目的:以患者对家庭的影响力为切入点,探讨患者型医疗意见领袖在慢性病干预中的介入可行性。方法:采用修改的Flynn意见领袖问卷进行识别,运用分阶段整群随机抽样的方法选取荆门市4个小区265名高血压患者进行调查,采用卡方检验、Wilcoxon秩和检验进行组间比较。结果:筛选出的医疗意见领袖在健康管理主动性(获得防治知识,Z=-5.347,P〈0.01;健康行为控制,Z=-4.729,P〈0.01)、健康管理影响他人意愿(影响他人防治知识,Z=-6.904,P〈0.01;劝说他人改善行为,Z=-6.931,P〈0.01;劝说他人戒烟戒酒,Z=-6.286,P〈0.01)和对家庭所有成员知识影响评分(Z=-3.696,P〈0.01)等方面显著高于普通患者;但对家庭所有成员健康行为影响力评分方面两组未见显著差异。结论:潜在医疗意见领袖具有较强的健康管理主动性、健康管理影响他人意愿,以及较高的家庭知识影响力,在社区慢性病干预中具有知识传播的介入可行性。
Objectives: With the patient's family influence as the breakthrough point, to explore the feasibility of medical opinion leaders in the chronic disease intervention from family support perspective. Methods: Revised opinion seeking scale by Flynn was used. Multistage randomized cluster sampling was used to select 4 communities in Jingmen. Face-to-face survey was carried out. Chi-square test and Wilcoxon test were used to compare the difference between groups. Results: The differences between med- ical opinion leader and ordinary patients in health management initiative (prevention knowledge: Z=-5.347,P〈0.01; health behavior control: Z=-4.729,P〈0.01), health management impact tendency (affect others prevention knowledge: Z=-6.904,P〈0. 01 ; persuade others to improve behavior: Z =- 6.931, P〈 0.01 ; persuade others to give up smoking and drinking: Z = -6.286, P〈 0. 01 ), family knowledge impact score (Z=-3.696,P〈0.01)were statistically significant. No difference was found between medical opinion leaders and ordinary patients in the family authority of prevention and treatment of chronic diseases. Conclusions: Potential medical opinion leaders who had higher health management initiative intend to influent families and change their health knowledge. Medical opinion leaders could be helper in Community chronic disease management.