Abstract
张珊,董文兰,毛凡,姜莹莹,吴蕾,娄青林,巫海娣,张永青,马少宁,任泽萍,董建群.社区“5+1”糖尿病分阶段达标管理对2型糖尿病患者生存质量干预效果分析[J].Chinese journal of Epidemiology,2019,40(2):170-174
社区“5+1”糖尿病分阶段达标管理对2型糖尿病患者生存质量干预效果分析
Effect of intervention programs regarding community “5+1” staged diabetes target management on patients with type 2 diabetes mellitus
Received:July 23, 2018  
DOI:10.3760/cma.j.issn.0254-6450.2019.02.009
KeyWord: 社区  糖尿病管理  生存质量  影响因素
English Key Word: Community  Diabetes management  Quality of life  Influencing factors
FundProject:国家自然科学基金(71373132)
Author NameAffiliationE-mail
Zhang Shan National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
Dong Wenlan National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
Mao Fan National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
Jiang Yingying National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
Wu Lei National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
Lou Qinglin Jiangsu Province Official Hospital, Nanjing, 210024, China endolou@163.com 
Wu Haidi Jiangsu Province Official Hospital, Nanjing, 210024, China  
Zhang Yongqing Jiangsu Center for Disease Control and Prevention, Nanjing 210009, China  
Ma Shaoning Ningxia Center for Disease Control and Prevention, Yinchuan 750004, China  
Ren Zeping Shanxi Center for Disease Control and Prevention, Taiyuan 030012, China  
Dong Jianqun National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China workdong@163.com 
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Abstract:
      目的 分析社区"5+1"糖尿病分阶段达标管理对2型糖尿病患者生存质量的干预效果及其影响因素,为提高患者生存质量提供依据。方法 采用分层整群抽样的方法在山西省、江苏省和宁夏回族自治区选择12个社区卫生服务中心,分别作为干预组(管理方式:社区"5+1"糖尿病分阶段达标管理)、对照组[管理方式:依据《国家基本公共卫生服务规范(2011年版)》的相关要求],进行为期2年的随访观察。采用面对面问卷调查的方式,收集患者的人口学信息等基本信息;采用健康调查简表(SF-36)对患者在干预前后测量生存质量。采用SAS 9.4软件进行双重差分法以及多重线性回归模型分析。结果 基线时共纳入2 467名研究对象,终末时共1 924人接受了为期2年完整的随访管理。干预后,干预组、对照组患者生理健康维度(PCS)、心理健康维度(MCS)评分变化净差值分别为13.6分、29.8分。多重线性回归分析结果显示,影响患者PCS得分的主要因素有年龄、医保类型、基线PCS得分以及所在地区,影响患者MCS得分的主要因素有年龄、医保类型、基线MCS得分、是否合并高血压以及所在地区。结论 社区"5+1"糖尿病分阶段达标管理对2型糖尿病患者生存质量的干预效果较好。
English Abstract:
      Objective To analyze the effect of intervention programs and influencing factors regarding the community "5+1" staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL). Methods A total of 12 community health service centers from Shanxi province, Jiangsu province, and Ningxia Hui autonomous region were selected as intervention group and control group, by stratified cluster sampling method. "5+1" model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up. Data was collected through a questionnaire on demographic and disease-related information, while the QOL was measured with SF-36. Multiple linear regression and conducted by SAS 9.4. Results A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service. After intervention programs being implemented, the net effect of PCS score between the intervention and the control groups was 13.6, with the net effect of MCS score as 29.8. Results from the multiple linear regression showed that the main factors affecting PCS scores included age, type of medical insurance, baseline PCS score and regions of residency. Main factors related to MCS score included age, type of medical insurance, baseline MCS score, hypertension, and region of residency. Conclusion Community "5+1" staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.
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