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刘诗莉,李莉,杨海琴,汪梅,刘颖,杨映萍,李颖.贵州省遵义市基层医疗机构慢性病管理的基本公共卫生服务需求评估[J].陆军军医大学学报(原第三军医大学学报),2016,38(23):2559-2565.
Liu Shili,Li Li,Yang Haiqin,Wang Mei,Liu Ying,Yang Yingping,Li Ying.Assessment for basic public health service needs of chronic diseases management in primary medical institutions[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(23):2559-2565.
刘诗莉,李莉,杨海琴,汪梅,刘颖,杨映萍,李颖.贵州省遵义市基层医疗机构慢性病管理的基本公共卫生服务需求评估[J].陆军军医大学学报(原第三军医大学学报),2016,38(23):2559-2565. DOI:
Liu Shili,Li Li,Yang Haiqin,Wang Mei,Liu Ying,Yang Yingping,Li Ying.Assessment for basic public health service needs of chronic diseases management in primary medical institutions[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(23):2559-2565. DOI:
目的 了解贵州省遵义市基层医疗机构基本公共卫生服务中慢性非传染性疾病(non-communicable chronic disease,NCDs) 管理的需求(NCDs患病现状、NCDs相关行为生活方式因素管理现状及存在的问题),对该地区慢性病管理提出建议。方法 通过分层随机抽样抽取了红花岗区的8个基层医疗机构为研究地点,采用问卷调查和个人深入访谈收集资料。结果 问卷调查了316人,该人群患有10种NCDs,其中57.6%的被调查者患有两种以上的NCDs。患病率较高的五种NCDs依次为高血压(54.6%)
糖尿病(20.1%),血脂异常(13.4%),冠心病(11.7%),慢性支气管炎(8.4%)。被调查者中,36.1%的人缺乏运动,吸烟率为16.1%,饮酒率为7.9%,18.1%的人睡眠时间少于5 h,40.5%的人食用蔬菜不足300 g,12%的人经常食用甜食,16.1%的人口味偏咸。来自8个社区的8名NCDs管理医务人员参加了个人深入访谈,结果也表明该地区常见的NCDs除了高血压和糖尿病外,冠心病、脑梗塞、心肌梗塞、高血脂也比较常见,NCDs患者的不良生活方式和饮食习惯的干预效果不够理想。结论 被调查地区居民的NCDs负担较重,随着社会经济发展,该地区基本公共卫生项目中NCDs管理的疾病应该从当前的糖尿病和高血压逐渐扩充,纳入血脂异常、冠心病等常见NCDs;应加强对该地区人群运动、睡眠、吸烟饮酒及饮食习惯(蔬菜、盐和糖的摄入)的干预和指导。
Objective To investigate the needs for management of non-communicable chronic diseases (NCDs) (including current statuses
management for related lifestyle factors and existing problems) in basic public health services by primary medical institutions and provide evidences for the intervention strategies to chronic disease management. Methods Stratified random sampling was applied to select 4 communities and 4 townships from Honghuagang District
Zunyi City
Guizhou Province. Questionnaire and in-depth interview were used to collect data. Results Totally 316 residents were included in this study. There were 10 different NCDs in the subjects
and 57.6% of them suffered from 2 or more chronic diseases. The top 5 NCDs with comparatively higher incidences were hypertension (54.6%)
diabetes (20.1%)
dyslipidemia (13.4%)
coronary heart disease (11.7%)
and chronic bronchitis (8.4%). Among the participants
36.1% were lack of physical activities
and 16.1%
7.9% and 18.1% had the habits of smoking
alcohol drinking
and sleep of less than 5 h
respectively. Some of them (40.5%) took vegetables less than 300 grams
12% often ate sweet food and 16.1% ate too much salt. The results of in-depth interview by 8 NCDs medical staffs from 8 communities indicated that besides hypertension and diabetes
coronary heart disease
cerebral infarction
myocardial infarction and hyperlipidemia were also common in their communities. And the intervention effect on the bad lifestyles and dietary habits were not satisfying in the management of NCDs patients. Conclusion The burden of NCDs was quite heavy in the residents of the surveyed regions. With the development of social economy
the care items included in the NCDs management in primary public health services should be gradually expanded from diabetes and hypertension to dyslipidemia
coronary heart disease and other common NCDs. Intervention and guidance on exercise
sleeping
smoking
drinking
and dietary habits (intakes of vegetable
salt and sugar) should be strengthened at the same time.
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