南京市社区高血压病患者自我管理效果评价

Effectiveness evaluation on self-management program among patients with hypertension disease in Nanjing community

目的评价南京社区高血压病患者自我管理效果。方法2016年4—6月,以街道/乡镇为单位,通过海报、电话、朋友推荐等方式招募南京市11个区符合招募条件并自愿参加的高血压病患者,共组建39个高血压自我管理小组。通过对组员小组活动前、活动后半年、活动后1年3次相同问卷调查、体格检查和实验室检测,比较相关指标的变化,综合评价自我管理效果。结果共登记患者450例,其中426例高血压病患者完成3次调查。与活动前相比,活动后半年、活动后1年患者每周伸展/力量锻炼时间(β1=16.066;β2=23.192)、耐力锻炼时间(β1=42.121;β2=49.177)、与医生交流评分(β1=0.558;β2=0.748)等3种自我管理行为得到增加,疲劳(β1=-0.905;β2=-1.253)、疼痛(β1=-0.432;β2=-0.866)、健康担忧(β1=-0.291;β2=-0.341)、社会活动/角色受限(β1=-0.196;β2=-0.323)等4种健康状况得到改善,同时体重(β1=-0.239;β2=-1.695)、收缩压(β1=-3.849;β2=-3.858)、甘油三酯(β1=-0.175;β2=-0.285)指标得到降低,差异均有统计学意义(P<0.01)。结论南京社区高血压病患者自我管理效果较好。说明南京社区推广自我管理的合理性和必要性。

Objective To evaluate the effectiveness for hypertension patients self-management in Nanjing community.Methods From April to June 2016,eligible hypertension patients who agreed to take part in self-management program were recruited by poster,telephone,and friend recommendation from 11 districts in Nanjing.A total of 39 self-management groups for hypertension were established.Through the same questionnaire survey,physical examination and laboratory test,the changes of relevant indicators were compared and the self-management effect was comprehensively evaluated at three measurement moments(baseline,after 6 months,and after 12 months).Results A total of 450 patients were enrolled,of which 426 patients with hypertension completed three questionnaire surveys.Compared with baseline,3 of self-management behaviors:stretching or strengthening exercise(β1=16.066;β2=23.192),aerobic exercise(β1=42.121;β2=49.177),communication with medical doctor scores(β1=0.558;β2=0.748)were all higher after 6 months and after 12 months interventions;whereas 4 of health status:fatigue(β1=-0.905;β2=-1.253),pain(β1=-0.432;β2=-0.866),health distress(β1=-0.291;β2=-0.341)and social/role activities limitation(β1=-0.196;β2=-0.323),the value of body weight(β1=-0.239;β2=-1.695),systolic blood pressure(β1=-3.849;β2=-3.858)and triglyceride(β1=-0.175;β2=0.285)were all lower(all P values<0.05).Conclusion The effect of hypertension patients self-management in Nanjing community is better and suggest that there were the rationality and necessity of disseminating CDSMP in Nanjing community.