基于筛查平台对肠息肉镜下切除术后人群的"医院-社区"联动管理干预效果评价
Study on impact assessment of hospital-community linkage management intervention based on screening platform for colorectal polyposectomy
钟燕 1许燕鸿 2钟春霞 3魏清风 4夏叶 5马盈 6黄蕾 6牛瑞祥6
作者信息
- 1. 江西省肿瘤医院,江西 南昌 330029;赣州市人民医院
- 2. 赣州市肿瘤医院,江西 赣州 341000
- 3. 南昌健康职业技术学院
- 4. 江西省肿瘤医院,江西 南昌 330029
- 5. 南昌大学第二附属医院
- 6. 南昌大学护理学院,江西 南昌 330000
- 折叠
摘要
目的:依托"城市癌症早诊早治项目"筛查平台,在前期构建的"医院-社区"联动管理模式的指导下,基于信息-动机-行为技巧模型(Information-motivation-behavioral skills model,IMB技巧模型)对肠息肉镜下切除术后居民进行健康管理干预,旨在促进居民结肠镜复查依从性,降低肠息肉复发率及其风险因素,进而降低城市人群结直肠癌发病率,提高其生存率.方法:采用随机抽样法选取南昌市97个社区1 200例肠息肉镜下切除术后居民作为研究对象,对照组和干预组各600例.对照组实施常规健康管理,干预组在对照组基础上实施"医院-社区"联动健康管理干预.比较2组干预后的结肠镜复查依从率及肠息肉复发率;比较2组干预前(T0)、干预结束后1个月(T1)及随访2年后(T2)社区居民的体质量指数(BMI)、腰围、结直肠癌防治知识知晓率和健康行为水平.结果:对照组509例、干预组521例完成本研究.结肠镜复查依从率干预组(59.12%)高于对照组(35.95%),肠息肉复发率干预组(34.09%)低于对照组(47.54%),差异均有统计学意义(P＜0.05).重复测量方差分析结果显示:干预后,不同时间点干预组居民结直肠癌防治知识知晓率和健康行为水平均高于对照组,BMI和腰围低于对照组,差异均有统计学意义(P＜0.05).结论:"医院-社区"联动健康管理干预对促进肠息肉切除术后人群结肠镜复查依从性、降低肠息肉复发率、改善BMI和腰围水平、提高结直肠癌防治知识水平和促进其健康行为具有积极意义,为政府部门癌症防控决策提供参考依据,也为其他癌症高危人群的健康管理提供了新思路与新模式.
Abstract
Objective:To reduce the recurrence rate of intestinal polyps and their risk factors,and thereby reduce the incidence of colorectal cancer in urban populations and improve their survival rate;relying on the urban cancer early diagnosis and early treatment project screening platform,under the guidance of the hospital-community linkage management model constructed in the early stage,based on the IMB skills model(information-motivation-behavioral skills model)to provide health management intervention for residents after intestinal polypectomy.Methods:A random sampling method was used to select 1 200 residents after intestinal polypectomy in 97 communities in Nanchang city as the research subjects,with 600 residents in the control group and 600 intervention groups each.The control group implemented routine health management,and the intervention group implemented hospital-community linkage health management intervention based on the control group.The colonoscopy re-examination compliance rate and intestinal polyp recurrence rate between the two groups after the intervention were compared,and also the BMI,waist circumference and colorectal status of community residents before the intervention(T0),one month after the intervention(T1)and after two years of follow-up(T2),cancer prevention and treatment knowledge awareness rate and health behavior level were also included.Results:Altogether 509 people in the control group and 521 people in the intervention group completed this study.The compliance rate of colonoscopy review in the intervention group(59.12%)was higher than that in the control group(35.95%),and the recurrence rate of intestinal polyps in the intervention group(34.09%)was lower than that in the control group(47.54%),with statistical significance(P＜0.05).The results of repeated measures analysis of variance showed that after the intervention,the awareness rate and health status of residents in the intervention group about colorectal cancer prevention and treatment at different time points were higher than those in the control group,and their weight and waist circumference levels were lower than those in the control group,with statistical significance(P＜0.05).Conclusion:The hospital-community linkage health management intervention is effective in promoting colonoscopy re-view compliance,reducing the recurrence rate of intestinal polyps,improving BMI and waist circumference levels,im-proving colorectal cancer prevention and treatment knowledge,and promoting healthy behaviors among people after intestinal polypectomy.The positive significance is that it provides a reference for government to make decisions on cancer prevention and control,and also provides new ideas and models for the health management of other high-risk groups of cancer.
关键词
肠息肉/"医院-社区"联动/健康干预/息肉复发/健康行为Key words
Intestinal polyps/Hospital-community linkage/Health intervention/Polyps recurrence/Health behavior引用本文复制引用
基金项目
国家癌症中心攀登基金项目(NCC201914B07)
江西省重点研发计划项目(2020BBGL73167)
江西省肿瘤医院科研开放基金项目(2021J11)
出版年
2024
国家科技期刊平台
NSTL
万方数据