健康教育对社区高血压患者服药依从性的干预效果评价  

Effect of health education interventions on medication adherence among community patients with hypertension

作　　者：胡康[1] 朱小柔 张幸[1] 吴士艳 王冯彬[1] 何朝[2] 李征[2] 孙昕霙[1] HU Kang;ZHU Xiao-rou;ZHANG Xing;WU Shi-yan;WANG Feng-bin;HE Chao;LI Zheng;SUN Xin- ying(Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China)

机构地区：[1]北京大学公共卫生学院社会医学与健康教育系,北京100191 [2]北京市顺义区疾病预防控制中心,北京101300

出　　处：《中国健康教育》2018年第4期304-308,316,共6页Chinese Journal of Health Education

基　　金：北京市自然科学基金资助项目(7162105)

摘　　要：目的了解社区高血压患者的服药依从性情况,评价针对服药依从性健康教育的干预效果。方法选取北京市顺义区8家社区卫生服务中心范围内的596名高血压患者,以社区为单位随机分为2组,其中干预组299人,对照组297人。干预组进行2次健康教育和为期6个月的随访,对照组则常规护理。干预前后使用包含Morisky服药依从性量表(MMAS-8)的调查问卷。结果干预6个月后,完成随访的患者为518人,其中干预组262人,对照组256人,2组患者均为随机性失访。干预结束后,干预组患者的服药依从性得分从(6.41±1.81)分提高到(7.15±1.41)分(配对t=6.486,P<0.001);而对照组患者的得分从(6.37±1.89)分提高到(6.83±1.58)分(配对t=4.162,P<0.001)。2组患者的基线得分(t=0.247,P=0.805)以及得分差值(t=1.750,P=0.081)差异无统计学意义,而终末得分趋异有统计学意义(t=2.427,P=0.016)。多因素协方差分析发现,基线服药依从性得分(β=0.336,P<0.001)、分组(β=0.264,P=0.032)、文化程度(β=-0.459,P=0.037)是影响终末服药依从性得分的因素。即控制其他因素后,干预组患者的终末得分高于对照组,说明干预有效果。结论针对高血压患者的健康教育一定程度上能提高其服药依从性。Objective To investigate the situation of medication adherence among community patients with hyper-tension, and evaluate the effect of health education interventions on medication adherence. Methods The study enrolled 596 hypertensive patients from 8 community health service centers in Shunyi District of Beijing. These patients were divided into two groups at community-based random method, one intervention group （ n = 299 ） and one control group （ n = 297 ） . Patients in the intervention group accepted 2 times health education activities and 6 - month follow-up visit, while patients in control group were given regular medical care. The effect was evaluated by the questionnaire including Morisky Medication Adherence Scale （ MMAS-8） before and after the intervention. Results 518 patients had completed the 6 - month follow-up visit, 262 patients in the intervention group and 256 patients in the control group. The withdraw in the two groups was ran-dom. After the intervention, the medication adherence score of patients in the intervention group was improved from （6. 41 ±1.81） to （7. 15 ±1.41） （paired t =6. 486, P 〈0. 001） , while the score in the control group was also improved, from （6.37±1.89） to （6. 83 ± 1. 58） （paired ^ =4. 162, P〈0.001）. The medication adherence score at baseline （β = 0. 247, P = 0. 805 ） showed no statistical significance between two groups as well as the difference of medication adherence score （ t = 1.750,P =0.081） . But the medication adherence score at terminal showed statistical significance among two groups. Multifactor covariance analysis found that the medication adherence score at baseline （β =0.336, P 〈0. 001） , grouping （β= 0.264, P =0.032） and educational level （β = - 0 .4 5 9 , P = 0. 037 ） were affecting factors of the medication adher-ence score at terminal. So the medication adherence score at terminal of patients in the intervent

关 键 词：高血压 服药依从性 健康教育 干预评价 

分 类 号：R193[医药卫生—卫生事业管理] R544.1[医药卫生—公共卫生与预防医学]