基于医院的延续性护理预防老年高血压出院患者跌倒的研究  

Study on the falling-preventive role of hospital-based continuing care model in elderly patients with high blood pressure

作　　者：李娟[1] 罗勇[1] 李勇兰[2] 杨静[2] 

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆400016 [2]贵州省人民医院护理部,贵州贵阳550002

出　　处：《中华疾病控制杂志》2015年第10期1030-1033,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家临床重点专科建设项目(卫办医政函[2010]649号);教育部"高等学校博士学科点专项科研基金"(20095503110001)

摘　　要：目的探讨基于医院的延续护理模式在老年高血压出院患者跌倒预防中应用效果。方法将189例老年高血压出院患者随机分为干预组96例和对照组93例。两组患者在出院前常规接受出院指导,干预组患者出院后1年内给予基于医院的延续性护理干预(环境干预、认知干预、运动干预、服药干预)。比较两组患者高血压治疗自护依从性、跌倒发生率、跌倒损害程度。结果 1年内高血压治疗自护依从性对照组低于干预组(均有P<0.001)。对照组的跌倒例数25例,骨折8例、软组织损伤15例;干预组的跌倒例数7例(X^2=12.889,P<0.001),骨折1例(X^2=5.922,P=0.017)、软组织损害5例(X^2=5.953,P=0.014),均低于对照组,差异均有统计学意义。结论基于医院的延续护理模式可以提高老年高血压患者出院后的高血压的自护依从性,降低其跌倒的发生率和减轻跌倒的损害程度。Objective To explore the falling-preventive role of hospital-based continuing care model in elderly discharged patients with high blood pressure. Methods A total of 189 senile patients with hypertension were randomly divided into intervention group （ n = 96） and control group （ n = 93 ）. Both of the two groups accepted regular guidance before discharging from hospital. Intervention group patients were given the hospital-based continuing care within 1 year after hospital discharge as well. The care contents included environmental intervention, cognitive intervention, exercise intervention and medication intervention. The self-care compliance, the incidence of falling and degree of injury of the intervention group were compared with those of the control group. Results The self-care compliance of control group was lower than that of the intervention group after one-year treatment （ P 〈 0. 001 ）. 25 patients in the control group fell down, 8 and 15 patients of which were suffering from fracture and soft tissue injury respectively; 1 and 5 patients of the 7 cases who fell down in the intervention group were suffering from fracture and soft tissue injury respectively , which were significantly low- er than those of control group （P 〈 0. 05）. Conclusions Hospital-based continuing care model can not onlyimprove the self-care compliance of the elderly patients with hypertension after hospital discharge, but also reduce the incidence of falling and the degree of injury.

关 键 词：护理工作 高血压 老年人 意外跌倒 

分 类 号：R473.59[医药卫生—护理学] R181.2[医药卫生—临床医学]