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目的调查广州市社区家庭医生式服务干预在慢性病管理的应用。方法选取2014年10月-2015年9月广州市某社区卫生服务中心门诊的88例慢性病患者,根据投硬币法分为观察组和对照组,44例每组,以提供家庭医生服务为干预。分析提供家庭医生服务前和提供家庭医生服务一年后两组患者的生化指标和生存质量变化情况,观察两组患者的血压、血糖控制率。结果干预后,观察组的甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平显著低于对照组[(1.75±0.21)mmol/L比(2.19±0.18)mmol/L,(4.18±0.76)mmol/L比(5.06±0.98)mmol/L,(2.36±0.18)mmol/L比(3.87±0.39)mmol/L],高密度脂蛋白胆固醇(HDL-C)显著高于对照组[(1.87±0.46)mmol/L比(1.53±0.31)mmol/L],差异均有统计学意义(P<0.05)。观察组患者的血压、血糖控制率分别为90.91%、88.64%,显著高于对照组的70.45%、65.91%,差异有统计学意义(均P<0.05)。干预前,两组患者的生存质量评分比较差异无统计学意义(P>0.05),干预后,两组患者的生存质量评分显著高于干预前(P<0.05),观察组的社会关系领域、心理领域、生理领域及环境领域生存质量评分显著高于对照组(P<0.05)。结论通过家庭医生式服务能周全、更好的服务社区慢性病患者,使患者不良的生活习惯得到改善,提高临床疗效及患者的生存质量。
Objective To investigate the application of community-based family doctor service intervention in chronic disease management in Guangzhou. Methods From October 2014 to September 2015, 88 chronic patients were selected as outpatients in a community health service center in Guangzhou. They were divided into observation group and control group according to the coin-in-coin method, and 44 patients in each group were treated with family doctor service. The changes of biochemical indexes and quality of life before and after providing family doctor service were analyzed. The blood pressure and blood glucose control rate of the two groups were observed. Results After intervention, the levels of triglyceride (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in the observation group were significantly lower than those in the control group [(1.75 ± 0.21) mmol / L (4.18 ± 0.76) mmol / L vs (5.06 ± 0.98) mmol / L, (2.36 ± 0.18) mmol / L vs 3.87 ± 0.39 mmol / L], and high density lipoprotein cholesterol C was significantly higher than that in the control group [(1.87 ± 0.46) mmol / L vs (1.53 ± 0.31) mmol / L], the difference was statistically significant (P <0.05). The observation group’s blood pressure and blood glucose control rate were 90.91% and 88.64%, respectively, which were significantly higher than those of the control group (70.45% and 65.91%, both P <0.05). Before intervention, there was no significant difference in quality of life between two groups (P> 0.05). After intervention, the quality of life scores of two groups were significantly higher than those before intervention (P <0.05) The quality of life in the field of psychology, physiology and environment was significantly higher than that of the control group (P <0.05). Conclusion Through the family doctor service can be comprehensive and better serve the community of patients with chronic diseases, so that patients with bad habits improved, improve clinical efficacy and quality of life of patients.