县级医院主导的高血压老人医院-社区-家庭健康管理模式的构建及效果评价  

Construction and effect evaluation of hospital-community-family health management model led by county-level hospitals for elderly patients with hypertension

作　　者：李敏[1] 张丹[1] 陈学军[1] 唐敏[1] LI Min;ZHANG Dan;CHEN Xue jun;TANG Min(Department of Nursing,Anyue County People's Hospital,Anyue 642350,China)

机构地区：[1]四川省安岳县人民医院护理部

出　　处：《实用医院临床杂志》2019年第6期194-197,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨县级医院主导的医院-社区-家庭健康管理模式在高血压老人护理服务中的应用效果。方法选取安岳县6个社区,以随机数字表法分为3个观察组社区与3个对照组社区,将两组社区内高血压老人进行编号,以随机抽样法各抽取81例高血压老人分别纳入观察组与对照组。对照组仅由社区服务中心医护人员提供常规血压管理干预,观察组则开展县级医院主导的医院-社区-家庭健康管理干预。比较干预前及干预6个月后,两组老人在疾病知识掌握程度(高血压防治知识知晓率问卷调查表)、自我效能(GSES)、用药依从性(MMAS 8)、自我护理能力(ESCA)、幸福感(MUNSH)、焦虑(GAD 7)、抑郁情绪(PHQ 9)及晨峰血压上的差异;分析干预6个月后两组老人自我管理行为评分(HPSMBRS)及护理满意度的差异。结果干预6个月后,两组老人的高血压防治知识知晓率、GSES、MMAS 8、ESCA、MUNSH评分均较干预前有显著提升且观察组明显高于对照组(P<0.05);两组GAD 7、PHQ 9评分及晨峰收缩压、舒张压均较干预前显著下降且观察组明显低于对照组(P<0.05);观察组老人的社区护理工作满意度调查问卷评分、HPSMBRS各项评分及总分均明显高于对照组(P<0.05)。结论县级医院主导的医院-社区-家庭健康管理模式能有效提高高血压老人防治知识知晓率、服药依从性、情绪调节能力和自我管理能力,降低高血压老人焦虑、抑郁情绪及晨峰血压值(收缩压、舒张压),提升护理质量与改善老人满意度,有利于高血压老人健康管理及提升高血压老人的生活质量。Objective To explore the application effects of hospital community family health management model led by county level hospitals in the nursing services of elderly with hypertension.Methods Six communities in Anyue County were selected and divided into three experimental group communities and three control group communities.The elderly with hypertension in the two groups were numbered,and each 81 patients were randomly selected as experimental group and control group,respectively according to the random sampling method.The control group was given routine blood pressure management intervention only by community service center medical staff,and the experimental group was given hospital community family health management intervention led by county lev el hospitals.Before intervention and after 6 months,intervention,the mastery degree of disease knowledge(questionnaire of awareness rate of hypertension prevention knowledge),self efficacy(general self efficacy scale,GSES),medication compliance(Morisky medica tion adherence scale,MMAS 8),self care ability(exercise of self care agency scale,ESCA),happiness(Memorial University of New foundland Happiness Scale,MUNSH),anxiety(generalized anxiety disorder 7 scale,GAD 7),depression(Patient Health Questionnaire 9 Depression Scale,PHQ 9)and morning blood pressure surge were compared between the two groups.The behavior man agement(hypertensive patient self management behavior rating scale,HPSMBRS)and nursing satisfaction(questionnaire of community nursing work satisfaction)were analyzed in the two groups after 6 months of intervention.Results After 6 months of intervention,the scores of hypertension prevention knowledge questionnaire,GSES,MMAS 8,ESCA and MUNSH in the two groups were significantly in creased compared with those before intervention,and the scores in the experimental group were significantly higher than those in the control group at the same time(P<0.05).The scores of GAD 7,PHQ 9 and morning systolic and diastolic blood pressure surge in the two groups were signifi

关 键 词：县级医院 高血压 老人 医院-社区-家庭 健康管理 

分 类 号：R544[医药卫生—心血管疾病]