依托社区高血压患者社会网络关系建立自我管理小组的可行性研究

摘要

目的：了解社区内高血压患者之间的网络关系及特征，探讨高血压患者依托社会网络关系组建和扩展社区自我管理的可行性。方法2013年1-5月，采用多阶段随机抽样的方法抽取北京市西城区4个社区卫生服务站1074例高血压患者，采用问卷调查和测量的方法调查性别、年龄、血压等基本情况，采用提名生成法对社会网络度数中心度进行调查。使用构成比、度数中心度、Spearman等级相关等进行统计描述和分析。结果社区高血压患者社会网络度数中心度为0的占31.0%（333/1074），为1的占41.4%（445/1074），≥2的占27.6%（296/1074）。社会网络度数中心度为1的社区高血压患者中，64.5%（287/445）的患者选择家属为其社会网络关系对象；社会网络度数中心度≥2的社区高血压患者中，61.1%（181/296）的患者选择社区内病友为其社会网络关系对象。社区高血压患者社区活动组织参与率为8.7%（93/1074），社区高血压患者的社会网络度数中心度与参加社区活动组织数呈正相关关系（rs =0.521，P<0.05）。患者之间的小群体中存在中心人物。结论社区高血压患者之间社会网络特征较松散，社区活动组织内部的高血压患者之间网络关系较为密切，可作为社区高血压自我管理小组覆盖范围扩展的基础，社会网络分析有助于完成自我管理小组长的选择。%Objective To understand the social network and its characteristics among hypertensive patients in the com-munity and explore the feasibility of establishing and expanding self-management group relying on the social networking of the pa-tients. Methods 1 074 hypertensive patients were extracted from 4 community health service stations of Xicheng district with Multi-stage random sampling method. They were investigated about age,gender and blood pressure using questionnaires and physical examination. Degree centrality was investigated by nomination generation method. Useing proportion,degree centrality and Spearman's rank correlation were adopted to describe and analyze. Results Social network degree centrality in patients with hypertension was 0 accounting for 31. 0%(333/1 074),1 accounting for 41. 4%(445/1 074),greater than or equal to 2 ac-counting for only 27. 6%( 296/1 074 ). 64. 5%( 287/445 ) of the patients whose centrality degree was 1 chose their family members as the main social networks relationship;61. 1%(181/296) of centrality degree being more than 2 chose community wardmates. 8. 7%(93/1 074) of the patients took part in the community activities and the number was positively correlated with social network degree centrality of hypertensive patients(rs =0. 521,P <0. 05). There were key persons in the small group within the same community activity organization. Conclusion Social network among the hypertensive patients of communi-ty is loose,but it's more closely tied between patients within the same organization,which can be used as a basis to expand the coverage of hypertension self-management group. Social network analysis helps to select leaders in the self management group.