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社区“5+1”阶段性糖尿病目标管理干预方案对2型糖尿病患者的影响

[Effect of intervention programs regarding community "5+1" staged diabetes target management on patients with type 2 diabetes mellitus].

作者信息

Zhang S, Dong W L, Mao F, Jiang Y Y, Wu L, Lou Q L, Wu H D, Zhang Y Q, Ma S N, Ren Z P, Dong J Q

机构信息

National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

Jiangsu Province Official Hospital, Nanjing, 210024, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Feb 10;40(2):170-174. doi: 10.3760/cma.j.issn.0254-6450.2019.02.009.

Abstract

To analyze the effect of intervention programs and influencing factors regarding the community "5+1" staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL). A total of 12 community health service centers from Shanxi province, Jiangsu province, and Ningxia Hui autonomous region were selected as intervention group and control group, by stratified cluster sampling method. "5+1" model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up. Data was collected through a questionnaire on demographic and disease-related information, while the QOL was measured with SF-36. Multiple linear regression and conducted by SAS 9.4. A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service. After intervention programs being implemented, the net effect of PCS score between the intervention and the control groups was 13.6, with the net effect of MCS score as 29.8. Results from the multiple linear regression showed that the main factors affecting PCS scores included age, type of medical insurance, baseline PCS score and regions of residency. Main factors related to MCS score included age, type of medical insurance, baseline MCS score, hypertension, and region of residency. Community "5+1" staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.

摘要

分析社区“5 + 1”阶段糖尿病目标管理干预方案及影响因素对2型糖尿病(T2DM)患者的作用,为提高生活质量(QOL)提供依据。采用分层整群抽样方法,选取山西省、江苏省和宁夏回族自治区的12个社区卫生服务中心作为干预组和对照组。干预组采用“5 + 1”模式,对照组采用基本公共卫生服务模式进行为期两年的随访。通过人口统计学和疾病相关信息问卷收集数据,同时用SF - 36测量生活质量。使用SAS 9.4进行多重线性回归分析。基线时共纳入2467名受试者,1924名完成了为期两年的管理服务。实施干预方案后,干预组与对照组之间PCS评分的净效应为13.6,MCS评分的净效应为29.8。多重线性回归结果显示,影响PCS评分的主要因素包括年龄、医疗保险类型、基线PCS评分和居住地区。与MCS评分相关的主要因素包括年龄、医疗保险类型、基线MCS评分、高血压和居住地区。社区“5 + 1”阶段糖尿病目标管理模式对T2DM患者生活质量的改善具有良好效果。

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