广州市某社区高血压患者自我管理效果评价

目的评价广州市某社区高血压患者实施自我管理10个月之后,对健康知识的知晓,健康的生活方式与健康行为的形成,以及血压控制的情况。方法按照随机对照试验研究设计方法,将某社区665名高血压患者,以居委会为单位随机分为干预组和对照组,分别进行高血压健康教育与健康促进。干预组采取以患者为主的高血压自我管理模式,共359人;对照组采取以医务人员占主导地位的宣传教育指导模式,共306人。10个月后,比较干预组和对照组高血压患者在健康知识的知晓、健康的生活方式与健康行为的形成及血压控制方面的变化。结果干预组高血压患者的健康知识知晓率提高了40个百分点,高于对照组32个百分点(P<0.001);干预组高血压患者的健康生活方式与健康行为形成率明显高于对照组(P<0.01);干预组高血压患者的规范用药率提高了34个百分点,显著高于对照组30个百分点(P<0.01);干预组10个月内平均比对照组多降低收缩压6.16mmHg、舒张压1.03mmHg,干预组血压控制率提高了52个百分点,明显优于对照组37个百分点,(0.01<P<0.05)。结论社区进行高血压健康教育与健康促进,以患者为主的高血压自我管理模式较传统的以医务人员占主导地位的宣传教育指导模式在提高高血压患者的健康知识知晓率、健康的生活方式与健康行为的形成率、血压控制率方面效果更好。

Objective To study the awareness of health knowledge,the formation of healthy life style and behavior and the condition of blood pressure controlling for the patients with hypertension in community who took a ten-month self-managed treatment.Methods A randomized controlled trial was conducted among 665 patients with hypertension in rural community.The patients were randomly grouped into intervention group（359 cases） and control group（306 cases）,which took the health education and health promotion of hypertension respectively.In the intervention group,the patient-dominated self-managed mode was used.In the control group,the doctor-dominated mode of health education and guidance was used.The cognition of health knowledge,the formation of healthy life style and behavior and the condition of blood pressure controlling were compared between two groups after ten months.Results The awareness rate of health knowledge in intervention group increased by 40% and 32% higher than in control group（P0.001）.The formation rate of healthy life style and behavior of the intervention group was significantly higher than that of control group（P0.01）.The regularity rate of treatment in intervention group increased by 34% and 30% higher than in control group（P0.01）.The decrease of systolic blood pressure in intervention group was 6.16mmHg more than in control group and diastolic blood pressure 1.03mmHg.The blood pressure control rate of the intervention group increased by 52% and was 37% higher than the control group（0.01P0.05）.Conclusion In the hypertension health education and promotion,the patient-dominated self-management model is more effective on the improvement of blood pressure control and follow-up services than the traditional doctor-guided model.