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群组医疗访问项目对拉丁裔健康相关生活质量的影响。

Impact of a group medical visit program on Latino health-related quality of life.

机构信息

Greater Lawrence Family Health Center, Lawrence, MA, USA.

出版信息

Explore (NY). 2011 Mar-Apr;7(2):94-9. doi: 10.1016/j.explore.2010.12.005.

Abstract

CONTEXT

Movement toward the Medical Home and group medical visits (GMV).

OBJECTIVE

To investigate the impact of a GMV program in an underserved Latino community.

DESIGN

Year-long observational community-based research pilot study evaluating the impact of twice weekly GMVs on quality of life, depression, and loneliness in Latinos with diabetes and other risk factors for heart disease.

SETTING

The Greater Lawrence Family Health Center in Lawrence, MA. Approved by the Tufts University review committee on human subjects as part of the CDC funded Latino Health 2010 initiative to evaluate and eliminate health disparities in minority populations. IRB # 5243.

PATIENTS

Fifty-seven Latino adults with diabetes and heart disease risk factors.

INTERVENTIONS

Participants had two intervention opportunities weekly, including the GMV.

MAIN OUTCOME MEASURES

Despite a high dropout rate, and baseline differences between groups, we found reduced depression and loneliness and improved quality-of-life indicators for participants with high attendance to GMVs during one year compared to those with low attendance. Mean depression scores in high attendees, measured by the Zung Depression Scale, improved from 46.83 to 38.85 (p < .001). Mean loneliness scores for high attendees, measured by the UCLA Loneliness Questionnaire, improved from 49.61 to 37.6 (P < .001). Quality-of-life indicators, measured by SF 36, showed statistically significant improvement in general health, vitality, bodily pain, mental health, and role-emotional (P < .05). High attendees also maintained constant weight with the average decreasing slightly during the year-long intervention.

RESULTS

Attending GMVs regularly was associated with improved health-related quality of life, decreased loneliness, decreased depression, and no weight gain. Despite a high dropout rate there were many participants mainly female. More research is needed.

摘要

背景

向医疗之家和团体医疗就诊转变。

目的

调查一个服务不足的拉丁裔社区的团体医疗就诊项目的影响。

设计

为期一年的观察性社区基础研究试点研究,评估每周两次的团体医疗就诊对糖尿病和其他心脏病风险因素的拉丁裔患者的生活质量、抑郁和孤独感的影响。

地点

马萨诸塞州劳伦斯的大劳伦斯家庭健康中心。作为疾病预防控制中心资助的拉丁裔健康 2010 倡议的一部分,该研究得到了塔夫茨大学人类受试者审查委员会的批准,旨在评估和消除少数民族人群中的健康差距。IRB #5243。

患者

57 名患有糖尿病和心脏病风险因素的拉丁裔成年人。

干预措施

参与者每周有两次干预机会,包括团体医疗就诊。

主要观察指标

尽管高辍学率和组间基线差异,我们发现与低出勤率的患者相比,高出勤率的患者在一年的时间内抑郁和孤独感降低,生活质量指标改善。高出勤率患者的抑郁评分(用 Zung 抑郁量表测量)从 46.83 降至 38.85(p<0.001)。高出勤率患者的孤独评分(用 UCLA 孤独感问卷测量)从 49.61 降至 37.6(p<0.001)。SF-36 测量的生活质量指标在总体健康、活力、身体疼痛、心理健康和角色情感方面显示出统计学上的显著改善(p<0.05)。高出勤率患者的体重也保持稳定,平均体重在一年的干预期间略有下降。

结果

定期参加团体医疗就诊与改善健康相关的生活质量、减少孤独感、减少抑郁和不增加体重有关。尽管辍学率很高,但仍有许多参与者,主要是女性。需要进一步研究。

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