浙江省城市社区基层医生家庭血压自测认知情况调查分析

目的调查浙江省城市社区基层医生对家庭血压自On,0的认知情况。方法选择杭州市下城区参加浙江省科技厅公益性技术应用研究计划项目《高血压社区控制技术对心血管病人群防治基地建设的影响研究》的干预组和对照组的138名社区医生，对两组社区医生进行中国家庭血压测量现状“医生版调查问卷”调查。结果收到有效问卷132份，其中干预组70份，对照组62份。在家庭血压自测的认知上，干预组社区医生优于对照组，其中：80．0％（56／70）干预组医生和62．9％（39／62）对照组医生在日常门诊工作中经常建议高血压患者进行家庭血压自测；正确选择上臂式电子血压计、测量时间在早晚进行、每次测量2—3遍、记录3次血压值，以及家庭自测血压诊断标准为血压≥135／85mmHg（1mmHg=0．133kPa）的干预组和对照组社区医生分别为：67．1％（47／70）和32．3％（20／62）、55．7％（39／70）和29．0％（18／62）、92．9％（65／70）和66．7％（40／62）、38．6％（27／70）和6．4％（4／62），以及57．1％（40／70）和38．7％（24／62），差异有统计学意义（P〈0．05）；对于血压测量的频率，92．9％（65／70）的干预组医生和67．7％（42／62）对照组医生认为控制不佳的患者应每日一测，81．4％（57／70）干预组医生和14．5％（9／62）对照组医生认为控制良好的患者应每周一测，87．1％（61／70）干预组医生和35．5％（22／62）对照组医生认为非高血压者至少每年测量一次血压，差异有统计学意义（P〈0．05）。社区医生普遍认为家庭血压自测简便、真实性强，能提高患者高血压知晓率以及降压治疗的达标率，但是其可靠性和准确性不够。结论社区医生总体上对家庭血压自测的了解不够、信任不足，经过培训的干预组医生对其的认知高于对照组医生；应普及《中国血压测量指南》培训，提高社区医生对家庭血压自测的认识和信任度。

Survey on knowledge of home blood pressure monitoring in community physicians of Zhejiang province

Objective To survey on knowledge of home blood pressure monitoring （HBPM） in community physicians of Zhejiang province. Methods One hundred and thirty eight community physicians from Xiacheng District of Hangzhou Municipality were assigned in intervention group （ n = 70 ） or control group （ n = 68 ）. The knowledge of home blood pressure monitoring was surveyed by using the China HBPM questionnaire in both groups. Results Total 132 valid questionnaires were returned, including 70 from intervention group and 62 from control group. The results showed that 80.0% （61/70） physicians in intervention group and 62. 9% in control group frequently suggested hypertensive patients to have HBPM in out-patient clinics （ P 〈 0. 05 ）. Physicians who correctly instructed patients to use upper arm electronic sphygrnomanometer, to measure blood pressure in morning and night, to repeat 2 - 3 times each time, to record result 3 times, and to take I〉 135/85 mmHg（ 1 mmHg = 0. 133 kPa） as criteria of hypertension in intervention and control groups were 67. 1% （47/70） versus 32. 3% （20/62） , 5.7% （39/70） versus 29.0% （18/62）, 92.9% （65/70）versus66.7% （40/62）, 38.6% （27/70）versus6.4% （4/62）and 57. 1% （40/70） versus 38.7% （24/62）, respectively, and the differences between two groups were all statistieally significant （P 〈 0. 05 ）. As for measuring frequeney, 92. 9% （65/70） physicians in intervention group and 67. 7% （42/62） in control group considered that blood pressure should be measured every clay for poorly controlled patients; 81.4% （61/70） versus 14. 5% （9/62） considered that blood pressure should be measured every week for well-controlled patients; 87.1% versus 35.5% （22/62） considered that blood pressure should be measured every year at least for people with normal blood pressure; there were significantly differences between two groups （ P 〈 0. 05 ）. The community physieians generally considered that HBPM can be used to improve the awareness of hypertension for patients and to increase the blood pressure control rate in community.