健康管理师三级专业能力案例分析题王先生，男，50 岁，汉族，本科毕业，医生，已婚，身高180cm，体重 100Kg，A 型血，血压 160/88mmHg，胆固醇 300mg/dl 饮食偏咸，爱吃油条、炸鱼、方便面等食品，不吸烟，喜欢喝酒，有时大醉。很少参加体育运动。最近工作特别忙，感觉心理压力大，无其他疾病。j根据以上情况请回答以下各题：j1.根据王先生的情况，请选择相应的健康调查表，将答案写在题后的括号里。（A）（10 分）jA.调查表 1j一、一般情况j1.年龄：jjj50jjj岁j2.性别：①男jjj②女jjjjjjjjjjjjj1j3.身高：jjj1.80jjjjjjmj4.体重：jjj100jjjjKgj5.民族：j①汉族j②满族jj③回族jj④蒙古族jj⑤朝鲜族jj⑥其它jjj1j6.血型：j① A 型j② B 型j③ AB 型j④ O 型jjjjjjjjjjjj1j7.家庭住址：jjjjjjjjjjjjjjjjjjjjjj联系电话：jjjjjjjjjjj8.文化程度：j①小学及以下j②初中j③高中/中专j④大专j⑤大学及以上jjjjj5j9.您的婚姻状况：j①未婚j②已婚j③离婚jj④丧偶jjjjjjjjj2j10.职业：j①机关干部jj②企业职工jj③医疗卫生人员jj④教育工作者jjj⑤三资职员j⑥个体业主jj⑦学生jj⑧农民jjjjjjjjjjjjjj3j11.家庭人均收入（元/月）①<500jj②500-1000j③1000-1500j④>1500jj□j二、生活方式和行为习惯j12.您是否吸烟jjjjjjjjjjjjjjj①是jjj②否jjjjjjjj2j13.您是否饮酒？jjjjjjjjjjjjj①是jjj②否jjjjjjjj1j14.您是否经常参加体育锻炼？j①是jjj②否jjjjjjjj2j饮食情况：j15.您饮食的口味是jjjjjjjjjjj①重jjj②适中jj③轻jjjjj1j16.您是否喜欢吃油炸食品？jjjjjjj①是jjjj②否jjjjjjjj□j三、家族史j18.j您亲属中是否有人被诊断为高血压？jj①无jjj②有jjjjjj□j19.如果有，是哪类？（如为多人，在方框中添入人数）j□j①父亲□；②母亲□；③子女□；④姊妹□；⑤祖父母□；⑥外祖父母□；⑦叔或姑□；⑧舅或姨□；⑨配偶□j20.j您亲属中是否有人被诊断为脑血管疾病？jj①无jjj②有jjjjj□j21.如果有，是哪类？（如为多人，在框中添入人数）j□j①父亲□；②母亲□；③子女□；④姊妹□；⑤祖父母□；⑥外祖父母□；j⑦叔或姑□；⑧舅或姨□；⑨配偶□j四、精神压力j22.您的性格属于jjjjjjjjjjjj①j内向j②j适中j③j外向jjjjjjjjjj□j23.您的脾气是否急躁jjjjjjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j24.您是否经常忧虑jjjjjjjjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j25.您是否经历过精神创伤jjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j26.您对自己人际关系的评价是j①很好j②较好j③一般j④不好j⑤很不好jj□j27.您有不良情绪时通常jjjjjjj①立刻爆发j②压抑在自己心里j③找人诉说j□j28.您感觉工作压力是jjjjjjjjj①很大j②较大j③一般j④较小j⑤很小jj1j调查员编号：j|__|__|__|jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj调查日期：j|__|__|__|__|j年j|__|__|j月j|__|__|j日jB.调查表 2j一、一般情况j1.年龄：jjjjjjjj岁j2.性别：①男jjj②女jjjjjjjjjjjjj□j3.民族：j①汉族j②满族jj③回族jj④蒙古族jj⑤朝鲜族jj⑥其它jjj□j4.血型：j① A 型j② B 型j③ AB 型j④ O 型jjjjjjjjjjjj□j5.家庭住址：jjjjjjjjjjjjjjjjjjjjjj联系电话：jjjjjjjjjjj6.文化程度：j①小学及以下j②初中j③高中/中专j④大专j⑤大学及以上jjjjj□j7.您的婚姻状况：j①未婚j②已婚j③离婚jj④丧偶jjjjjjjjj□j8.职业：j①机关干部jj②企业职工jj③医疗卫生人员jj④教育工作者jjj⑤三资职员j⑥个体业主jj⑦学生j j⑧农民jjjjjjjjjjjjjj□j9.家庭人均收入（元/月）①<500jj②500-1000j③1000-1500j④>1500jjjjjj□j二、生活方式和行为习惯j10.是否吸烟jjjjjjjjjjjjjjj①是jjj②否jjjjjjjjjjj□j11.您是否饮酒？jjjjjjjjjjjjj①是jjj②否jjjjjjjj□j12.您是否有呼吸疾病史？j①是jjj②否jjjjjjjjjjjj□j13.您是否接触石棉？j①是jjj②否jjjjjjjjjjjjjjjj□j三、家族史jjjjj14．你的亲属中有无患肺癌？①有jjj②无jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj□j15.您的性格属于：jjjjjjjjjj①j内向j②j适中j③j外向jjjjjjjjjj□j16.您的脾气是否急躁jjjjjjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j17.您是否经常忧虑jjjjjjjjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j18.您是否经历过精神创伤jjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j19.您对自己人际关系的评价是j①很好j②较好j③一般j④不好j⑤很不好jj□j20.您有不良情绪时通常jjjjjjj①立刻爆发j②压抑在自己心里j③找人诉说j□j21.您感觉工作压力是jjjjjjjjj①很大j②较大j③一般j④较小j⑤很小jj□j调查员编号：j|__|__|__|jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj调查日期：j|__|__|__|__|j年j|__|__|j月j|__|__|j日 C.调查表 3j一、一般情况j1.年龄：jjjjjjjj岁j2.性别：①男jjj②女jjjjjjjjjjjjj□j3.身高：jjjjjjjjjmj4.体重：jjjjjjjjjKgj5.民族：j①汉族j②满族jj③回族jj④蒙古族jj⑤朝鲜族jj⑥其它jjj□j6.血型：j① A 型j② B 型j③ AB 型j④ O 型jjjjjjjjjjjj□j7.家庭住址：jjjjjjjjjjjjjjjjjjjjjj联系电话：jjjjjjjjjjj8.文化程度：j①小学及以下j②初中j③高中/中专j④大专j⑤大学及以上jjjjj□j9.您的婚姻状况：j①未婚j②已婚j③离婚jj④丧偶jjjjjjjjj□j10.职业：j①机关干部jj②企业职工jj③医疗卫生人员jj④教育工作者jjj⑤三资职员j⑥个体业主jj⑦学生jj⑧农民jjjjjjjjjjjjjj□j11.家庭人均收入（元/月）①<500jj②500-1000j③1000-1500j④>1500jjjjj□j二、生活方式和行为习惯j12.您是否吸烟jjjjjjjjjjjjjjj①是jjj②否jjjjjjjj□j13.您是否饮酒？jjjjjjjjjjjjj①是jjj②否jjjjjjjj□j14.您是否经常参加体育锻炼？j①是jjj②否jjjjjjjj□j饮食情况：j15.您是否喜欢吃甜食jjjjjjjjj①是jjj②否jjjjjjjjjjjjjjjjjjj□j16.您是否喜欢喝咖啡？jjjjjjj①是jjjj②否jjjjjjjj□j三、家族史j17.您的亲属中，有无患糖尿病的？jj①无jjj②有jjjjjj□j18.您的性格属于：jjjjjjjjjj①j内向j②j适中j③j外向jjjjjjjjjj□j19.您的脾气是否急躁jjjjjjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j20.您是否经常忧虑jjjjjjjjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j21.您是否经历过精神创伤jjjj①j是jjj②j否jjjjjjjjjjjjjjjjjjjj□j22.您对自己人际关系的评价是j①很好j②较好j③一般j④不好j⑤很不好jj□j23.您有不良情绪时通常jjjjjjj①立刻爆发j②压抑在自己心里j③找人诉说j□j24.您感觉工作压力是jjjjjjjjj①很大j②较大j③一般j④较小j⑤很小jj□j调查员编号：j|__|__|__|jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj调查日期：j|__|__|__|__|j年j|__|__|j月j|__|__|j日jD.调查表 4j一、一般情况j1.年龄：jjjjjjjj岁j2.性别：①男jjj②女jjjjjjjjjjjjj□j3.身高：jjjjjjjjjmj4.体重：jjjjjjjjjKgj5.民族：j①汉族j②满族jj③回族jj④蒙古族jj⑤朝鲜族jj⑥其它jjj□j6.血型：j ① A 型j② B 型j③ AB 型j④ O 型jjjjjjjjjjjj□j7.家庭住址：jjjjjjjjjjjjjjjjjjjjjj联系电话：jjjjjjjjjjj8.文化程度：j①小学及以下j②初中j③高中/中专j④大专j⑤大学及以上jjjj□9.您的婚姻状况：j①未婚j②已婚j③离婚jj④丧偶jjjjjjjjj□j10.职业：j①机关干部jj②企业职工jj③医疗卫生人员jj④教育工作者jjj⑤三资职员j⑥个体业主jj⑦学生jj⑧农民jjjjjjjjjjjjjj□j11.家庭人均收入（元/月）①<500jj②500-1000j③1000-1500j④>1500jjjjj□j二、生活方式和行为习惯j12.您是否暴饮暴食？jjjjjjjjjjjjjjj①是jjj②否jjjjjj□j13.您是否夜间加餐？jjjjjjjjjjjjjj①是jjj②否jjjjjjj□jj调查员编号：j|__|__|__|jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj调查日期：j|__|__|__|__|j年j|__|__|j月j|__|__|j日j2.根据案例给出的信息，填写第一题你选出的健康调查表中所有数据（直接写在选项的空格上）。（15 分）j评分要点：j每个项目 1 分，包括调查员编号、调查日期。j3.收缩压 160mmHg，危险分数为 1.4；舒张压 88jmmHg，危险分数 0.8；胆固醇 300mg/dl，危险分数 1.5，不吸烟，危险分数 0.5；体重超重 30%，1.3，饮酒的危险分数为 1.21j计算王先生的组合危险因素分数，列出计算过程及结果。（10 分）j评分要点：j组合危险分数：(1.4-1)+(1.5-1)+(1.3-1)+(1.21-1)+0.8×0.5=1.81j4.根据王先生的情况，如果用相关的健康风险评估工具进行分析，他可能会出现哪种疾病的危险？列出疾病危险因素？j（15 分）j评分要点：j存在高血压病、糖尿病及心血管病的危险（5 分），疾病危险因素：高盐饮食、肥胖（BMI=31）、过量饮酒、缺乏体力活动、长期精神紧张。（每个危险因素 2 分）5.针对王先生的情况撰写一份健康风险评估报告。（10 分）j评分要点：j个人报告一般包括健康风险评估的结果和健康教育的信息，评估结果是健康风险评估报告的主要内容，可以用多种形式表示，举 1-2 个表示方式的例子（5 分）。健康教育的信息根据王先生的情况（5分）。jj6.如果王先生评价年龄是 58 岁，实际年龄是 50 岁；或王先生的评价年龄是 56 岁，实际年龄是 50岁，可达到年龄为 55 岁。请分别评价两种情况下王先生的健康状况，并说明可能采取的健康管理措施。（20 分）j评分要点：j王先生评价年龄 58 岁，实际年龄 50 岁，危险高于同年龄人，可达到年龄为 44 岁，评价年龄和增长年龄相差较大，属于自创性危险因素型（5 分），危险因素可以通过自身的行为改变降低或去除可改变的危险因素，可较大程度的延长预期寿命。（3 分）j王先生的评价年龄是 56 岁，实际年龄是 50 岁，危险高于同年龄人，可达到年龄为 55 岁，评价年龄和可达到年龄相差较小，属于难以改变的危险因素型，说明个体的危险因素主要来自过去病史或遗传因素，不容易降低和改变这些因素（3 分）。j干预措施：控制血压、胆固醇，控制体重，控制饮酒，经常体育锻炼。（4 分，每项 1 分）j7.下面是根据王先生的情况制定的健康干预方案，请根据该方案制定简要的整体实施计划。（20分）j评分要点：j健康干预方案j(1)限制钠盐摄入量j(2)增加新鲜蔬菜、瓜果的摄入，减少油炸食品的摄入。j(3)限制饮酒及戒酒j(4)减轻体重jjj(5)适度的体力活动和体育运动jjj(6)保持良好的心理状态j计划应包括以下内容：项目计划、制定监测和评价计划（2 分），准备阶段（包括制作健康教育材料和预试验、人员培训、物质资源准备等）（2 分），执行阶段（包括争取领导，各种媒介渠道应用，监测与评价计划的执行等）（3 分），总结阶段（包括整理、分析所收集的材料和数据等，撰写项目总 结评价报告，规划今后工作等。）（3 分）j然后根据以上六个方面具体论述。（10 分）