| Objective: To understand the current situation of chronic disease management of patients with hypertension and diabetes in community health service stations in Aksu area of Xinjiang,analyze the influencing factors of health management and quality of life of patients with hypertension and diabetes in primary health service institutions,and explore the related factors affecting the quality of life of patients with chronic disease management,so as to provide reference for targeted management of patients with hypertension and diabetes in primary health service institutions Objective to provide reference for improving the quality of life and health management.Methods: From October 2019 to October 2020,a total of 2028(1088,940)patients with hypertension and diabetes mellitus in Xinjiang grassroots community managed by the third edition of national basic public health service standard(2017 Edition)were selected by multi-stage random sampling method in three counties(Ushturpan,Bai,Onsu)of Southern Xinjiang.The quality of life of European five dimensional health EQ-5D-5L scale was evaluated.EQ-5D-5Lwas scored by the utility value conversion table of British time trade-off method(TTO),EQ-VAS was described by X±S,and t-test and ANOVA were used to compare the means.EQ-5D scale score was used as the dependent variable,and each factor was used as the independent variable to assign values to each variable.Results: The effective sample size of patients with hypertension in this survey is 1088,of which 58.8% are male and 41.1%are female.The EQ-5D quality of life scores of patients with different genders are statistically different;86% are Uygur,12% are Han,and 2% are other ethnic groups.648(59.6%)patients with hypertension had lower quality of life than those with hypertension(t=5.275,P< 0.001).54.4% of the patients had a course of disease in the past five years.The patients with a longer course had a lower quality of life.There were statistically significant differences in the quality of life between the patients with hypertension of different levels(P<0.05).The patients with standardized management and those with non standardized management were scored by five dimension scale.The EQ-5D scores of patients with standardized management were higher than those of patients with non standardized management in the four dimensions of action ability,self-care,daily activities,pain / discomfort,anxiety / depression(P<0.05).The effective sample size of diabetic patients was 940,50.8% of them were male,49.2% were female,and there was no significant difference in the quality of life score between different genders;Uygur accounted for 90%,Han accounted for 9%,and other ethnic groups accounted for 1%.The EQ-5D score of patients with higher age group was lower than that of patients with lower age group(t=249.35,P<0.001).57.69% of them had BMI over 24.There were 532(56.8%)patients with hypertension,and their quality of life was lower than that of diabetic patients.There were significant differences in EQ-5D,EQ-VAS quality of life scores between those who strengthened exercise(at least one hour exercise every day)and those who did not pay attention to exercise;those whose blood glucose level was controlled(blood glucose level remained stable for six months)and those who did not control;and patients with different types of diabetes mellitus(P<0.05).The EQ-5D scores of the patients with standardized management were higher than those of the patients with non standardized management in the four dimensions of action ability,daily activities,pain /discomfort,anxiety / depression(P< 0.05).The scores of EQ-VAS in the three dimensions of action ability,pain / discomfort and anxiety / depression were higher than those in the patients with non-standard management(P<0.05).Conclusion:According to the national basic public health service standards,the standardized management of patients with hypertension and diabetes can improve the quality of life score of patients.While strengthening the standardized management of diabetic patients,primary health service institutions should strengthen the self-management ability of diabetic patients,strengthen the filing management of chronic diseases,timely follow-up of patients,evaluate the quality of life,and do a good job in health assessment.In the intervention work,we should actively help patients effectively control blood pressure,blood sugar,and emotional counseling,improve their biological indicators.The patients with different blood pressure levels should be managed by classification,and the patients with poor prognosis should be referred in time,so as to strengthen the management of chronic diseases. |
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