李君++王德良++刘斌++詹国庆

[摘要] 目的 了解鄉村中老年人慢性病自我管理的现状，探索以乡村社区卫生服务中心为基础的中老年人慢性病防治适宜技术。方法 2015年3～10月选取广州市从化区50～70岁中老年慢性病农民168例为研究对象，采用单纯随机抽样法分为管理组83例和对照组85例。管理组进行6个月健康自我管理培训，对照组不接受培训，完成6个月对照期。采用自行设计调查问卷进行现场调查，获得培训前后中老年农民慢性病健康自我管理“知、信、行”方面资料。采用SPSS 19.0软件进行统计分析。 结果 基线调查显示，两组健康自我管理得分均较低；管理培训6个月后，管理组知、信、行得分和等级均较培训前显著提高，差异有统计学意义（P < 0.05）；对照组无明显改善，差异无统计学意义（P > 0.05）；两组比较管理组明显优于对照组，差异有统计学意义（P < 0.05）。 结论 乡村中老年慢性病患者健康自我管理能力普遍较低，健康自我管理培训可以提高乡村中老年慢性病患者相关知识、能力与信心，是一项可以推广的慢性病防治适宜技术。

[关键词] 健康自我管理；培训；乡村中老年人；慢性病；知、信、行

[中图分类号] R193 [文献标识码] A [文章编号] 1673-7210（2017）01（b）-0058-05

Effect analysis of health self-management training on knowledge， attitude and practice of elderly chronic patients in rural areas

LI Jun WANG Deliang LIU Bin ZHAN Guoqing ZHAN Yangfan

Health Science Vocational College of Guangzhou Medical University， Guangdong Province， Guangzhou 510925， China

[Abstract] Objective To learn about the current status of elderly chronic disease self-management in rural areas， and to seek out appropriate technologies for the prevention and control of elderly chronic diseases in village health care centers. Methods From March to October 2015， 168 elderly peasants （aged 50 to 70） with chronic diseases from Conghua District of Guangzhou were selected as research objects， and simply divided at random into an management group （83 peasants） and a control group （85 peasants）. The management group was offered 6 months' health self-management training， while the control group received no training. The surveyed peasants were asked to complete a questionnaire about their knowledge， belief and behavior in the health self-management right before and after the training. SPSS 19.0 was used here for the statistical analysis. Results The baseline survey showed that both groups scored low in the health self-management； the management group improved apparently after the 6 months' training which revealed statistical significance （P < 0.05）； the control group improved little and had no statistical significance （P > 0.05）； the management group were remarkably superior to the control group， with statistically significant differences （P < 0.05）. Conclusion The health self-management ability is usually weak among the elderly chronically-diseased patients in rural areas. Health self-management training can improve the patients' knowledge， ability and confidence of health self-management， which is a technology appropriate for the chronic disease prevention and control in rural areas.

[Key words] Health self-management； Training； Elderly in rural areas； Chronic disease； Knowledge， attitude and practice

随着人口老龄化和生活方式的变化，慢性非传染性疾病（简称“慢性病”）严重危害着人们的健康。有调查显示，乡村社区老年人一种及以上慢性病的患病率为69.20%[1]。健康自我管理是针对一般人群、慢性病高危人群开展以自我健康促进为理念，对目标人群进行知识、技能与效能的规范健康管理的干预模式[2]，旨在促进个体对健康进行自我管理，建立健康的管理观念和生活方式。既往大量研究主要针对城区慢性病自我管理，忽视了在乡村以健康为中心的自我管理[3-4]。为了解乡村中老年人慢性病自我管理现状，探索适宜乡村中老年慢性病健康自我管理技术，本研究以健康自我管理培训为措施，探索其对慢性病患者知识、态度、行为的影响，为推广适宜乡村社区的健康自我管理培训提供依据。……