社区推行不同慢性病人自我管理课程的效果评估-现代医学

社区推行不同慢性病人自我管理课程的效果评估

单位：1. 南京医科大学公共卫生学院, 江苏南京 211166;
2. 无锡市疾病预防控制中心, 江苏无锡 214023

分类号：R181.3+2

出版年·卷·期（页码）：2017·36·第九期（1338-1341）

摘要：

目的：探讨和评估斯坦福大学慢性病人自我管理课程（CDSMP）和本土设计的高血压、糖尿病自我管理教程（HDSMP）在社区实施的可行性和效果。方法：从无锡市滨湖区和锡山区各随机抽取6个社区，运用招募和自愿报名的方式确定研究对象，分别通过两种课程开展干预，并于干预前后进行问卷调查、评估干预效果。结果：两组分别有90例和220例患者纳入分析，干预后CDSMP组及HDSMP组的患者在总体健康状况、症状管理、自我效能、与医生交流、门急诊就诊次数、饮食习惯等方面均有显著改善。结论：CDSMP及HDSMP均可改善社区慢性病患者的生活方式，提高自我管理效能，从而改善慢性病患者的健康状况。后续课程可根据本研究结果整合两种课程各自优势，更好的帮助社区患者提高自我管理能力。

Objective: To evaluate the effectiveness and feasibility of chronic disease self-management program (CDSMP) from Stanford University and the local design hypertension & diabetes self-management program (HDSMP) in community. Methods: Participants were either recruited or volunteered from six communities which were randomly selected from Binhu District and Xishan District in Wuxi. Interviews were conducted to evaluate the effectiveness of interventions. Results: 90 and 220 patients who completed program and interviews were included in the final analysis. CDSMP and HDSMP both statistically significant improved the overall health status, symptom management, self-efficacy and communication with doctors, the number of outpatients or emergency visits in the last 4 months and salt and oil intake. Conclusion: Both CDSMP and HDSMP proved to be effective in improving health behaviors and self-efficacy in the community, so as to improve the overall health status. Appropriate adjustment for this program would be made to improve the self-management capability.

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