慢性病患者保健、医疗和药学护理的预测因素(以糖尿病患者为例)

I. A. Kirshcina, A. Karimova, A. Soloninina
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摘要

慢性病患者卫生素养形成活动的组织是一个具有社会意义的问题,对于慢性病较多的老年群体患者来说非常重要。在分析数据遵从性时,有必要确定并考虑到一些节省健康的预测因素的影响。这项研究的目的是对慢性病患者挽救健康的预测因素进行多因素分析,并为组织他们的医疗和药物支助发展方法学基础。材料和方法。在对2型糖尿病患者的行为和生活方式进行评估的基础上,对慢性病患者的健康预测因素进行了研究。实证数据库是通过对411名患者的调查结果形成的。统计分析方法采用Statistica 10、Microsoft Excel等软件。采用数理统计方法(学生双样本检验评估组间显著差异;平均秩分析和方差分析)。结果和讨论。通过对糖尿病患者健康状况的多变量预测分析,确定了慢性病患者健康状况的最显著参数。在“可控性”的基础上,对预测因子进行了系统化处理。无法控制的病人健康预测因素包括性别、年龄、教育水平和收入;有条件控制的预测因素包括身体的功能状态、合并症和/或多发性疾病的存在、多语用症的严重程度、疾病的持续时间;控制预测因素包括卫生知识水平和患者依从性,疾病自控能力的存在,社会适应水平和生活方式。结论。建立了慢性病患者医疗和药物保健战略管理的逻辑和功能模型,并在健康储蓄控制预测因子的基础上形成了一个一般化的累积指标(患者健康储蓄系数),可以评估特定患者的健康储蓄潜力。
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PREDICTORS OF HEALTH-SAVING, MEDICAL AND PHARMACEUTICAL CARE FOR PATIENTS WITH CHRONIC DISEASES (ON THE EXAMPLE OF PATIENTS WITH DIABETES MELLITUS)
The organization of activities for the formation of sanitary literacy of patients with chronic diseases is a socially significant problem, which is very important for patients of the older age group who have many chronic diseases. When analyzing data compliance, it is necessary to identify and take into account the influence of a number of health-saving predictors. The aim of the study is to conduct a multifactorial analysis of health-saving predictors for patients with chronic diseases and to develop methodological foundations for the organization of their medical and pharmaceutical support. Materials and methods. The study of health-saving predictors for patients with chronic diseases was conducted on the basis of the results of an assessment of the behavior and lifestyle of patients with type 2 diabetes mellitus. The empirical database is formed by the results of a survey of 411 patients. Methods of statistical analysis using software products Statistica 10, Microsoft Excel were used. Methods of mathematical statistics were used (Student's two-sample test to assess significant intergroup differences; analysis of average ranks and analysis of variance). Results and discussion. By means of multivariate analysis of health-saving predictors for patients with diabetes mellitus, the most significant parameters of health-saving of patients with chronic diseases have been identified. The systematization of predictors on the basis of "controllability" was carried out. Unmanageable predictors of a patient's health include gender, age, level of education and income; conditionally controlled predictors include the functional state of the body, the presence of comorbidity and/or polymorbidity, the severity of polypragmasia, the duration of the disease; controlled predictors include the level of sanitary literacy and patient compliance, the presence of self-control skills of the disease, the level of social adaptation and the lifestyle. Conclusion. A logical and functional model of strategic management of medical and pharmaceutical care for patients with chronic diseases has been developed and a generalizing cumulative indicator (patient's health saving coefficient) has been formed on the basis of controlled predictors of health saving, which allows to evaluate the health saving potential of a particular patient.
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