RESUMEN
From January to July 2017, 872 high-risk middle-aged and elderly patients of stroke who visited general practice clinics in 10 community health service centers in Shanghai were enrolled in the study. Cluster randomization was used to select 427 patients from 5 community centers as the intervention group, and 445 patients from other 5 community centers as the control group. The intervention group received health education and traditional Chinese exercise training on the basis of conventional treatment;while the control group received conventional treatment only. After 12 months of intervention physical examinations and related laboratory tests were performed,and the risk factors were compared between two groups before and after the intervention. The results showed that there were significant differences in the systolic and diastolic blood pressure,blood urea nitrogen (BUN),creatinine (Cr) and homocysteine before and after the intervention in both groups (all P<0.05); and compared the control group the improvement of above indicators was more marked in the intervention group. There was no significant difference in cholesterol, triglyceride, and low-density lipoprotein between the two groups before and after the intervention ( P>0.05). The health management with integrated traditional Chinese and western medicine can effectively control some risk factors of stroke for middle-aged and elderly people, which is beneficial for the prevention and control of stroke in the community.
RESUMEN
Objective To develop a stroke knowledge instrument for middle-aged and aged people in community general outpatient clinics.Methods A stroke knowledge measurement tool was developed and the reliability and validity of the tool were evaluated.The developed measurement tool was applied for patients aged 45 to 75 years old from 10 community health service centers of three Shanghai districts,and the knowledge scores of the target population were analyzed.Results A total of three dimensions and 14 items were made up of the stroke knowledge instrument.A total of 1 750 subjects,including 709 males and 1 041 females with an average age of (65.93±3.67) years,were included in the survey.The standardized Cronbach's coefficient was 0.742,and split-half correlation coefficient was 0.686 (P＜0.01) for instrument test performance.There was a positive correlation between the sub-instrument and the overall-instrument,and the correlation coefficient was 0.448-0.728 (P＜0.01) for content validity.The full score rate of overall stroke knowledge instrument was 8.46％(148/1 750),the full score rate for disease early symptomswas 46.00％(805/1 750),that for drug-related knowledge was 54.40％(95/1 750) and that for high risk factors was 17.94％(314/1 750).Logistic regression analysis showed that females,subjects with higher education level and married/cohabitation state had higher knowledge scores (P＜0.01).Conclusions The developed stroke knowledge instrument has good reliability and validity for the middle-aged and aged population of community general outpatient clinic.The stroke knowledge levels are less satisfactory for this study population.
RESUMEN
Objective To screen stroke risks among middle-aged and elderly people in community outpatient clinics in Shanghai.Methods A stroke risk screening was conducted among people aged 45-75 years selected with convenient sampling method from 10 community health service centers in Putuo district,Yangpu district and Pudong New Area of Shanghai during January to July 2017.The questionnaire and clinical measurement were used for screening.Multivariate logistic regression analysis was used to analyze the risk factors in subjects with high stroke risk.Results In this study,1 094 individuals with high stroke risk were screened out from 1 750 participants (62.5％).The proportion of high risk cases was higher among men (66.7％,473/709) than that among women (59.7％,621/1 041),unmarried,divorced or widowed (75.0％,90/120)than married or cohabitants (61.6％,1 004/1 630),living alone (72.1％,70/97) than living with others (61.9％,1 024/1 653) (x5=8.969,8.571,4.081;P＜0.01).Compared with non-high-risk subjects,the high-risk subjects had higher BMI,systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycated hemoglobin,total cholesterol,triglycerides,serum creatinine and homocysteine,and were more likely to have carotid plaques or stenosis,the difference was statistically significant (P＜0.05).Multiple logistic regression analysis showed that unmarried/divorce/widowed,high BMI,systolic blood pressure,fasting blood glucose,total cholesterol,and carotid plaque or stenosis were positively associated with high stroke risk(OR=2.015,1.173,1.013,1.456,1.139,1.026,2.103;P＜0.05).Conclusions The proportion of high stroke risk individuals among middle-aged and elderly people is higher in community general practice outpatient clinics in Shanghai.Patients with high BMI,systolic blood pressure,fasting blood glucose and total cholesterol,and carotid plaque or stenosis,as well as those unmarried/divorced/widower should be the subjects for stroke intervention.
