社区管理高血压患者自我管理与血压控制相关性分析

Correlation analysis between the self-management and the controlling blood pressure in community managed hypertension patients

目的了解参加社区管理高血压患者的自我管理、血压控制及其两者之间的相关性,为基层医疗机构能够更好地开展慢病管理提供理论依据。方法采用多阶段抽样的方法,于2019-03-01-2019-09-30对泸州市大山坪、北城、莲花池和红星社区卫生服务中心参加社区管理的1270例高血压患者进行问卷调查及体格检查,收集高血压患者的基本情况、自我管理和血压等情况,分析高血压患者自我管理水平、血压控制情况及其影响因素、自我管理与血压的相关性。结果高血压患者总的自我管理标准得分为(71.36±10.54)分,高水平比例达到22.2%。血压控制率为48.4%。Pearson相关分析结果显示,治疗依从性管理(r=-0.104,P<0.001)和自我管理总水平(r=-0.078,P=0.005)与血压控制率之间呈负相关,饮食管理(r=-0.156,P<0.001)、治疗依从性管理(r=-0.132,P<0.001)、社会心理管理(r=-0.082,P=0.004)和自我管理总水平(r=-0.157,P<0.001)与舒张压之间呈负相关。多因素Logistic回归分析结果显示,文化程度(P=0.015)、患病年限(P=0.003)、治疗依从性管理(P=0.003)、日常活动管理(P=0.008)和自我管理总水平(P=0.007)是血压控制率的影响因素。结论参加社区管理的高血压患者自我管理水平与血压控制有关,尤其是治疗依从性管理。社区慢病管理人员应加强对患者的健康教育,并通过干预不断提高患者的自我管理水平,进而帮助患者更好地控制血压。

Objective This study analyzed the self-management and the blood pressure control of hypertension patients participating in community management and explored the relationship between the self-management and the blood pressure control,to provid a theoretical basis for community health service center for carrying out chronic disease management better.Methods A total of 1270 patients with hypertension who participated in community management in Dashanping,Beicheng,Lianhuachi and Hongxing Community health service centers in Luzhou City were selected by stratified and multistage sampling for questionnaire survey and physical examination from March 1 to September 30,2019.Basic information,the self-management and the blood pressure of patients with hypertension were collected.Moreover,the self-management level,the blood pressure control and its influencing factors,correlation between the self-management and blood pressure of hypertension patients were analyzed.Results The standardized score of the total self-management of hypertension patients was(71.36±10.54)points,the high level proportion reached to 22.2%.The blood pressure control rate was 48.4%.Pearson correlation analysis showed that the overall level of the treatment compliance management(r=-0.104,P<0.001),and the self-management(r=-0.078,P=0.005)were negatively correlated with systolic blood pressure,while the overall level of the diet management(r=-0.156,P<0.001),the treatment compliance management(r=-0.132,P<0.001),the psychosocial management(r=-0.082,P=0.004)and the self-management(r=-0.157,P<0.001)were negatively correlated with the diastolic blood pressure.Multiple Logistic analysis showed that,the education level(P=0.015),years of illness(P=0.003),the treatment compliance management(P=0.003),the general level of daily activity management(P=0.008)and the whole self-management(P=0.007)were the influencing factors of the diastolic blood pressure.Conclusions The self-management of hypertension patients participating in community management in Luzhou is related to blood pressure control,especially the treatment compliance management.The community chronic disease managers should strengthen the level of self-management health education for patients and through the intervention to continuously improve patients’self-management level,so as to help patients better control the blood pressure.