高血压社区防治中共同学习方法的应用探讨

目的在社区卫生服务中引入“共同学习”方法，探讨其在高血压社区防治中的效果。方法在四川成都和青海西宁各选取社区卫生服务机构10个（干预组、对照组各5个）。采用方便抽样方法在每个社区卫生服务机构辖区内选取60岁及以上老年人200名左右，比较引入“共同学习”方法前后，居民血压控制率及高血压患者的管理覆盖率变化，干预时间为一年。结果西宁市干预组与对照组结局血压控制率分别为50．3％和34．2％，高于基线的43．6％和25．4％，干预组结局的血压控制率高于对照组，经x^2检验，有统计学差异（P〈0．05）。成都市武侯区干预组结局高血压患者的管理覆盖率为8．2％，高于基线5．4％，对照组结局高血压患者的管理覆盖率为2.8％，低于基线3．4％；西宁市干预组、对照组结局高血压患者的管理覆盖率分别为2．8％和1．5％，高于基线的1．6％和0．5％，两地的干预组结局高血压患者的管理覆盖率均高于对照组，经x^2检验，均有统计学差异（P〈0．05）。结论“共同学习”方法在高血压社区防治中具有一定效果。

A study of the use of Cooperative Learning in the community-based intervention on hypertension

Objective To assess the effect of using Cooperative Learning to improve the community-based intervention on hypertension. Xining City and Wuhou District of Chengdu City were chosen as the two demonstration areas. It took one year to conduct this study. Ten community health organizations of each area were selected as the experimental units by purposive sampling. Methods Five of ten were the intervention group and others were the control group. About two hundred subjects, aged over sixty years, were sampled by convenience sampling method from the residents in each community in which the community health organization was. In every organization of intervention group, Cooperative Learning was applied to the community-based intervention on hypertension. The results obtained before and after intervention were analyzed in contrast blood pressure control rate and hypertension patient management rate were used to assess the effect. Results Within one year, in Xining, blood pressure control rate of intervention group was higher than those of control group （P〈0.05）, the rate of intervention group elevated from 43.6% to 50.3% （P〈0.05）, and the rate of control group was increasing from 25.4 % to 34.2 % （P 〈 0.05 ）. In both areas, hypertension patient manangement rate of the two intervention groups were raised （P〈0.05） and higher than those of the two control groups （P〈0.05） . After one- year intervention, the rate of hypertension patient management in Chengdu in intervention group was 8.2 %, which was higher than that of baseline. The rate of control group was 2.8 %, which was lower than that of baseline. While in Xining, the rate of hypertension patient management in intervention group at end line was 2.8%, which was higher than that of baseline, 1.6 %. The rate of control group was 1.5 %, which was higher than that of baseline, 0.5 %. In both areas, hypertension patient management rate of the two intervention groups were raised （P 〈 0.05） and higher than that of the two control groups （P