Rana A K M M, Lundborg C S, Wahlin A, Ahmed S M, Kabir Z N
Research and Evaluation Division, BRAC, Dhaka 1212, Bangladesh.
Health Educ Res. 2008 Feb;23(1):94-105. doi: 10.1093/her/cym002. Epub 2007 Feb 14.
This study examines the impact of health education on prevalence of and expenditure on treatment of self-reported arthritis-related illness among elderly persons in rural Bangladesh. An intervention study was conducted, including 1135 elderly persons (>or=60 years) from eight randomly selected villages, four each of an intervention and a control area. The analyses include 839 elderly persons who participated in both pre- and post-intervention surveys (intervention area: n = 425, control area: n = 414). Participants of the intervention area were further categorized as compliant (n = 315) and non-compliant (n = 110) based on adherence to the intervention instructions. The intervention that lasted for 15 months comprised home-based physical exercise, dietary instructions and other aspects of management. Results show that although there was no significant difference in self-reported arthritis-related illness between the compliant and non-compliant groups at baseline, it was significantly lower in the compliant group (71%) at post-intervention compared with the non-compliant (81%). Related monthly expenditure on treatment was significantly reduced in the compliant group (from Taka 104 to Taka 52) but not in the other two groups. Logistic regressions further showed that the control group had a higher probability of increased treatment-related expenditure compared with the compliant group (OR 2.0, 95% CI 1.4-2.8).
本研究考察了健康教育对孟加拉国农村老年人自我报告的关节炎相关疾病患病率及治疗费用的影响。开展了一项干预研究,纳入了来自8个随机选取村庄的1135名老年人(≥60岁),其中干预地区和对照地区各4个村庄。分析纳入了839名参与了干预前和干预后调查的老年人(干预地区:n = 425,对照地区:n = 414)。根据对干预指导的依从性,将干预地区的参与者进一步分为依从组(n = 315)和不依从组(n = 110)。为期15个月的干预包括居家体育锻炼、饮食指导及其他管理方面。结果显示,尽管依从组和不依从组在基线时自我报告的关节炎相关疾病无显著差异,但干预后依从组(71%)的该疾病患病率显著低于不依从组(81%)。依从组的相关月度治疗费用显著降低(从104塔卡降至52塔卡),但其他两组未降低。逻辑回归进一步显示,与依从组相比,对照组治疗相关费用增加的概率更高(比值比2.0,95%置信区间1.4 - 2.8)。