Effect of health management interventions on chronic diseases in the elderly
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摘要: 目的 评价健康管理干预手段对老年人慢性疾病的效果,为老年人慢性疾病防治提供建议。方法 招募2013年3~12月到南京市某社区医院进行体检的60岁及以上老年人作为调查对象,筛选患有高血压、糖尿病患者654名,随机分成管理组和对照组,管理组进行为期18个月的健康管理,对照组常规管理,比较管理前后的客观指标和生命质量改变情况。结果 健康管理干预后,管理组与对照组相比,收缩压控制平均降低(5.56±1.66)mmHg、舒张压控制平均降低(2.94±1.24)mmHg、血糖控制平均降低(0.70±0.12)mmol/L,差异均具有统计学意义(均有P<0.05)。生命质量方面,管理组与对照组相比,躯体功能得分平均提高(0.81±0.06)分、心理功能得分平均提高(0.75±0.07)分、社会功能方得分平均提高(0.81±0.09)分、糖尿病特异模块得分平均提高(2.07±0.10)分、生命质量得分平均提高(0.95±0.04)分、而高血压特异模块得分平均降低(0.67±1.12)分,差异均具有统计学意义(均有P<0.05)。由多水平模型可知,在管理期内,管理组生命质量得分每月增加0.03分,对照组生命质量得分每月减少0.04分。老年人慢性疾病患者的生命质量随时间迁移有所提升。结论 健康管理的实施有利于慢性疾病患者对血压及血糖的控制,且对老年人慢性病患者生命质量的提高具有一定的积极作用。Abstract: Objective To evaluate the effect of health management interventions on chronic diseases in the elderly and provide policy recommendations for the prevention and treatment of chronic diseases in the elderly. Methods The elderly over 60 years old who received the physical examination in a community hospital in Nanjing were recruited. A total of 654 patients with hypertension or diabetes were selected. The patients were randomly divided into control group and management group. Health management interventions were conducted for 18 months in the management group, while the control group was under regular management without any interventions. Health status and the quality of life before and after the interventions were compared. Results The 18-month health management interventions were beneficial to the control of blood pressure and blood glucose in patients with chronic disease. Compared with the control group, the management group had an average decrease of (5.56±1.66) mmHg in systolic pressure control,(2.94±1.24) mmHg in diastolic pressure and (0.70±0.12) mmol/L in blood glucose,which were all statistically significant (all P<0.05). As for the quality of life, compared with the control group, the management group had an average increase of (0.81±0.06) points in the physical function scores, by (0.75±0.07) points in the psychological function scores, by (0.81±0.09) points in the social function scores, by (2.07±0.10) points in the diabetes-specific module and by (0.95±0.04) points in the quality of life scores. However, the score of the hypertension-specific module decreased by (0.67±1.12) points. The differences were all statistically significant (all P<0.05). The multilevel model showed that the quality of life of the management group increased by 0.03 points per month, and the quality of life of the control group decreased by 0.04 points per month in the management period. The quality of life of the elderly patients with chronic diseases has improved over time. Conclusions The implementation of health management is conducive to the control of blood pressure and blood sugar and has a positive effect on the quality of life in the elderly with chronic diseases.
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Key words:
- Health management /
- Intervention /
- Chronic disease /
- Effect
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