南京市下关区社区高血压患者自我管理项目实施效果评价

Evaluation on the effectiveness for self-management program of hypertension in Xiaguan community of Nanjing city

目的:评价社区高血压患者自我管理项目的效果。方法:按照以群落为基础的随机对照试验研究设计,将738例高血压患者分成干预组和对照组,干预组患者接受高血压自我管理健康教育项目课程,9个月后比较两组在自我管理行为、健康状况、卫生服务利用、心血管系统和并发症等方面的差异。结果:干预后两组患者自我管理行为中的认知性症状管理实践及按照要求规律服药间差别有统计学意义(P<0.01);干预后两组的门急诊次数、健康状况评价指标、心功能分级和并发症方面统计均有差异(P<0.05)。结论:南京市高血压自我管理项目的实施,增加了参加者的自我管理知识,培养了健康的行为,改善了躯体和精神部分健康状况、自我效能,减少就诊次数,缓解症状和预后。

Objective：To evaluate the effectiveness of implementation of hypertension self-management program in Nanjing.Methods：A community-based randomly controlled trial was taken.A total of 738 voluntary participants with hypertension were randomly divided as trial group and control group.The patients in the trial group received the education of hypertension self-management program for 9 months.Then the changes in self-management of behaviors,health condition,health service utilization,occurrence of cardiovascular disease and complications between the two groups were compared.Results：There were significant differences in practice of cognitive symptom management,communication with physician and self-efficacies of management of symptom between the two groups（P 〈 0.01）.There were also significant differences in scores of nine items of health status,times of clinic and emergent visit（P 〈 0.05）,blood pressure,body weight,waist circumference,obesity index and cardiac function classification,etc（P 〈 0.05）,There were statistically significant significances in complications,ECG left ventricular high voltage and retinal arteriosclerosis intervention（P 〈 0.05）.Conclusion：Nine-month implementation of hypertension self-management program can improve the knowledge of self-management,cultivate healthy behavior,partly improve physical and mental health condition and self-efficacy,reduce the frequencies of clinic and emergent doctor visiting for the participators.