Development and Evaluation of a Community Staged Education Program for the Cardiocerebrovascular Disease High-risk Patients

Abstract

= Abstract =Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients.Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct.2009 to May 2010. Results:The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001)and their self efficacy. Conclusion:In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.

Factors affecting screening for diabetic complications in the community: a multilevel analysis

“…A study conducted in Korea has reported that as a consequence of a project to register and manage people at high risk for cardiovascular disease, the continuous treatment rate and utilization rate of medical clinics among outpatients increased [ 21 ]. Additionally, a study in which registered patients were followed up over five years reported that blood pressure significantly decreased and the proportion of patients whose glycemic control was managed increased [ 22 ].…”

Prioritizing Community-Based Intervention Programs for Improving Treatment Compliance of Patients with Chronic Diseases: Applying an Analytic Hierarchy Process

“…To date, diverse interventions have been applied along with various theoretical models to solve this problem at national or community level in both developed and developing countries. Korea is currently trying to quickly respond to policy suggestions through implementation and expansion of community-based intervention programs in the primary care setting in a national level [ 19 , 21 , 22 , 23 , 24 , 28 , 29 ]. It is important not only to find hidden hypertension and diabetes patients within the community, but also to find patients who do not continue treatment early [ 10 ].…”

“…Therefore, it is necessary to emphasize the specialty of health behaviors and lifestyle modification from the planning stage of future community-based intervention programs. It is also important to provide feedback to not only health practitioners, but also primary care physicians in the community in consideration of continuity of care [ 21 , 49 , 62 ]. Furthermore, the government should not only strengthen medical education on patients’ behavioral changes [ 77 ] such as with family physicians, but also actively promote the development of health insurance benefits package, such as in Thailand’s case [ 83 ].…”

“…First of all, theoretical models related to treatment compliance of patients with chronic diseases included a health belief model [ 53 ], Andersen’s medical care utilization model [ 54 , 55 ], and the health lifestyle paradigm [ 56 ]. Results of 32 articles (including Korean articles) [ 6 , 7 , 8 , 10 , 11 , 12 , 13 , 14 , 17 , 18 , 20 , 21 , 57 , 58 ] were collected and divided into domains (or variables) of each theoretical model to identify effects on treatment compliance and draft an evaluation model. Up to 2014, 428 articles on continuity of care and health care system were collected through literature search using databases such as PubMed.…”

“…This chronic disease management intervention (Korea Hypertension Diabetes Daegu Initiative, KHyDDI) first began four years ago in a rural area. It is foremost now within the main framework of CCM [ 20 , 21 ]. Afterwards, registration and education centers for hypertension and diabetes in 2012 were expanded to 19 districts of 12 Metropolitan cities and Provinces [ 22 ] with budgets allocated from central and local government as shown in Figure 1 .…”