
| Effect of comprehensive intervention on capacity in prevention and control of chronic diseases in community medical staff in Hangzhou |
| Received:April 28, 2015 |
| DOI：10.3760/cma.j.issn.0254-6450.2015.11.009 |
| KeyWord: 慢性病控制 干预 评价 |
| English Key Word: Chronic disease control Intervention Evaluation |
| FundProject:社区健康干预(CIH)项目(牛津健康联盟·中国·杭州) |
| Author Name | Affiliation | E-mail | | Liu Qingmin | Hangzhou Municipal Center for Disease Control and Prevention, Hangzhou 310021, China | | | Liu Bing | Hangzhou Municipal Center for Disease Control and Prevention, Hangzhou 310021, China | | | Ren Yanjun | Hangzhou Municipal Center for Disease Control and Prevention, Hangzhou 310021, China | | | Cao Chengjian | Hangzhou Municipal Center for Disease Control and Prevention, Hangzhou 310021, China | | | Lyu Jun | Department of Epidemiology and Biostatistics, School of Public Health, Peking University | lvjun@bjmu.edu.cn | | Li Liming | Department of Epidemiology and Biostatistics, School of Public Health, Peking University | |
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| Abstract: |
| 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(χ2=7.97,P=0.05; χ2=27.21,P=0.00; χ2=21.32,P=0.00),对照区的血糖测量比例(31.19%)高于基线调查时比例(25.37%),差异有统计学意义(χ2=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(χ2=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。 |
| English Abstract: |
| 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 (χ2=7.97,P=0.05; χ2=27.21,P=0.00;χ2=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(χ2=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(χ2=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. |
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