Analysis Of Management Status Of High Risk Population Of Stroke And Establishment Of Standardized Management Process

Objective1.To understand the main risk factors,exposure level and population distribution characteristics of high risk stroke patients through screening.2.To investigate the management status and needs of high-risk groups in Guangzhou,and explore the influencing factors.3.To establish a standardized management process for high-risk stroke patients,and to provide basis for the establishment of high-risk groups for stroke in hospitals and communities.MethodsA group sampling method was adopted.1693 people?1311 males and 382 females?over 40 years old who were medically examined in a Third Grade Class A hospital in Guangzhou from April 1^st,2017 to May 30^th,2017 were selected as the research object.A unified questionnaire survey and physical examination were conducted.The questionnaire was used to screen the risk of stroke in the risk screening and intervention project management?Trial?.A questionnaire on the management status and management needs of high risk population of stroke was designed on the basis of reading literature and repeatedly discussion and revision of disease management experts.310 high-risk groups were sampled by stratified sampling from early screening of high-risk groups of stroke.875 patients with high risk of stroke were investigated by questionnaire and WeChat survey from the inpatients of two Third Grade Class A hospitals and physical examination population of a Third Grade Class A hospital in Guangzhou in 2017.Through reviewing the domestic and foreign literatures and combining the above research results,the standardized management process of high-risk stroke population was formulated.Results1.The screening results of high risk population of stroke?1?General information:among the 1693 subjects,1311 men?77.4%?,382 women?22.6%?,40⁹9years old,average age of?69.28±17.3?years;539 people of 40⁵5 years old,342 of56⁷0 years old,305 of 71⁸5 years old,507 of 85 years old.?2?Distribution of dangerous population:Among the 1693 subjects,588 were screened for stroke in low risk population,285 in middle risk,820 in high-risk groups.The detection rate of high risk population was 48.4%,including 690 men and 130 women.The proportion of high risk groups in men was 52.6%,and 34%in women.Of the 820 high-risk groups,there were 403 cases?57.2%?with 3 risk factors,194?27.3%?with 4 risk factors,85?12.1%?with 5 risk factors and 22?3.1%?cases with more than 6 risk factors.?3?Screening of risk factors:The exposure rate of risk factors of each high risk group from high to low were hypertension?71.1%?,dyslipidemia?58.3%?,lack of exercise?55.5%?,atrial fibrillation?42.6%?,diabetes?39.6%?,obesity?27.9%?,smoking?21.8%?,and family history of stroke?10.9%?.With the increase of age,the exposure rate of high risk group of stroke increased gradually??²=168.87,P<0.001?.2.The survey results of high risk population management The average age was 71.01±15.845 years old,620?70.9%?males and 255?29.1%?females.The proportion of complete control of risk factors of 875 high-risk groups of stroke was12.7%.Logistic regression analysis showed that the factors affecting risk factors control of high risk population of stroke are life self-care ability,whether to be aware of the high-risk group,whether to know risk factors,whether to treat,no time management,management too much trouble,lack of knowledge about stroke,not obvious effect of drug,influence of stroke on family,family awareness and so on.3.Survey results of management needs for high risk groups of stroke 739?84.5%?want to participate in screening for high risk population of stroke;789?90.2%?expressed management requirements;626?71.5%?want to be monitored and managed by wearable devices on data of diseases;497?56.8%?want to use“Internet plus”to manage disease.The different age,sex,residence,living condition,monthly income,medical insurance and other aspects of the high risk population of stroke have an influence on the management needs of the high risk population of stroke.The demographic characteristics of high risk group of stroke have significant difference in management style?P<0.05?,and the health management needs for hospitals,communities and family members are higher.4.Establishment of standardized management process for high risk stroke patients Position the functions of hospitals,communities,families,the individuals.It can be set about from seven aspects,such as screening for high risk population of stroke,setting up management files for high risk population,standardized diagnosis and treatment,the monitoring of the risk factors,the control of the risk factors,the two-way referral,training and the examination.ConclusionsThe overall level of risk factors for high risk groups of stroke in people over 40years of age is higher,and there were differences in major risk factors among different age groups.The management status of the high risk population of stroke is not optimistic.Self-care ability,awareness of the high risk population,the awareness of risk factors,the treatment and no time management,management too much trouble,lack of knowledge about stroke,not obvious effect of drug,influence of stroke on family,family awareness and so on are influencing factors of risk factors control in high risk population of stroke.The demand for screening and management of high risk population of stroke is higher,and the contents of management needs of each organization are different.At present,the management for high risk stroke patients can not meet their needs.From the aspects of government management,hospital management standards,community managers,patients themselves and patients'families,the screening of high-risk groups for stroke,the establishment of management files for high-risk groups,standardized diagnosis and treatment,monitoring of risk factors,control of risk factors,two-way referral,training and assessment are standardized.And then it can be better carried out to manage the high-risk groups for stroke.