以家庭为单位进行高血压管理的生存质量评价研究  

Evaluation of QOL of patients adopting family-based management of hypertension

作　　者：蔡敏[1] 汪学军[1] 方长庚[1] 孔镇江 潘伟[3] 侯晓亮 邓雪凝 李伟荣[1] 

机构地区：[1]广东医学院附属三水医院普内科,广东省佛山市528100 [2]三水西南社区卫生服务中心 [3]南方医科大学附属南海医院心内科 [4]佛山中医院三水医院心内科 [5]三水健康教育所

出　　处：《中华全科医学》2014年第7期1095-1098,共4页Chinese Journal of General Practice

基　　金：广东省医学科研基金课题(A2011627);广东省社会发展领域科技项目(20120318043);2011年广东省佛山市三水区科技项目(201112C)

摘　　要：目的探讨以家庭为单位联合社区医疗网络对高血压病进行群体和个人管理相结合管理模式下高血压的生存质量和社会支持情况。方法以三水西南街道康华、布心、沙头、园林、文峰东等5个居委为主要试点,在知情同意的基础上筛选检出的原发性高血压个体300人300户家庭,按综合医院负责指导培训和负责高血压重症;社区医院负责轻症管理、建档、健康教育、随访、转诊;高血压群组和家庭成员互相协助、督促的综合管理模式,随访观察1年后评价患者在干预前后的生存质量。结果经以家庭为单位的各级医疗网络联合干预后,高血压患者生存质量在生理职能、身体疼痛、一般健康、精力、社会功能和精神健康等6个维度中,均比干预前得分高,差异具有统计学意义(P<0.05);而生理功能、情感职能两项,干预前后没有发生明显差异(P>0.05)。社会支持评价在综合干预后主观支持和社会支持总分有明显提升,差异有统计学意义,而客观支持和对支持的利用度偏低,干预前后无明显差异。结论建立综合医院为指导,社区医院负责轻中症治疗、随访、宣教,高血压群组和家庭成员互相协助、配合、督促,群体管理和个人自我管理相结合的综合医院-社区医院-高血压家庭群组-家庭户-个人的管理模式能提高高血压患者的生存质量。Objective To evaluate the quality of life of patients adopting family-based management combined with community medical network group management of hypertension. Methods All 300 cases of essential hypertensive from 300 households in 5 neighborhood committees were enrolled in the study. The general hospital took the charge of direction, training and the treatment of severe hypertension; while the community hospitals took the charge of the administration of mild hypertension,establishment of archive,health education,follow-up,patient referral; Mutual assistance and supervision proceeded among the hypertension group and family members. After 1 years of follow-up,the quality of life of patients was evaluated. Results After the coordinated intervention,the QOL of patients was significantly improved in body pain,general health,vitality,social function and mental health（ P〈0. 05）; There was no significant differences in physiological function and emotional function（ P〈0. 05）. The score for the subjective support and social support assessment increased and the difference was significant（ P〈0. 05）,but the objective support and utilization of support were not improved obviously（ P〈0. 05）. Conclusion The comprehensive mode grouped with general hospital,community hospital,hypertension group,family and patients can improve the quality of life of patients with hypertension.

关 键 词：高血压 社区管理 群体管理 生存质量 社会支持 

分 类 号：R544.1[医药卫生—心血管疾病]