Cox健康行为互动模式在社区糖尿病患者健康管理中的应用研究

发布时间：2018-05-31 00:46

本文选题：Cox健康行为互动模式 + 社区　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的探讨基于Cox健康行为互动模式的健康管理对社区糖尿病患者糖尿病相关生活方式、临床指标及满意度的影响。方法本研究采用类试验研究的方法,通过目的抽样法,选取某三级甲等医院内分泌科2015年3月至7月住院治疗、病情稳定出院且分属大小、规模相仿的2个社区卫生服务中心(兰州市张掖路广武门社区卫生服务中心和团结新村社区卫生服务中心)的2型糖尿病患者作为研究对象。对所有研究对象进行基线调查后按其所属的社区卫生服务中心分为试验组和对照组。对照组应用常规健康管理模式进行管理,试验组进行以Cox健康行为互动模式为指导的健康管理。测评干预0、6、12个月两组患者的糖尿病相关生活方式、腰臀比(WHR)、体质指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)以及干预12个月患者对健康管理服务的满意度,与传统健康管理模式对比,评价Cox健康行为互动模式在在社区糖尿病患者健康管理中的应用效果。结果(1)根据诊断、纳入、排除标准,本研究共纳入110例2型糖尿病患者,试验组和对照组各55例,经过为期12个月的健康管理后,试验组失访4例,剩余51例,对照组患者失访5例,剩余50例,最终纳入101例2型糖尿病患者进行统计分析。(2)干预前,试验组和对照组之间的一般资料、糖尿病相关生活方式得分及临床指标等方面的比较,差异均无统计学意义(P0.05),具有可比性。(3)干预6个月和12个月,两组患者在饮食结构、尼古丁依赖评分、运动评分、WHR、FPG、HbA1c等方面均有所改善,且试验组明显优于对照组,差异均具有统计学意义(P0.05);而两组患者的饮酒评分及BMI在干预后各时间点均无明显改善(P0.05)。(4)干预12个月后,试验组患者对社区健康管理服务的满意度评分明显高于对照组,差异均有统计学意义(P0.05)。结论基于Cox健康行为互动模式的健康管理在社区2型糖尿病患者纠正不合理的饮食结构、吸烟、运动不足等不良生活习惯,改善WHR和血糖控制水平方面发挥了积极作用,有利于提高患者满意度,为社区2型糖尿病患者健康管理提供了可参考模式。
[Abstract]:Objective to investigate the effect of health management based on Cox health behavior interaction model on diabetes related lifestyle, clinical indexes and satisfaction in community diabetic patients. Methods by using the method of class experiment and objective sampling, we selected the department of Endocrinology in a Grade 3A hospital from March to July of 2015. The patients were discharged stably and were in different size. Patients with type 2 diabetes mellitus from two similar community health service centers (Zhangye Lu Guang Wu Men Community Health Service Center and United New Village Community Health Service Center) were studied. After baseline investigation, all subjects were divided into trial group and control group according to their community health service centers. The normal health management model was used in the control group, and the health management guided by the Cox health behavior interaction model was used in the experimental group. Diabetes related lifestyle, WHR, BMI, FBG, HbA1c) were measured in both groups at 6 and 12 months after intervention, and compared with the traditional health management model. To evaluate the effect of Cox health behavior interaction model in community diabetes health management. Results 1) according to the criteria of diagnosis, inclusion and exclusion, 110 patients with type 2 diabetes were included in this study, 55 cases in each group and 55 cases in control group. After 12 months of health management, 4 cases were lost in the trial group and 51 cases in the remaining group. There were 5 cases in the control group and 50 cases in the control group, and 101 patients with type 2 diabetes were included in the study group. Before the intervention, the general data, the scores of diabetes related lifestyle and the clinical indexes were compared between the trial group and the control group. There was no significant difference between the two groups in dietary structure, nicotine dependence score, exercise score and so on, and the experimental group was significantly better than the control group in dietary structure, nicotine dependence score, exercise score and so on. The difference was statistically significant (P 0.05), but the scores of alcohol consumption and BMI were not significantly improved at each time point after intervention. After 12 months of intervention, the satisfaction scores of the patients in the trial group were significantly higher than those in the control group. The difference was statistically significant (P 0.05). Conclusion the health management based on Cox health behavior interaction model plays an active role in correcting unreasonable diet structure, smoking, lack of exercise, and improving the level of WHR and blood sugar control in community type 2 diabetes patients. It is beneficial to improve patient satisfaction and provide a reference model for the health management of type 2 diabetes patients in community.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.2

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