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老年痴呆——基于社区干预策略的政策探讨
引用本文:杨辉,Shane Thomas.老年痴呆——基于社区干预策略的政策探讨[J].中国全科医学,2008,11(15):1323-1325.
作者姓名:杨辉  Shane Thomas
作者单位:1. 3165澳大利亚维多利亚州,Monash大学初级卫生保健学院
2. Monash大学卫生服务研究所
摘    要:目的探讨在快速人口老龄化的中国,如何开发和实施社区干预策略,降低老年痴呆的风险。方法文献学习和政策分析。结果中国以往的研究主要侧重于发病机制和治疗药物方面的西医和传统中医研究,社区服务也主要以病人的家庭和机构护理为主。社区中病人的卫生服务资源和利用严重不足。结论中国在社区卫生服务的政策和实践中,还缺乏明确的防治策略,并存在资源缺乏和协调不力等问题。对减少危险因素、增强保护因素、筛选可干预因素方面的研究甚少。澳大利亚等国家从其他慢性非传染性疾病的经验着手,探讨老年痴呆的社会干预政策的思路值得借鉴。建议从中上层危险因素的干预入手,采用全方位和参与策略,开展社区健康教育和促进。通过研究明确可干预的、多种老年疾病共享的危险因素,把干预重点放在社会弱势群体和高危险人群上,并把提高社区干预可持续性和健康收益作为社区干预的过程和结果评价重点。

关 键 词:痴呆  阿尔茨海默病  痴呆  血管性  社区干预

Community-based Intervention Strategy: a policy analysis on dementia management
Colette Browning,Shane Thomas.Community-based Intervention Strategy: a policy analysis on dementia management[J].Chinese General Practice,2008,11(15):1323-1325.
Authors:Colette Browning  Shane Thomas
Abstract:Objective To explore community-based strategy on reducing risk of dementia in rapid ageing China.Methods Literature review and document analysis.Results There are five million dementia patients in China;the number will be doubled after 20 years.Most previous researches in China focused on clinical mechanism,laboratory study and pharmaceutical research,both in west medicine and traditional Chinese medicine.Available reports on community-based program were family or institutionalized nursing.China has significant shortage of community health resource and utilisation for dementia diagnosis,treatment and rehabilitation.Conclusion In Chinese community health policy and practice,community-based dementia prevention and management is under developed.Few researchers focused on community-based strategy of reducing risk factors,improving protective factors,and identifying modifiable factors.Australian researchers analyzed experience of other national health priorities and explored effective community-based interventions.Suggestions provided in this article,including focusing middle and top level risk factors,implementing multi faceted strategy and participation strategy,and conducting health promotion and education program.Researchers should further identify modifiable risk factors and those factors shared by all other chronic conditions.Interventions should be designed for socioeconomic disadvantaged groups and population at risk.Sustainability as well as social and health benefits should be concerned in evaluation of community programs.
Keywords:Dementia  Alzheimer disease  Dementia  vascular  Community-based intervention
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