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将充足经济皇家理念与参与式行动研究方法相结合,以促进泰国南部部分社区的中风预防自我保健。

Integrating the Sufficiency Economy Royal Philosophy and Participatory Action Research Approach to Promote Self-Care for Stroke Prevention in Selected Communities of Southern Thailand.

作者信息

Sathirapanya Chutarat, Trijun Jamaree, Sathirapanya Pornchai

机构信息

Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.

Department of Pharmacy, Khaochaison Hospital, Phatthalung Provincial Public Health Office, Khaochaison, Phatthalung 93130, Thailand.

出版信息

Healthcare (Basel). 2024 Jul 9;12(14):1367. doi: 10.3390/healthcare12141367.

Abstract

(1) Introduction: Effective control of stroke risk factors can reduce stroke incidence. Motivation for participatory action of community dwellers to practice self-care to modify stroke risk after providing them with knowledge of stroke risk factors is considered useful under a situation of limited healthcare resources. This study aimed to evaluate the outcomes of integrating the sufficiency economy philosophy (SEP), a royal economic philosophy in Thailand, and the participatory action research (PAR) approach on stroke risk factors control among selected communities. (2) Methods: Villagers who had medium to high stroke risk from two provinces with leading stroke incidences in southern Thailand were invited to participate in an eight-month SEP-PAR program conducted in 2019. Group meetings among the study participants, local healthcare providers, the researchers, and relevant stakeholders in the communities were held to co-design a health behaviors program targeting lower waist circumference (WC), body weight (BW), blood pressure (BP), fasting blood sugar, blood lipids, and smoking and alcohol consumption rates. Follow-up physical measurements and blood tests were compared with the baseline results for significant differences by descriptive statistics ( < 0.05) using the R program. (3) Results: Of 126 participants, 75.4% were female. Moderate and high stroke risk levels were found in 58.2% and 19.8%, respectively. Elevated baseline WC, BW, BP, and blood test results were found in 50-80% of the participants. The co-designed health behaviors in this study were dietary control, regular exercise, relieving psychological stress, and stopping smoking and alcohol consumption. Overall, the participants had significant adherence to the co-designed health behaviors. At the end of the program, the follow-up tests showed significant reductions in BW, BP, fasting blood sugar, and lipids, but not in WC. (4) Conclusions: A combined SEP and PAR approach was effective for stroke risk factors control among the community dwellers. Motivation for self-care is a significant strategic outcome expected of this approach. Longer follow-up studies in larger populations are needed.

摘要

(1) 引言:有效控制中风风险因素可降低中风发病率。在医疗资源有限的情况下,让社区居民在了解中风风险因素后积极参与自我护理以改变中风风险的动机被认为是有益的。本研究旨在评估将泰国皇家经济理念——充足经济哲学(SEP)与参与式行动研究(PAR)方法相结合对特定社区中风风险因素控制的效果。(2) 方法:邀请来自泰国南部中风发病率较高的两个省份、中风风险为中到高的村民参加2019年开展的为期八个月的SEP - PAR项目。研究参与者、当地医疗服务提供者、研究人员以及社区相关利益攸关方召开小组会议,共同设计一项针对降低腰围(WC)、体重(BW)、血压(BP)、空腹血糖、血脂以及吸烟和饮酒率的健康行为项目。使用R程序通过描述性统计(<0.05)将后续的身体测量和血液检测结果与基线结果进行比较,以找出显著差异。(3) 结果:126名参与者中,75.4%为女性。分别有58.2%和19.8%的参与者处于中度和高度中风风险水平。50 - 80%的参与者基线时WC、BW、BP升高,血液检测结果异常。本研究共同设计的健康行为包括饮食控制、定期锻炼、缓解心理压力以及戒烟戒酒。总体而言,参与者对共同设计的健康行为有显著的依从性。项目结束时,后续检测显示BW、BP、空腹血糖和血脂显著降低,但WC未降低。(4) 结论:SEP与PAR相结合的方法对社区居民中风风险因素的控制是有效的。自我护理的动机是该方法预期的一项重要战略成果。需要在更多人群中进行更长时间的随访研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b097/11275373/6f6b94bfe85d/healthcare-12-01367-g001.jpg

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