| 沈啸翼,丁晶晶,周军,等.分级诊疗模式下社区-综合性医院联合对老年痴呆症患者及照顾者的管理效果[J].中国临床保健杂志,2022,25(2):176-178. |
| 分级诊疗模式下社区-综合性医院联合对老年痴呆症患者及照顾者的管理效果 |
| The effect of community-general hospital joint management on senile dementia patients and caregivers under the hierarchical diagnosis and treatment model |
| 投稿时间：2022-01-17 |
| DOI：10.3969/J.issn.1672-6790.2022.02.009 |
| 中文关键词: 痴呆 患者分级医疗 照顾者负担 卫生保健提供 老年人 |
| 英文关键词: Dementia Progressive patient care Caregiver burden Delivery of health care Aged 〖FL |
| 基金项目:上海交通大学中国医院发展研究院社区医疗研究所开放课题(JTS-2020-02) |
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| 中文摘要: |
| 目的 探讨分级诊疗模式下社区-综合性医院联合对老年痴呆症患者及照顾者的管理效果。方法 收集2019年7—12月在社区医院门诊和上海市同仁医院全科门诊已经由专科确诊的老年痴呆症患者及病患主要照顾者,分别纳入受试者50例,由上海市同仁医院神经专科-全科-社区家庭医生分层进行联合管理,建立起三级综合医院与社区服务中心二级分工的合作机制。定期对患者进行指导用药、认知功能干预、监测疾病变化,为照顾者提供专业的照护知识培训、心理辅导、健康信念干预。1年后对痴呆患者重新进行老年失能评估(采用老年失能评估量表)及对照顾者进行健康状况评估(采用健康调查简表SF-36)。结果 老年痴呆症患者器官功能、家庭生活、经济和社会生活评分前后对比,差异无统计学意义(P>0.05),精神功能、交流、活动、自理方面评分较前提高,前后对比差异有统计学意义(P＜0.05)；照顾者生理功能、生理职能、躯体疼痛、一般健康状况、社会功能、精神健康前后对比,差异无统计学意义(P>0.05),精力、情感职能评分提高,健康变化好转,前后对比差异有统计学意义(P＜0.05)。结论 社区和综合医院建立的专科-全科-社区家庭医生合作的多学科团队管理,为老年痴呆症患者及主要照顾者提供全方位照顾模式能够明显改善患者及照顾者健康状况,提高痴呆患者及照顾者的生活质量。 |
| 英文摘要: |
| Objective To explore the management effect of community-general hospital joint management on senile dementia patients and caregivers under the hierarchical diagnosis and treatment model.Methods Fifty senile dementia patients and their main caregivers who had been diagnosed in the outpatient department of the community hospital and the general outpatient department of our hospital from July to December 2019 were included as subjects,respectively.The subjects were administered jointly by the neurologist,general medicine department and community family doctor in different levels.The cooperation mechanism of division of labor between tertiary general hospitals and community service centers has been established.Regular medication guidance for patients,cognitive function intervention,monitoring of disease changes,professional care knowledge training,psychological counseling,health beliefs intervention for caregivers.One year later,dementia patients were reassessed for geriatric disability (using the geriatric disability assessment scale) and caregivers were assessed for health status (using the SF-36 health questionnaire).Results There was no statistical significance in the scores of organ function,family life,economic and social life of senile dementia patients before and after comparison (P>0.05),but the scores of mental function,communication,activity and self-care of senile dementia patients were improved compared with before,and the differences were statistically significant (P<0.05).There was no statistical significance in physiological function,physical work capacity,physical pain,general health status,social function and mental health of caregivers before and after comparison (P>0.05).The scores of energy and emotional function were improved,and the health changes were improved,and the differences before and after comparison were statistically significant (P<0.05).Conclusions The establishment of amultidisciplinary team management of specialized,general practitioner and community family doctor cooperation to provide comprehensive care mode for senile dementia patients and primary caregivers can significantly improve the health status of patients and caregivers,and ultimately improve the quality of life of dementia patients and caregivers. |
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