运用健康信念模式定性分析高血压患者的减盐影响因素  

Analysis on salt-reduction behaviors among patients with hypertension based on health belief model:a qualitative study

作　　者：张幸[1] 朱小柔 沈莹 蔡颖 胡康[1] 董静[2] 郭晓雷[2] 马吉祥[3] 孙昕霙[1] ZHANG Xing;ZHU Xiao-rou;SHEN Ying;CAI Ying;HU Kang;DONG Jing;GUO Xiao-lei;MA Ji- xiang;SUN Xin-ying(School of Public Health, Peking University, Beijing 100191, China)

机构地区：[1]北京大学公共卫生学院,北京100191 [2]山东省疾病预防控制中心,山东济南250014 [3]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050

出　　处：《中国健康教育》2018年第6期529-532,共4页Chinese Journal of Health Education

基　　金：山东省人民政府和原卫生部联合减盐防控高血压项目(2011-2015);山东省科技发展计划(2012GSF11828)

摘　　要：目的用定性方法较深入探索高血压患者减盐影响因素,为下一阶段的减盐干预提供科学依据。方法以健康信念模式为框架设计访谈提纲,选取高血压患者进行半结构式访谈,借助QSR公司的NVivo 11.0软件进行资料分析。结果在山东省德州市、聊城市、莱芜市和菏泽市共访谈31位高血压患者,以农村高血压患者居多,且年龄多在50岁以上。根据健康信念模式,严重性包括高盐饮食会引起高血压、不利于心脑血管,行为益处包括低盐饮食有益于血压及心脑血管,减盐障碍包括低钠盐可及性低、价格偏高,限盐勺实用性较低以及口味难改,大部分高血压患者的减盐易感性和自我效能的知觉程度较高,其减盐的提示因素主要包括:医生劝诫、家人劝导、接触宣传品和减盐工具、"小手拉大手"学校活动以及大众媒体宣传。结论后续减盐工作可以针对高血压患者的减盐行为影响因素采取针对性的措施,从而有效提高居民的减盐行为率。Objective To explore factors that may influence salt-reduction behaviors among patients with hyperten- sion by qualitative analysis. Methods The interview outline was designed based on Health Belief Model （HBM）. Semi- structured interviews were conducted among selected patients with hypertension. NVivo 11.0 of QSR was used to analyze the data. Results Totally 31 patients with hypertension were selected from Dezhou City, Liaocheng City, Laiwu City and Heze City in Shandong Province. Most of participants were from rural areas and above 50 years old. According to HBM, perceived severity included high-sah intake was harmful to cardio cerebrovascular and would cause hypertension, perceived benefit in- cluded low-salt intake was benefit to their blood pressure and cardio cerebrovascular, perceived barrier included poor acces- sibility and high price of low sodium salt, the poor practicability of salt-restriction-spoon and the difficulty to change their taste. The perceived susceptibility and self-efficacy of most hypertensive patients were high. The cues to salt-reduction actions included： doctors＇ exhortation, families＇ advice, the contact with propaganda materials and salt-reduction tools, salt-re- duction courses and activities in school and mass media propagation. Conclusion Intervention strategy formulating accord- ing these influencing factors in further work will be useful to impel people to take salt-reduction behavior.

关 键 词：减盐 高血压 健康信念模式 定性分析 

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]