| 多种慢性病管理模式在社区老年高血压患者中的综合应用与评价 |
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| 引用本文： | 周晓丽,刘曼玲,焦艳会.多种慢性病管理模式在社区老年高血压患者中的综合应用与评价[J].中华全科医学,2020,18(3):449-453. |
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| 作者姓名： | 周晓丽 刘曼玲 焦艳会 |
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| 作者单位： | 1. 西安医学院护理学院, 陕西 西安 710021; |
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| 基金项目： | 西安医学院护理学省级重点学科建设项目(16hlxk07)陕西省教育厅2017年专项科学研究计划项目(17JK0658) |
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| 摘 要： | 目的 分析多种慢性病管理模式在社区老年高血压患者中综合应用的效果,为改进慢性病社区防控效果提供依据。 方法 按照简单随机抽样法从社区卫生服务中心初建慢性病管理档案的老年高血压患者中抽取120例,使用随机数字表法分为干预组和对照组各60例。对照组依照《高血压患者健康管理服务规范》管理,干预组在此基础上融入自我管理、群组管理、家庭干预、同伴教育,6个月后使用《高血压患者自我管理行为测评量表》《高血压自我功效量表》《焦虑自评量表SAS》《高血压病相关知识调查表》对2组患者进行测评。 结果 干预组高血压病相关知识知晓率高于对照组,干预组自我管理行为测评总分(124.50±17.32)分、自我效能得分(63.33±7.02)分均高于对照组(113.77±20.65)分和(58.12±8.68)分,干预组的平均血压(132.63±7.14/74.40±7.46)mm Hg(1 mm Hg=0.133 kPa)低于对照组(140.48±10.69/78.53±7.58)mm Hg、干预组焦虑自评得分(54.15±8.40)分低于对照组(59.41±9.10)分,以上差异具有统计学意义(P<0.05)。干预组自我效能感与焦虑程度呈负相关(r=-0.288,P=0.026),与自我管理行为能力呈正相关(r=0.382,P=0.003)。对自我效能影响最大的因素是自我管理水平(P<0.01),其次是焦虑情绪(P<0.05)。 结论 多种慢性病管理模式综合应用于老年高血压患者的日常管理中有助于患者对疾病知识的掌握,促进其情绪改善,提高自我管理能力,通过自我效能感的提升,促进健康行为的长期改善。
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| 关 键 词： | 老年人 高血压 自我管理 |
| 收稿时间： | 2019-09-05 |
Comprehensive application and evaluation of multiple chronic disease management models in elderly patients with hypertension in community |
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| Affiliation: | 1. Nursing College, Xian Medical University, Xi'an, Shaanxi 710021, China |
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| Abstract: | Objective To analyze the effect of comprehensive application of multiple chronic disease management models in elderly hypertension patients in community, and provide basis for improving the effect of community prevention and control of chronic diseases. Methods According to the simple random sampling method, 120 elderly patients with hypertension were selected from the newly established chronic disease management files in the community health service center. The patients were randomly divided into intervention group(n=60) and control group(n=60). The control group was managed according to the Health Management Service Standard of Hypertension patients, on the basis of which the intervention group was integrated into self-management, group management, family intervention and peer education. Six months later, the self-management behavior scale of hypertension patients, hypertension self-efficacy scale, self-rating anxiety scale and hypertension related knowledge questionnaire were used to evaluate two groups of patients. Results The awareness rate of hypertension-related knowledge in the intervention group was higher than that in the control group. The total score of self-management behavior evaluation(124.50±17.32), self-efficacy score(63.33±7.02) in the intervention group were higher than those in the control group(113.77±20.65, 58.12±8.68). The average blood pressure in the intervention group(132.63±7.14)/(74.40±7.46)] was lower than that in the control group(140.48±10.69)/(78.53±7.58)], and the anxiety score in the intervention group(54.15±8.40) was lower than that in the control group(59.41±9.10), the above difference was statistically significant(all P<0.05). The self-efficacy of the intervention group was negatively correlated with anxiety level(r=-0.288, P=0.025) and positively correlated with self-management behavioral capacity(r=0.382, P=0.003). The most influential factor for self-efficacy was the level of self-management(P<0.01), followed by anxiety(P<0.05). Conclusion The comprehensive application of multiple chronic disease management models in the daily management of elderly patients with hypertension will help them master the knowledge of disease, promote their emotional improvement, improve their self-management ability, and promote the long-term improvement of healthy behavior through the promotion of self-efficacy. |
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