Article(id=1321170440094077084, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170430187130949, articleNumber=null, orderNo=null, doi=10.11847/zgggws1143931, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1724947200000, receivedDateStr=2024-08-30, revisedDate=1726243200000, revisedDateStr=2024-09-14, acceptedDate=1737820800000, acceptedDateStr=2025-01-26, onlineDate=1792921179078, onlineDateStr=2026-10-25, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921179078, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921179078, creator=13701087609, updateTime=1792921179078, updator=13701087609, issue=Issue{id=1321170430187130949, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='2', pageStart='129', pageEnd='256', issueExtLink='null', onlineDate='null', pubDate='1739116800000', pubDateStr='2025-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921176716, creator='13701087609', updateTime=1792921176716, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=144, endPage=147, ext={EN=ArticleExt(id=1321170441251704989, articleId=1321170440094077084, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Trends and influencing factors of health-related behaviors of elderly "three highs" patients with the management of "Integrated Control and Prevention of Three Highs and Six Diseases" in a district of Qingdao city: an analysis of 2019–2022 surveillance data, columnId=1321170430958882886, journalTitle=Chinese Journal of Public Health, columnName=Special Report – "Integrated Control and Prevention of Three Highs and Six Diseases" strategy for chronic disease management, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the prevalence and influencing factors of health-related behaviors of elderly hypertension/hyperglycemia/hyperlipidemia (abbreviated as "three highs)" patients with the management of "Integrated Control and Prevention of Three Highs and Six Diseases", and to provide a reference for improving the chronic disease management model.

Methods

Data of 43 150 elderly (≥ 60 years) "three highs" patients with consecutive follow-up information on health-related behaviors (smoking, alcohol consumption and physical activity) from 2019 to 2022 were collected from the Chronic Disease Management Information System of Chengyang District of Qingdao City. Generalized estimating equations were used to analyze the factors influencing patients' health-related behaviors.

Results

For all participants over the period, the prevalence of smoking and alcohol consumption showed the same trend of slightly increasing and then decreasing (smoking/alcohol consumption: from 13.09%/16.44% in 2019 to 13.39%/16.93% in 2020, 12.25%/15.07% in 2022); the prevalence of physical activity increased gradually from 35.47% in 2019 to 42.39% in 2022. The generalized estimating equation analysis showed that the male participants were more likely to have a higher rate of smoking, the participants who were male and those with primary or junior high school education were more likely to have a higher rate of alcohol consumption, and the participants with non-local household registration, with occupations other than agricultural worker, and with comorbidity of hypertension/ hyperglycemia/hyperlipidemia were more likely to have a lower rate of physical activity.

Conclusions

The implementation of the "Integrated Control and Prevention of Three Highs and Six Diseases" chronic disease management strategy in Shandong province generally improved health-related behaviors among elderly residents with hypertension/hyperglycemia/hyperlipidemia in a district of Qingdao city.

, authors=Xingli MA1, 2, Gaohui ZHANG3, Shilong ZHANG1, 2, Wenyu FAN1, 2, Yang ZHAO4, 5, Liangxia CHEN3, Cong QI3, Xueying DU3, Haipeng WANG1, 2, authorsList=Xingli MA, Gaohui ZHANG, Shilong ZHANG, Wenyu FAN, Yang ZHAO, Liangxia CHEN, Cong QI, Xueying DU, Haipeng WANG, authorCompany=null, correspAuthors=Haipeng WANG, authorNote=null, correspAuthorsNote=
WANG Haipeng,E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170442489024670, articleId=1321170440094077084, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=2019—2022年青岛市城阳区“三高共管 六病同防”慢病管理模式对老年患者健康行为变化趋势及影响因素分析, columnId=1321170432707907656, journalTitle=中国公共卫生, columnName=专题报道——“三高共管 六病同防”慢性病管理模式, runingTitle=null, highlight=null, articleAbstract=
目的

探讨“三高共管 六病同防”慢病管理模式下老年患者健康行为的影响因素,为改进慢病管理模式提供参考依据。

方法

利用2019—2022年青岛市城阳区乡镇卫生院/社区卫生服务中心“三高”管理信息系统数据,纳入连续4年进行监测且数据完整的43 150例≥60岁患者,选取吸烟、饮酒和体育锻炼3个指标来衡量患者健康行为,采用广义估计方程对患者健康行为进行影响因素分析。

结果

2019—2022年青岛市城阳区≥60岁“三高”患者吸烟率呈先上升后下降趋势,2019年为13.09%,2020年略微上升到13.39%,2022年下降到12.25%。饮酒率呈先上升后下降趋势,2019年为16.44%,2020年略微上升到16.93%,2022年下降到15.07%。体育锻炼率呈现逐渐上升的趋势,从2019年的35.47%上升到2022年的42.39%。广义估计方程分析结果显示,男性患者吸烟率更高;男性、文化程度为小学和初中的患者更饮酒率更高;非本地户籍、文化程度较高、职业类型为非务农以及患“三高”种类较多的患者体育锻炼率更低。

结论

山东省青岛市城阳区开展“三高共管 六病同防”慢病管理模式后,患者健康行为总体上呈好转趋势,但吸烟率和饮酒率仍处于较高水平,体育锻炼也有待进一步加强。

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马兴丽(2000—),硕士在读,研究方向:慢病管理与服务

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王海鹏,E-mail:
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Year-specific prevalence of smoking, alcohol consumption, and physical activity among 43 150 elderly patients with hypertension/hyperglycemia/hyperlipidemia in Chengyang district, Qingdao city in 2019–2022 with the implementation of the "Integrated Control and Prevention of Three Highs and Six Diseases" management

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项目2019年2020年2021年2022年χ2值P值
例数构成比/%例数构成比/%例数构成比/%例数构成比/%
吸烟行为17.32<0.001
 吸烟564713.09577613.39555712.88528812.25
 不吸烟37 50386.9137 37486.6137 59387.1237 86287.75
饮酒行为45.97<0.001
 饮酒709516.44730616.93676815.68650415.07
 不饮酒36 05583.5635 84483.0736 38284.3236 64684.93
锻炼行为534.60<0.001
 锻炼15 30535.4716 96639.3218 52642.9318 29342.39
 不锻炼27 84564.5326 18460.6824 62457.0724 85757.61
), ArticleFig(id=1321170446180012263, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170440094077084, language=CN, label=表1, caption=

2019—2022年“三高”患者健康行为及变化趋势(N=43 150)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目2019年2020年2021年2022年χ2值P值
例数构成比/%例数构成比/%例数构成比/%例数构成比/%
吸烟行为17.32<0.001
 吸烟564713.09577613.39555712.88528812.25
 不吸烟37 50386.9137 37486.6137 59387.1237 86287.75
饮酒行为45.97<0.001
 饮酒709516.44730616.93676815.68650415.07
 不饮酒36 05583.5635 84483.0736 38284.3236 64684.93
锻炼行为534.60<0.001
 锻炼15 30535.4716 96639.3218 52642.9318 29342.39
 不锻炼27 84564.5326 18460.6824 62457.0724 85757.61
), ArticleFig(id=1321170446268092648, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170440094077084, language=EN, label=Tab.2, caption=

Associations of gender, age, household registration, education, occupation, comorbidity of hypertension/ hyperglycemia/hyperlipidemia, self-care, and year with smoking, alcohol consumption, and physical activity in 43 150 elderly patients with hypertension, hyperglycemia, and hyperlipidemia in Chengyang district, Qingdao city: generalized estimating equation analysis of 2019–2022 surveillance data

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变量参照组吸烟饮酒体育锻炼
OR值95%CIOR值95%CIOR值95%CI
性别
 男女2 788.371 499.54~5 184.931 427.221 037.14~1964.031.121.09~1.16
年龄/岁
 70~7960~690.730.68~0.780.790.75~0.841.000.97~1.03
 ≥800.420.38~0.470.450.41~0.491.471.40~1.54
户籍类型
 非本地户籍本地户籍0.460.38~0.560.440.37~0.520.850.78~0.93
文化程度
 小学文盲/半文盲1.120.99~1.261.131.02~1.260.760.73~0.79
 初中0.960.85~1.101.141.02~1.280.650.62~0.68
 高中及以上0.840.72~0.980.970.85~1.110.540.50~0.57
职业
 职工务农1.030.89~1.181.010.89~1.140.840.77~0.92
 无职业0.880.79~0.970.860.79~0.940.660.63~0.69
 其他0.860.81~0.920.890.84~0.940.920.90~0.95
“三高”种类
 二高一高0.770.73~0.821.040.99~1.100.890.86~0.92
 三高0.380.34~0.431.010.93~1.100.770.74~0.80
自理能力
 自评不能自理自评可自理0.710.63~0.800.520.46~0596.515.70~7.44
年份
 202020191.021.00~1.051.020.99~1.060.850.83~0.87
 20210.950.92~0.980.870.84~0.900.730.71~0.75
 20220.880.85~0.900.790.76~0.820.750.73~0.77
), ArticleFig(id=1321170446351978729, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170440094077084, language=CN, label=表2, caption=

“三高”患者健康行为影响因素的广义估计方程分析(N=43 150)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量参照组吸烟饮酒体育锻炼
OR值95%CIOR值95%CIOR值95%CI
性别
 男女2 788.371 499.54~5 184.931 427.221 037.14~1964.031.121.09~1.16
年龄/岁
 70~7960~690.730.68~0.780.790.75~0.841.000.97~1.03
 ≥800.420.38~0.470.450.41~0.491.471.40~1.54
户籍类型
 非本地户籍本地户籍0.460.38~0.560.440.37~0.520.850.78~0.93
文化程度
 小学文盲/半文盲1.120.99~1.261.131.02~1.260.760.73~0.79
 初中0.960.85~1.101.141.02~1.280.650.62~0.68
 高中及以上0.840.72~0.980.970.85~1.110.540.50~0.57
职业
 职工务农1.030.89~1.181.010.89~1.140.840.77~0.92
 无职业0.880.79~0.970.860.79~0.940.660.63~0.69
 其他0.860.81~0.920.890.84~0.940.920.90~0.95
“三高”种类
 二高一高0.770.73~0.821.040.99~1.100.890.86~0.92
 三高0.380.34~0.431.010.93~1.100.770.74~0.80
自理能力
 自评不能自理自评可自理0.710.63~0.800.520.46~0596.515.70~7.44
年份
 202020191.021.00~1.051.020.99~1.060.850.83~0.87
 20210.950.92~0.980.870.84~0.900.730.71~0.75
 20220.880.85~0.900.790.76~0.820.750.73~0.77
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2019—2022年青岛市城阳区“三高共管 六病同防”慢病管理模式对老年患者健康行为变化趋势及影响因素分析
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马兴丽 1, 2 , 张高辉 3 , 张世龙 1, 2 , 范文瑜 1, 2 , 赵洋 4, 5 , 陈良侠 3 , 齐聪 3 , 杜雪莹 3 , 王海鹏 1, 2, *, *
中国公共卫生 | 专题报道——“三高共管 六病同防”慢性病管理模式 2025,41(2): 144-147
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中国公共卫生 |专题报道——“三高共管 六病同防”慢性病管理模式 2025 , 41 (2) : 144 -147
2019—2022年青岛市城阳区“三高共管 六病同防”慢病管理模式对老年患者健康行为变化趋势及影响因素分析
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马兴丽1, 2, 张高辉3, 张世龙1, 2, 范文瑜1, 2, 赵洋4, 5, 陈良侠3, 齐聪3, 杜雪莹3, 王海鹏1, 2, *, *
作者信息
  • 1山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,济南 250012
  • 2国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),济南 250012
  • 3山东省疾病预防控制中心健康管理所 济南 250014
  • 4新南威尔士大学乔治全球健康研究院,悉尼 2050
  • 5墨尔本大学人口与全球健康学院,墨尔本 3010
通讯作者:
王海鹏,E-mail:
作者简介:

马兴丽(2000—),硕士在读,研究方向:慢病管理与服务

Trends and influencing factors of health-related behaviors of elderly "three highs" patients with the management of "Integrated Control and Prevention of Three Highs and Six Diseases" in a district of Qingdao city: an analysis of 2019–2022 surveillance data
Xingli MA1, 2, Gaohui ZHANG3, Shilong ZHANG1, 2, Wenyu FAN1, 2, Yang ZHAO4, 5, Liangxia CHEN3, Cong QI3, Xueying DU3, Haipeng WANG1, 2
Affiliations
  • 1Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
  • 2NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan 250012, China
  • 3Department of Health Management, Shandong Center for Disease Control and Prevention, Jinan 250014, China
  • 4The George Institute for Global Health, University of New South Wales, Sydney 2050, Australia
  • 5Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, 3010 Australia
  • Corresponding Author:
    WANG Haipeng,E-mail:
出版时间: 2025-02-10 doi: 10.11847/zgggws1143931
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目的

探讨“三高共管 六病同防”慢病管理模式下老年患者健康行为的影响因素,为改进慢病管理模式提供参考依据。

方法

利用2019—2022年青岛市城阳区乡镇卫生院/社区卫生服务中心“三高”管理信息系统数据,纳入连续4年进行监测且数据完整的43 150例≥60岁患者,选取吸烟、饮酒和体育锻炼3个指标来衡量患者健康行为,采用广义估计方程对患者健康行为进行影响因素分析。

结果

2019—2022年青岛市城阳区≥60岁“三高”患者吸烟率呈先上升后下降趋势,2019年为13.09%,2020年略微上升到13.39%,2022年下降到12.25%。饮酒率呈先上升后下降趋势,2019年为16.44%,2020年略微上升到16.93%,2022年下降到15.07%。体育锻炼率呈现逐渐上升的趋势,从2019年的35.47%上升到2022年的42.39%。广义估计方程分析结果显示,男性患者吸烟率更高;男性、文化程度为小学和初中的患者更饮酒率更高;非本地户籍、文化程度较高、职业类型为非务农以及患“三高”种类较多的患者体育锻炼率更低。

结论

山东省青岛市城阳区开展“三高共管 六病同防”慢病管理模式后,患者健康行为总体上呈好转趋势,但吸烟率和饮酒率仍处于较高水平,体育锻炼也有待进一步加强。

“三高共管 六病同防”  /  慢病管理模式  /  健康行为
Objective

To analyze the prevalence and influencing factors of health-related behaviors of elderly hypertension/hyperglycemia/hyperlipidemia (abbreviated as "three highs)" patients with the management of "Integrated Control and Prevention of Three Highs and Six Diseases", and to provide a reference for improving the chronic disease management model.

Methods

Data of 43 150 elderly (≥ 60 years) "three highs" patients with consecutive follow-up information on health-related behaviors (smoking, alcohol consumption and physical activity) from 2019 to 2022 were collected from the Chronic Disease Management Information System of Chengyang District of Qingdao City. Generalized estimating equations were used to analyze the factors influencing patients' health-related behaviors.

Results

For all participants over the period, the prevalence of smoking and alcohol consumption showed the same trend of slightly increasing and then decreasing (smoking/alcohol consumption: from 13.09%/16.44% in 2019 to 13.39%/16.93% in 2020, 12.25%/15.07% in 2022); the prevalence of physical activity increased gradually from 35.47% in 2019 to 42.39% in 2022. The generalized estimating equation analysis showed that the male participants were more likely to have a higher rate of smoking, the participants who were male and those with primary or junior high school education were more likely to have a higher rate of alcohol consumption, and the participants with non-local household registration, with occupations other than agricultural worker, and with comorbidity of hypertension/ hyperglycemia/hyperlipidemia were more likely to have a lower rate of physical activity.

Conclusions

The implementation of the "Integrated Control and Prevention of Three Highs and Six Diseases" chronic disease management strategy in Shandong province generally improved health-related behaviors among elderly residents with hypertension/hyperglycemia/hyperlipidemia in a district of Qingdao city.

"Integrated Control and Prevention of Three Highs and Six Diseases" strategy  /  chronic disease management model  /  health behavior
马兴丽, 张高辉, 张世龙, 范文瑜, 赵洋, 陈良侠, 齐聪, 杜雪莹, 王海鹏. 2019—2022年青岛市城阳区“三高共管 六病同防”慢病管理模式对老年患者健康行为变化趋势及影响因素分析. 中国公共卫生, 2025 , 41 (2) : 144 -147 . DOI: 10.11847/zgggws1143931
Xingli MA, Gaohui ZHANG, Shilong ZHANG, Wenyu FAN, Yang ZHAO, Liangxia CHEN, Cong QI, Xueying DU, Haipeng WANG. Trends and influencing factors of health-related behaviors of elderly "three highs" patients with the management of "Integrated Control and Prevention of Three Highs and Six Diseases" in a district of Qingdao city: an analysis of 2019–2022 surveillance data[J]. Chinese Journal of Public Health, 2025 , 41 (2) : 144 -147 . DOI: 10.11847/zgggws1143931
高血压、糖尿病和高血脂(简称“三高”),是引起心血管疾病的重要危险因素[1]。研究表明, 我国2型糖尿病患者多患有高血压、血脂异常或两者兼有[2],但高血糖、高血压和高血脂患者的发现、治疗、管理规范化水平尚不足[3],疾病的预防与控制能力还需要进一步提升。健康行为是指个体为预防疾病或早期发现疾病,维持和促进健康而采取的行为[4]。吸烟、饮酒、缺乏体育锻炼等不良行为生活方式是导致慢性疾病的重要危险因素[5–6]。山东省青岛市城阳区于2019年开始探索“三高共管 六病同防”的慢性病管理模式,该模式以医共体牵头医院为临床诊疗技术支撑、以乡镇卫生院和社区卫生服务中心为联系纽带、以家庭医生团队为基础网底的“高血压、高血糖、高血脂”三级协同、医防融合的一体化服务体系,建立区域冠心病、脑卒中、肾病综合征、眼底病变、周围神经病变、周围血管病变等并发症(简称“六病”)预防、筛查、治疗、康复闭环管理路径,将患者纳入信息化平台,实现“三高”和“六病”患者全过程、全周期健康管理。该模式对“三高”患者进行风险评估和分层,通过强化宣传教育引导,对患者进行吸烟、饮酒、运动等行为生活方式干预,指导患者参加自我管理小组,督导患者落实自我管理记录。本研究通过分析“三高共管 六病同防”慢病管理模式对患者健康行为的影响,为进一步完善我国慢性病管理工作实践和相关政策提供参考依据。
本研究资料来源于山东省青岛市城阳区乡镇卫生院/社区卫生服务中心“三高”管理信息系统数据。选取2019—2022年均纳入“三高共管 六病同防”管理模式,进行了4年连续监测且数据完整的43 150例≥60岁的“三高”患者。本研究中“三高”患者是指患高血压、高血糖、高血脂三种疾病中的一种及一种以上疾病的患者。
参照《2020版国际高血压实践指南》[7]、《中国老年2型糖尿病防治临床指南(2022年版)》[8]、《中国成人血脂异常防治指南(2016年修订版) 》[9] 诊断高血压、高血糖、高血脂。
本研究选取吸烟、饮酒和体育锻炼来衡量患者健康行为,其中,吸烟行为指现在仍然吸烟的患者,从不吸烟及已戒烟的患者为不吸烟者;饮酒行为是指偶尔饮酒、经常饮酒和每天饮酒;体育锻炼是指偶尔锻炼、每周锻炼一次以上和每天进行体育锻炼。
利用SPSS 26.0统计软件对数据进行分析,采用趋势χ2检验对“三高”患者2019—2022年连续监测的健康行为率变化趋势是否具有统计学意义进行统计推断;采用广义估计方程中的多因素逻辑回归模型对“三高”患者4年连续监测的吸烟、饮酒以及体育锻炼的影响因素进行分析,以校正重复测量中存在的相关性,得到更可靠的参数估计值。检验水准为双侧检验α=0.05。
纳入“三高共管 六病同防”慢病管理模式的43 150例患者中,以2019年为基线描述人群的一般情况。女性患者占比61.73%;60~69岁占36.52%,70~79岁比49.05%,≥80岁占比14.43%;本地户籍患者占比96.67%;文盲/半文盲文化程度患者占16.65%,小学文化程度患者占比49.54%,初中文化程度占比26.82%,高中及以上文化程度占比6.99%;务农患者占37.91%,无职业占13.24%;“三高”种类为“两高”患者占比49.84%,“三高”患者占比17.23%;自评可自理患者占比97.67%。
从2019—2022年,“三高”患者吸烟率、饮酒率、体育锻炼率在不同年份之间的差异均具有统计学意义(P<0.05)。吸烟率整体上呈下降趋势,2019年为13.09%,2020年略微上升到13.39%,2022年下降到12.25%。饮酒率整体上也呈下降趋势,2019年为16.44%,2020年略微上升到16.93%,2022年下降到15.07%。体育锻炼率呈现逐渐上升的趋势,从2019年的35.47%上升到2022年的42.39%。
以吸烟(吸烟=1,不吸烟=0)、饮酒(饮酒=1,不饮酒=0)和体育锻炼(体育锻炼=1,不锻炼=0)情况分别作为因变量;性别、年龄、户籍类型、文化程度、职业类型、“三高”种类、自评自理能力和年份作为自变量进行多因素分析。结果显示,男性患者吸烟率更高;男性、文化程度为小学和初中的患饮酒率更高;非本地户籍、文化程度较高、职业类型为非务农以及患“三高”种类较多的患者体育锻炼率更低。
研究结果显示,青岛市城阳区开展“三高共管 六病同防”慢病管理模式之后,“三高”患者体育锻炼行为总体呈逐渐上升趋势,吸烟率和饮酒率整体上呈下降趋势。“三高共管 六病同防”慢病管理模式以信息化技术作为手段,家庭医生签约服务为抓手,将患者自我管理纳入“三高”防治的全链条中。该模式要求医生依据患者健康状况和“三高基地”制定生活方式干预计划,包括戒烟干预、运动干预和营养干预等,指导患者参加自我管理小组,督导患者落实自我管理记录。“三高共管 六病同防”慢病管理模式中进行个体化健康教育、生活方式指导和自我管理督导等策略有助于提高患者的健康意识,对患者戒烟、限酒、体育锻炼等健康行为的养成有很好的促进作用[10]。然而,目前吸烟率和饮酒率仍处于较高水平,体育锻炼也有待进一步加强。因此,需要继续加强构建“三高”共管上下级联动体系,实施符合患者情况的规范化的“三高”健康生活行为管理。
从患者吸烟行为来看,男性吸烟率较高,在“三高共管 六病同防”的实际工作中要对男性患者重点给予戒烟帮助及健康行为指导[11]。高中及以上学历的患者吸烟行为较少,这说明学历较高的人群对吸烟危害知识相对较高。患“三高”种类越多的患者吸烟行为越少,这说明多重慢病患者更加注重寻求健康行为。从饮酒行为来看,务农患者相较于其他患者饮酒率更高,可能是因为体力劳动者工作强度较大、体力消耗更多,导致其为缓解疲劳对酒精的消耗更大[12]。同时,务农患者由于知识、意识和休闲时间的局限使他们较不容易改变危害健康的行为[13]。从体育锻炼行为来看,患疾病种类多的患者更少进行体育锻炼,这与先前的研究一致[14]。年龄≥80岁的患者更易进行体育锻炼,可能是因为该年龄段患者更加注重通过进行体育锻炼来维护健康。自评不能自理的患者更易进行体育锻炼,自评不能自理的患者大多认为自身健康水平较低,会更加注重增强自身体质和健康而去寻求各种活动。因此,医生在进行健康教育时要针对不同人群采取其易于接受的方式及制定符合其实际情况的行为干预计划。综上所述,在实施了持续性、计划性的慢病管理后,“三高”患者的健康行为整体上呈现上升趋势,产生了良好的健康效益和经济效益。在管理过程中医务工作者可以对针对不同特征的“三高”患者制定并实施个性化的生活行为方式干预策略。医生在制定运动干预计划时要根据年龄较大患者的具体情况为其选择适合强度、时间和频率的运动方案。同时,在对患者进行管理时更应注重将其健康意识与知识转化为实际的健康行为习惯,制定符合所在地区患者具体情况的“三高”共管路径,促进“三高”患者健康行为的形成。

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doi: 10.11847/zgggws1143931
  • 接收时间:2024-08-30
  • 首发时间:2026-10-25
  • 出版时间:2025-02-10
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  • 收稿日期:2024-08-30
  • 修回日期:2024-09-14
  • 录用日期:2025-01-26
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    1山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,济南 250012
    2国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),济南 250012
    3山东省疾病预防控制中心健康管理所 济南 250014
    4新南威尔士大学乔治全球健康研究院,悉尼 2050
    5墨尔本大学人口与全球健康学院,墨尔本 3010

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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