基于4P医学模式的社区护理在脑卒中高危人群一级预防中的应用效果
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摘要
目的探讨基于4P医学模式的社区护理对改善社区脑卒中高危人群危险因素、自我管理能力效果。方法以整群抽样的方法选取石家庄市某社区> 40岁的常住居民1 196人进行基线调查,筛选出符合条件的脑卒中高危人群218人为研究对象。按照随机数字表法将研究对象分为对照组和干预组,每组109例。对照组实施常规的健康宣教,干预组在健康宣教的基础上实施基于4p医学模式的社区干预,干预12个月。比较干预前后两组行为危险因素管理效果及自我管理能力改善情况。结果干预前,2组人群在行为危险因素情况、自我管理能力方面比较,差异均无统计学意义(P> 0. 05);干预后,干预组的行为危险因素情况、自我管理能力均优于干预前,二者比较差异均有统计学意义(P <0. 05)。结论基于4P医学模式的社区干预有利于改善社区脑卒中高危人群危险因素管理效果、提高自我管理能力,值得推广。
Objective To investigate the effects of community care based on 4P medical model in improving the risk factors and self-management ability of stroke high risk group in community. Methods A total of 1196 inhabitants( age > 40years) who lived in a certain community of Shijiazhuang were selected by using cluster sampling method to perform baseline survey. And 218 persons in high risk population of stroke who were accordant with the condition were screened out as research subjects. The subjects were divided into control group( n = 109) and intervention group( n = 109) according to the random number table method. The subjects in control group were given routine health education,on the basis of that,the subjects in intervention group were given community intervention based on 4p medical model,with the intervention duration of 12 months for both groups. Before and after intervention,the management effects of behavioral risk factors and improvement status of selfmanagement ability were observed and compared between the two grousp. Results Before intervention,there were no significant differences in behavioral risk factors and self-management ability between the two groups( P > 0. 05). After intervention,the behavior risk factors and self-management ability in intervention group were superior to those before intervention( P < 0. 05),moreover,there were significant differences between the two groups( P < 0. 05). Conclusion The community intervention based on 4P medical model is beneficial to improve the management effects of risk factors in high risk population of community stroke and enhangce self-management ability,which is worthy of popularization.
Objective To investigate the effects of community care based on 4P medical model in improving the risk factors and self-management ability of stroke high risk group in community. Methods A total of 1196 inhabitants( age > 40years) who lived in a certain community of Shijiazhuang were selected by using cluster sampling method to perform baseline survey. And 218 persons in high risk population of stroke who were accordant with the condition were screened out as research subjects. The subjects were divided into control group( n = 109) and intervention group( n = 109) according to the random number table method. The subjects in control group were given routine health education,on the basis of that,the subjects in intervention group were given community intervention based on 4p medical model,with the intervention duration of 12 months for both groups. Before and after intervention,the management effects of behavioral risk factors and improvement status of selfmanagement ability were observed and compared between the two grousp. Results Before intervention,there were no significant differences in behavioral risk factors and self-management ability between the two groups( P > 0. 05). After intervention,the behavior risk factors and self-management ability in intervention group were superior to those before intervention( P < 0. 05),moreover,there were significant differences between the two groups( P < 0. 05). Conclusion The community intervention based on 4P medical model is beneficial to improve the management effects of risk factors in high risk population of community stroke and enhangce self-management ability,which is worthy of popularization.
引文
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11伍梦娟,沙永红,黎梅,等.4P医学模式对中老年2型糖尿病患者的影响.社区医学杂志,2016,14:1-3.
12隆学文,韩晓芳.“十三五”规划医改八大看点.中国医院院长,2016,12:68-69.
13彭晓敏.英国慢性非传染性疾病管理经验带来的思考和借鉴.中华全科医师杂志,2017,16:410-413.
14 Diem G,Brownson RC,Grabauskas V,et al.Prevention and control of noncommunicable diseases through evidence-based public health:Implementing the NCD 2020 Action Plan.Glob Health Promot,2016,23:5-13.
15 Board of the International College of Person-Centered Medicine.Zagreb declaration on person centered health professional education.Croatian medical journal,2014,55:81-82.
16 Aguiar EJ,Morgan PJ,Collins CE,et al.Efficacy of interventions that include diet,aerobic and resistance training components for type 2diabetes prevention:a systematic review with meta-analysis.International Journal of Behavioral Nutrition and Physical Acttivity,2014,11:1-10.
2国家卫生和计划生育委员会主编.中国卫生和计划生育统计年鉴2015.第1版.北京:中国协和医科大学出版社,2015.28-314.
3 Zhou M,Wang H,Zhu J,et al.Cause-specific mortality for 240 causes in China during 1990-2013:a systematic subnating analysis for the Global Burden of Disease Study 2013.Lancet,2016,387:251-272.
4 Auffray C,Chen Z,Hood L.Systems medicine:the future of medical genomics and healthcare.Genome Med,2009,1:2-11.
5罗旭,陈博,罗莉娅,等.4P医学理念下医院健康管理体系重构思考.中国医院,2014,18:61-63.
6王艳娇.中风自我管理项目的构建与应用研究.成都中医药大学,2009.
7杨伟梅,张军,童莉,等.脑卒中自我管理测量工具研究进展.中国护理管理,2017,17:410-413.
8国家卫生计生委.国务院办公厅关于印发中国防治慢性病中长期规划(2017-2025年)的通知.
9李大旭,姚玉春,石克强.建立3P医学模式下的疾病预防与健康管理中心的初步探讨---以鄂尔多斯康巴什医院为例.中国卫生产业,2013,10:48-49.
10孟强.血脂异常个体化健康管理关键因素的探索.杭州师范大学,2012.
11伍梦娟,沙永红,黎梅,等.4P医学模式对中老年2型糖尿病患者的影响.社区医学杂志,2016,14:1-3.
12隆学文,韩晓芳.“十三五”规划医改八大看点.中国医院院长,2016,12:68-69.
13彭晓敏.英国慢性非传染性疾病管理经验带来的思考和借鉴.中华全科医师杂志,2017,16:410-413.
14 Diem G,Brownson RC,Grabauskas V,et al.Prevention and control of noncommunicable diseases through evidence-based public health:Implementing the NCD 2020 Action Plan.Glob Health Promot,2016,23:5-13.
15 Board of the International College of Person-Centered Medicine.Zagreb declaration on person centered health professional education.Croatian medical journal,2014,55:81-82.
16 Aguiar EJ,Morgan PJ,Collins CE,et al.Efficacy of interventions that include diet,aerobic and resistance training components for type 2diabetes prevention:a systematic review with meta-analysis.International Journal of Behavioral Nutrition and Physical Acttivity,2014,11:1-10.