ABSTRACT
Objective To explore the effectiveness of KAP-HBM-TTM(KHT)-based health management on patients with chronic diseases in community. Method From April 2014 to June 2015, 834 patients with chronic diseases living in Desheng Community were randomly sampled and assigned to the intervention group (n=423, and the control group n=411). The K-H-T mode was used for the intervention group, and the routine management mode was applied to the control group. Using self-made questionnaire we tested two groups of patients' knowledge, attitude and life-style behavior. Chi-square test was used for data analysis. Result After one year KHT-based health management, the proportion of patients with reaching the standard knowledge such as diagnosis based, risk factors, correct treatment method, life-style for prevention of chronic disease and regular check-up of the intervention group (84.9%, 88.0%, 95.2%, 89.6%, 96.9%) obviously raised compared with the control group (56.3%, 53.6%, 59.5%,55.8%, 62.7%), and the difference was statistically significant (? 2=81.270, 118.394, 155.166, 119.672, 150.173,P<0.05). The proportion of patients with reaching the standard attitude such as on the importance of chronic diseases, the family doctor service, the nurses' health management and changing risk factors of the intervention group (80.8%, 78.2%, 81.8%, 77.5%) obviously raised comapred with the control group (59.0%, 54.3%, 52.8%, 56.5%), and the difference was statistically significant (?2=46.573, 52.429, 78.435, 40.744,P<0.05). The proportion of patients with reaching the standard life-style behavior such as diet, physical exercises, psychological states, correct medication, monitoring blood pressure and glucose of the intervention group (76.7%, 72.2%, 90.6%, 99.3%, 86.1%,42.0%) obviously raised than the control group (30.9%, 30.6%, 58.0%, 73.1%, 57.5%, 28.9%), and the difference was statistically significant (? 2=174.142, 142.147, 115.318, 119.783, 83.164, 15.341,P<0.05). The rate of blood pressure and glucose control of the intervention group (84.2%, 74.8%) also improved as compared with the control group (74.3%, 60.0%), and the difference was statistically significant (? 2=11.598, 20.576,P<0.05). Conclusion KAP-HBM-TTM (KHT)-based health management was proved to be effective in the control of chronic diseases of community and improve the effectiveness of the management.
ABSTRACT
Objective To evaluate the effects of known-to-have health management on diabetes patients.Methods A total of 585 diabetic patients from Desheng Community of Beijing received an intensive health management for 3 months,including diet intervention,physical exercises,medication,health education and individual health guidance.Body weight (BW),body mass index (BMI),waist circumference (WC),blood pressure (BP),fasting blood glucose (FBG),2-h postprandial blood glucose (PBG),glycated hemoglobin A1C (HbA1 c),total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),total physical exercises,effective physical exercises,effective physical exercise ratio to BW and dietary intake were compared before and after the intervention.Results Of 585 patients with type 2 diabetes mellitus,240 were male and 345 were female (average age (64.4 ± 9.1) years old).BW,BMI,WC,systolic blood pressure,diastolic blood pressure,FBG,2-h PBG,HbA1c,TC,TG,HDL-C,LDL-C,amount and time or frequency of effective physical exercises,effective physical exercise ratio to BW and total dietary intake were significantly improved after intensive health management (t values were 20.35,20.34,23.74,14.06,12.35,13.35,16.50,9.90,7.53,6.37,-3.74,4.91,-7.44,-7.91,-5.60,-8.41 and 5.21,respectively ; all P ＜ 0.05).More healthy eating habits were found in 321 subjects (54.8％).Those having normal FBG were increased from 54.2％ to 80.1％ following known-to-have health management,with 2-h PBG from 60.4％ to 87.8％ and HbA1c from 58.9％ to 77.9％ (x2 values were 88.21,109.31 and 39.97,respectively; all P ＜ 0.05).Conclusion Known-to-have management may provide an effective tool for community diabetics.