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一项社区层面的教育干预试验,旨在研究生活方式改变对控制高血压和糖尿病的影响——一项非随机试验(干预前后研究,无对照)

A community-level educational intervention trail to study the impact of life style modification in control of hypertension and diabetes- A non-randomized trial (Before and after intervention study without control).

作者信息

Kundapur Rashmi, Modi Bhavesh, Mary Lavanya, Manjula R, Santhosh P, Saxena Deepak

机构信息

Department of Community Medicine AIIMS, Bibanagar, Hyderabad, Telangana, India.

Department of Community Medicine GMERS Gandhinagar, Gujarat, India.

出版信息

J Family Med Prim Care. 2022 Nov;11(11):6759-6764. doi: 10.4103/jfmpc.jfmpc_2174_21. Epub 2022 Dec 16.

Abstract

BACKGROUND

Dietary habits and physical inactivity are related to the risks of non-communicable diseases (NCDs), such as cardiovascular diseases, Diabetes and Hypertension, of which burdens are increasing all over the world. . It is essential that lifestyle modification and nondrug treatment measures such as health education, reduction in weight through regular exercise, changing in eating patterns is essential to control of Diabetes and Hypertension. Hence the present study is taken up with objectives.

OBJECTIVES

  1. to assess and compare the impact of health education on life style modification (diet modification) on control of hypertension and diabetes of intervention group. 2. To assess and compare the practice of changed pattern of life style modification (diet modification) of known hypertensives and diabetics with continuous health education module and follow up.

METHODOLOGY

This community-level education intervention trial to reduce the burden of Non communicable diseases (hypertension and diabetes) was conducted in coastal Karnataka. The study was taken up in a rural area of coastal Karnataka . A specific module for physical activity, diet modification separately for hypertension and diabetics was prepared by experts and this specific module trained social worker introduced diet modification, exercise pattern and habits to the village enrolled participants with involvement of family member who actually cooks at home for 2 months.

RESULTS

In the study subjects, it was observed that, the subjects who had higher systolic and diastolic pressure before intervention, changed to the lower levels after intervention. Though the change in blood pressure is not statistically significant. The intervention of overall lifestyle intervention, there was increased subjects with Hb1Ac in the range of 7-9% and reduced subjects with Hb1Ac of >9.1%. Though it was not statistically significant. There was significant improvement in the mean duration of physical activity in order to control the hypertension and Diabetes mellitus. We also noticed that there was reduction in the sedentary hours, though the difference was not statistically significant.

CONCLUSION

Life style intervention with continuous monitoring is essential to bring down the blood pressure and diabetic sugars. We donot need doctors alone to bring the life style modifications and the health workers can initiate it in the villages. The intervention of life style modifications have brought in better care and quality of life in the villages compared to control village.

摘要

背景

饮食习惯和缺乏身体活动与非传染性疾病(如心血管疾病、糖尿病和高血压)的风险相关,这些疾病在全球的负担正在增加。通过生活方式改变和非药物治疗措施(如健康教育、通过定期锻炼减轻体重、改变饮食模式)来控制糖尿病和高血压至关重要。因此开展了本研究。

目的

  1. 评估并比较健康教育对干预组高血压和糖尿病患者生活方式改变(饮食调整)的影响。2. 评估并比较已知高血压患者和糖尿病患者在持续健康教育模块及随访下改变生活方式(饮食调整)模式的实践情况。

方法

在卡纳塔克邦沿海地区开展了这项社区层面的教育干预试验,以减轻非传染性疾病(高血压和糖尿病)的负担。该研究在卡纳塔克邦沿海的一个农村地区进行。专家们分别为高血压和糖尿病患者制定了关于身体活动、饮食调整的特定模块,由经过该特定模块培训的社会工作者在家庭成员(实际在家做饭者)的参与下,向参与村庄的受试者介绍饮食调整、运动模式和习惯,为期2个月。

结果

在研究对象中,观察到干预前收缩压和舒张压较高的受试者,干预后变为较低水平。尽管血压变化无统计学意义。在整体生活方式干预中,糖化血红蛋白(Hb1Ac)在7 - 9%范围内的受试者增加,糖化血红蛋白>9.1%的受试者减少。尽管无统计学意义。为控制高血压和糖尿病,身体活动的平均时长有显著改善。我们还注意到久坐时间减少,尽管差异无统计学意义。

结论

持续监测下的生活方式干预对于降低血压和血糖至关重要。实现生活方式改变并非仅需医生,卫生工作者可在村庄发起。与对照村相比,生活方式改变的干预为村庄带来了更好的护理和生活质量。

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