个体化健康教育对慢性病患者自我管理能力的效果评价

目的：研究个体化健康教育对社区慢性病患者相关知识、信念和自我管理能力的影响。方法：选择397名建有慢性病管理档案的社区高血压或（和）糖尿病患者,分干预组和对照组,对照组实施一般性的健康教育和常规随访管理,干预组进行自我管理专题讲座和一对一的健康教育和行为干预,观察一年后两组知、信、行及血压、血糖控制率等方面变化。结果：干预组实施一年个体化健康教育后在正常BMI值、推荐盐摄入量、高血压诊断标准、危险因素、损害和糖尿病危险因素、并发症等方面知识知晓率高于对照组,两组差别均有统计学意义（P〈0.05）;坚持控制饮食的自我效能提高,与对照组的差异有统计学意义（P〈0.01）;在控制饮食、有效运动、自我检测血压方面的行为形成率明显提高,与对照组的差异有统计学意义（P〈0.05）;干预组的血压控制率为85.9%,血糖控制率为85.5%,均高于对照组（56.4%、68.4%）,差异具有统计学意义（P〈0.05）;干预组患者收缩压、舒张压、血糖值均低于对照组,差异具有统计学意义（P〈0.01）。结论：个体化健康教育和随访干预,对提高社区慢性病患者知识知晓率、自我管理能力及血压、血糖控制率等方面具有重要意义。

Effect evaluation of individual health education on self management ability of community patients with chronic diseases

Objective To explore the effects of individual health education on community patients with chronic disease related knowledge,belief and self management ability.Methods Three hundred and ninety-seven hypertension or（and）diabetes mellitus patients who had chronic disease management files in communities were assigned into intervention group and control group.The control group carried out health education in general and regular follow-up management while the intervention group took lectures and self management of health education and behavior intervention.Changes in knowledge,belief,practice and blood pressure,blood glucose control rate after one year were observed and compared between two groups.Results The intervention group received one year of individual health education and achieved statistically higher knowledge rate in normal BMI values,the recommended intake of salt,hypertension,risk factors,damage and risk factors of diabetes and complications than the control group（P〈0.05）.The increase of the intervention group in self-efficacy to adhere to the diet was significantly different from compared with control group（P〈0.01）.Behavior forming rate in diet control,exercise,self detection of blood pressure increased significantly in the intervention group,and the difference was statistically significant compared with the control group（P〈0.05）.Blood pressure control rate and blood sugar control rate in the intervention group were 85.9%,85.5%,respectively,significantly higher than the control group（56.4%,68.4%）（P〈0.05）.Systolic blood pressure,diastolic blood pressure,blood glucose values of the intervention group were statistically lower than those of the control group（P〈0.01）.Conclusions Individual health education and intervention is of great significance to improve the knowledge,self management ability and awareness rate,blood pressure,blood glucose control rate of community patients with chronic diseases.