社区高血压患者自我管理健康教育的定性需求评价

[目的] 了解上海某社区高血压病人在高血压管理方面的问题及需求,为创建适合病人需求的高血压自我管理健康教育项目提供依据。[方法] 对32名社区高血压病人进行一对一的定性访谈。采用内容分析法对访谈资料进行归纳分析。[结果]高血压病人报告的高血压病的症状、表现主要为头晕、头痛、乏力及伴发心绞痛和中风,与专业人员的看法基本一致。高血压病对其躯体功能、情绪、日常生活及社会交往都有一定影响,病人必须处理如“体力下降、“活动减少”、“烦躁”、“紧张”、“担忧”、“家务劳动减少”、“休息质量差”、“饮食不佳”、“社会交往减少”、“增加家人的担心和家务负担”等问题。病人常用的高血压病管理方法有:坚持服药、心理调节、锻炼、饮食调节、改善睡眠、积极参加社交活动等。目前尚有部分病人不知如何管理高血压病、缺乏信心及应用缺乏科学依据的管理方法等不足。病人建议在高血压管理方面增加社区医生对其疾病管理、血压测量、提供医药进展及改变不良行为生活方式的教育和指导等服务。[结论] 高血压病人的日常管理有一定经验,但仍有一些问题及建议需要在将来的社区高血压自我管理健康教育中针对解决,必须以教授管理疾病的技能和执行这些技能的信心为主,来帮助病人完成高血压病所致的医疗?

Needs assessment of health education for hypertension self-management

[Objective] To find the perceived problems and needs of hypertension patients in disease management. [Methods] 32 diagnosed community hypertension patients were interviewed one-to-one in the community. The qualitative data were analyzed using Content Analysis. [Results] The symptoms reported by the patients were dizzyiness, headache, fatigue sometimes complicated with angina and stroke, which were almost the same as what professionals concerned. Hypertension caused problems in physical function, emotion, daily living and social interaction, such as decrease of physical power, limited activities of daily living, under stress, irritable, anxious, difficult to do housework and sleeping problem, etc. The commonly used methods for hypertension management were adherence to medication, relaxation, exercise, dict regulation, improve sleeping and activate social interaction. But there were still some patients who did not know hypertension management, such as lack of effective skills, lack of confidence, etc, which need to be addressed in the future health education programs. More support by doctors, providing blood pressure monitoring and high risk behavior change guidelines were required by the patients. [Conclusion] Hypertension patients already had some experiences to manage their disease. But there were still some problems and needs in their hypertension management activities which need to be addressed. This study suggested that the future community-based hypertension self-management program should focus on hypertension management skills and their confidence in using them, to help patients complete treatment, behavior, emotion and role management. Promoting professional support to self-management activities of patients and good doctor-patient relationship should be strengthened in the future hypertension self-management program.