三位一体机制下H型高血压健康管理模式效果评价  

The effect evaluation of the"trinity"health management mode(health center-community-family)of H-type hypertension

作　　者：朱敏[1] 唐岚 李娅玲[1] 张勰义 邵洁[1] Zhu Min;Tang Lan;Li Yaling;Zhang Xieyi;Shao Jie(Pudong New District Weifang Community Health Center,Shanghai 200122,China;不详)

机构地区：[1]上海市浦东新区潍坊社区卫生服务中心,200122 [2]日本群马大学大学院医学系研究科

出　　处：《山西医药杂志》2020年第8期927-929,共3页Shanxi Medical Journal

基　　金：上海市卫生健康委员会卫生行业临床研究专项(201940435)。

摘　　要：目的实施中心-社区-家庭“三位一体”H型高血压健康管理模式,并对其效果进行综合评价。方法选择上海市浦东新区某社区家庭医生签约管理的H型高血压患者297例,跟踪观察12个月,运用广泛性焦虑障碍量表(GAD-7)、匹兹堡睡眠质量指数量表(PQSI)及常规血压管理指标,比较分析“三位一体”健康管理前后的效果。结果干预管理后,各项管理指标均有明显变化。患者的收缩压和舒张压均分别从(134±14)mmHg和(76±9)mmHg下降至(132±14)mmHg和(75±8)mmHg;103例失眠患者PQSI平均值从5.9±4.6下降至5.5±4.0,重度睡眠障碍者下降更为明显;12例广泛性焦虑障碍患者GAD-7评分从11.5±2.6明显下降至9.5±2.1;叶酸的使用率从10.8%升高到34.7%。结论“三位一体”H型高血压健康管理模式,有利于帮助患者获取疾病相关的知识和技能,建立并保持健康行为,提高治疗的依从性及血压的有效控制率。Objective To carry out the "trinity" health management mode (health center-community-family) of H-type hypertension, and to evaluate the effect comprehensively. Methods A total of 297 patients with H-type hypertension who were contracted and managed by general practitioners in a community from Shanghai Pudong New District were selected and followed up for 12 months. Generalized anxiety disorder scale (GAD-7), Pittsburgh quality sleep index scale (PQSI) and routine blood pressure management indexes were applied to analyze the effect before and after the "trinity" health management mode. Results After the intervention, all the management indexes had apparent changes. Systolic and diastolic pressure decreased from (134±14) mmHg to (132±14) mmHg, and (76±9) mmHg to (75±8) mmHg. The mean value of PQSI decreased from (5.9±4.6) to (5.5±4.0) in 103 cases of insomnia, and the decline was more pronounced in people with severe sleep disorders. GAD-7 score decreased significantly from 11.5±2.6 to 9.5±2.1 in 12 patients with a generalized anxiety disorder. The use of folic acid increased from 10.8% to 34.7%. Conclusions The "trinity" H-type hypertension health management mode is conducive to helping patients acquire disease-related knowledge and skills, establish and maintain healthy behaviors, improve treatment compliance and the effective control rate of blood pressure.

关 键 词：高血压 健康管理 三位一体 

分 类 号：R544.1[医药卫生—心血管疾病]