高血压社区干预和自我管理效果对比  

A Comparative Study on the Efficacy of Community Intervention and Self-management of Hypertension

作　　者：邓俊国[1] 谢荣爱[2] 于佳丽[1] 

机构地区：[1]秦皇岛市第二医院,秦皇岛市066600 [2]北京大学首钢医院,北京市100041

出　　处：《中国分子心脏病学杂志》2015年第2期1277-1279,共3页Molecular Cardiology of China

摘　　要：目的对比高血压患者社区干预和自我管理和单纯患者自我管理的效果。方法将在2013年5月至2014年5月我院确诊后回家治疗并电话随访的208例高血压患者,将年龄和性别匹配后,分为干预组(社区干预联合自我管理组)及对照组(单纯自我管理组)。干预措施包括认知干预和行为干预。两组患者随访观察1年。结果两组人群基线血压水平、心血管病危险因素比例和慢性病患病率均无统计学差异。干预1年后,干预组患者的规律监测血压比例由46.7%增至76.2%,增幅为63.2%(P<0.05);规律服药和合理膳食增幅分别为35.4%和37.0%(P<0.05)。血压达标率增加了10.5%,增幅为32.4%(P<0.05)。对照组除规律服药比例增加外,其他生活方式改变较基线均无统计学差异。多因素分析结果显示,定期测量血压、规律服药和定期接受健康教育是影响高血压患者干预效果的独立影响因素。结论社区干预和患者自我管理较单纯自我管理更能有效提高患者依从性和血压达标率,提示在高血压社区管理过程中应重视社区医护人员和患者的定期沟通。Objectives To compare the efficacy of the community intervention and the self-management ofhypertensive patients. Methods A total of 208 hypertension patients confirmed in our hospital from May 2013 to May 2014 were enrolled. All participants were divided into the intervention group （community intervention and self-management） and the control group （only self-management） with matchedage and gender.Intervention strategies included education interventions and behavior interventions. ResuRs Baseline blood pressure, the percentages of cardiovascular disease risk factors and the prevalence of chronic disease among two groups were similar （P〉0.05）. The percentage of BP monitoring in the intervention group hadincreasedfrom 46.7% to 76.2 %（P〈0.05） after l-year follow up. The growth of the percentages of treatment and healthy diet in patients were 35.4 % and 37.0%, respectively （P〈0.05）.The proportion of hypertensive patients whoachieved target BP increased by 10.5% （P〈0.05）.When compared to the baseline, the chattges in the percentages of healthy lifestyle in the control group had no statistical difference except for the proportion of treatment. Multivariate analysis showed that measuring blood pressure, taking medicine regularly and routine health education were associated with the intervention effect independently. Conclusions Community intervention and self-management of hypertension were more effective in improving the compliance of patients and the BP control rate. The communications between the medical staffs and the patients should be stressed in the community management of hypertension.

关 键 词：高血压 社区干预 自我管理 

分 类 号：R473.2[医药卫生—护理学]