摘要
目的随着社会发展,以糖尿病和高血压等为代表的慢性病发病率逐年上升,对慢性病患者进行健康管理对防治慢性病具有重要意义。本研究探讨KTH整合模式在社区全科门诊签约慢性病患者健康管理中的应用效果,以探索合理有效的健康管理模式。方法选取2018-01-01-2019-06-30洛阳市西工区唐宫路社区全科门诊121例签约慢性病患者,按照组间年龄、性别、病程和慢性病种类均衡可比的原则分为研究组(n=61)和对照组(n=60),对照组采用常规健康管理,研究组采用KTH整合模式健康管理,即知信行(KAP)理论、转化理论模式(TTM)和健康信念模式(HBM)3种模式整合,开展健康管理。对比两组遵医行为、干预前后慢性病知识达标率、心理压力和生活方式达标率。结果干预后研究组慢性病知识中慢性病危险因素达标率为88.52%,高于对照组的51.67%,χ2=19.661,P<0.001;诊断依据达标率为88.52%,高于对照组的53.33%,χ2=18.221,P<0.001;正确服药方法达标率为91.80%,高于对照组的60.00%,χ2=16.789,P<0.001;预防慢性病生活方式达标率为88.52%,高于对照组的55.00%,χ2=18.827,P<0.001;急性情况处理达标率为60.66%,高于对照组的33.33%,χ2=9.063,P=0.001。研究组干预后心理压力评分为(25.12±5.96)分,低于对照组的(34.29±6.04)分,t=8.406,P<0.001。研究组正确服药遵医率为98.36%,高于对照组的73.33%,χ2=15.690,P<0.001;监测血糖遵医率为85.25%,高于对照组的60.00%,χ2=9.720,P=0.002;监测血压遵医率为80.33%,高于对照组的58.33%,χ2=6.893,P=0.009。干预后研究组饮食达标率为80.33%,高于对照组的40.00%,χ2=20.555,P<0.001;运动达标率为78.69%,高于对照组的41.67%,χ2=17.323,P<0.001;精神心理达标率为91.80%,高于对照组的60.00%,χ2=16.789,P<0.001。结论KTH整合模式应用于社区全科门诊签约慢性病患者健康管理中,能缓解心理压力,提高疾病知晓率、遵医行为和健康生活方式达标率。
Objective With the development of society,the incidence of chronic diseases represented by diabetes and hypertension has increased year by year,and the health management of patients with chronic diseases is of great significance for the prevention and treatment of chronic diseases.This study explored the application effect of KTH integration model in the health management of chronic disease patients contracted in community general outpatient clinics,in order to explore a reasonable and effective health management model.Methods A total of 121 patients with chronic diseases contracted from January 1,2018 to June 30,2019 in community general outpatient clinics were selected and divided into a research group(n=61)and a control group(n=60)according to the principle of balanced and comparable age,gender,course of disease,and types of chronic diseases between groups,the control group adopted conventional health management,and the research group adopted KTH integrated model health management,namely knowledge-attitude-practice(KAP)theory,transtheoretical model and stages of change(TTM)and the health belief model(HBM)were integrated to carry out health management.The compliance behaviors,pre-and post-intervention chronic disease knowledge compliance rates,psychological pressure,and lifestyle compliance rates between the two groups were compared.Results After intervention,the chronic disease risk factor compliance rate in the research group was 88.52%,which was higher than that of the control group’s 51.67%,χ2=19.661,P<0.001.The diagnostic basis compliance rate was 88.52%,which was higher than that of the control group’s 53.33%,χ2=18.221,P<0.001.The compliance rate of correct medication was91.80%,which was higher than that of the control group(60.00%),χ2=16.789,P<0.001.The compliance rate of prevention of chronic diseases lifestyle was 88.52%,which was higher than that of the control group(55.00%),χ2=18.827,P<0.001.The treatment rate of acute conditions was 60.66%,which was higher than that of the control group(33.33%),χ2=9.063,P=0.001.The psychological stress score of the study group after intervention was 25.12±5.96,which was lower than that of the control group(34.29±6.04),t=8.406,P<0.001.The compliance rate of correct medication in the study group was 98.36%,which was higher than that of the control group(73.33%),χ2=15.690,P<0.001.The compliance rate of monitoring blood glucose was 85.25%,which was higher than that of the control group(60.00%),χ2=9.720,P=0.002.The compliance rate of monitoring blood pressure was 80.33%,which was higher than that of the control group(58.33%),χ2=6.893,P=0.009.After intervention,the diet compliance rate of the study group was 80.33%,which was higher than that of the control group(40.00%),χ2=20.555,P<0.001.The exercise compliance rate was 78.69%,which was higher than that of the control group(41.67%),χ2=17.323,P<0.001.The mental and psychological compliance rate was 91.80%,which was higher than that of the control group(60.00%),χ2=16.789,P<0.001.Conclusion The KTH integration model is applied to the health management of chronic disease patients in community general outpatient clinics,which can relieve psychological pressure,improve disease awareness rate,compliance behavior,and healthy lifestyle compliance rate.
作者
屈玉花
胡博生
QU Yu-hua;HU Bo-sheng(Community Health Service Center,Tanggong Road,Xigong District,Luoyang 471000,China)
出处
《社区医学杂志》
CAS
2021年第2期126-130,共5页
Journal Of Community Medicine
关键词
KTH整合模式
健康管理
慢性病
遵医行为
生活方式
KTH integration mode
health management
chronic diseases
compliance behavior
lifestyle
