社区家庭干预对有高血压家族史家庭成员行为生活方式的影响研究

Research on the Influence of Community Family Intervention on the Behavior and Life Style of Family Members from Family with Hypertension History

目的探讨社区家庭干预对有高血压家族史家庭成员行为生活方式的影响,为有高血压家族史家庭成员有效预防和控制高血压提供依据和方法。方法从北京市东城区社区卫生服务管理中心下属清水苑卫生站2010年建立的居民健康档案中找出原发性高血压患者,从中选取有高血压家族史的家庭成员作为研究对象,于2011年2月—2012年1月对这些研究对象以家庭为单位进行社区家庭干预。干预内容包括戒烟、控制和改善不良情绪、戒酒、合理膳食、适量盐摄入及适量运动。干预方式为组织社区讲座,观看教育片,病友亲身讲述控制高血压的经验和体会,组织健康知识竞赛及适量的户外运动。观察其干预前后生活方式的改变,并比较干预前后高血压知晓率、服药率及控制率。结果共有64个高血压家庭288人参与社区家庭干预活动,除外旁系人员,最终选出直系亲属152人参与结果比较。其中高血压患者77人(高血压组),非高血压者75人(非高血压组)。在实施社区家庭干预前,高血压组和非高血压组在体质指数(BMI)、吸烟情况、不良情绪、饮酒情况、膳食口味和适量运动方面差异有统计学意义(P<0.05);干预后两组上述指标均较干预前显著改善,差异有统计学意义(P<0.05)。干预后两组间仅BMI差异有统计学意义(P<0.05)。干预后高血压组患者的知晓率、服药率、控制率分别为100.0%(77/77)、89.6%(69/77)和76.6%(59/77),均显著高于干预前的64.9%(50/77)、48.1%(37/77)和39.0%(30/77),差异有统计学意义(P<0.05)。结论有高血压家族史的家庭成员中,高血压患者较非高血压患者有更多的不良生活方式;以家庭为单位的社区家庭干预能改善有高血压家族史家庭成员的行为生活方式,提高患者的高血压知晓率、服药率及控制率。

Objective To explore the influence of community family intervention on the behavior and lifestyle of family members from families with hypertension history in order to provide evidence and method for effective prevention and control of hypertension.Methods Among the primary hypertension patients from the health record established in 2010 in Qingshuiyuan Health Station affiliated to Dongcheng District Community Health Service Management Center of Beijing,the ones with hypertension history were selected as study objects.Interventions were performed from February 2011 to January 2012 on these patients.The content of interventions included quitting smoking,controlling and improving of bad mood,quitting alcohol,and rational diet,reasonable intake of salt and moderate exercise.The means of intervention included community lectures,watching educational film,patients talking about experiences of controlling hypertension,organizing competition and recreational activities related to health knowledge and organizing moderate outdoor activities.The changes of lifestyle before and after intervention were observed and the awareness rate,drug-taking rate and control rate before and after intervention were also compared.Results A total of 288 people from 64 hypertension family participated in the community family intervention and at last 152 lineal relatives were selected to compare the results.There were 77 hypertension people（hypertension group） and 75 non-hypertension people（non-hypertension group）.Before the intervention,the BMI,smoking,bad mood,drinking,flavor and exercises showed statistically significant differences between hypertension group and non-hypertension group（P0.05）.The above mentioned indexes were all significantly improved after intervention（P0.05）.After intervention only BMI showed statistically significant difference between the two groups（P0.05）.After intervention,the awareness rate,drug-taking rate and control rate of hypertension group were 100.0%（77/77）,89.6%（69/77） and 76.6%（59/77） respectively,significantly higher than those before intervention,which were 64.9%（50/77）,48.1%（37/77）,and 39.0%（30/77）（P0.05）.Conclusion Among family members with hypertension history,hypertension patients have more bad habits compared with non-hypertension patients.Community family intervention can improve the lifestyle of family members with hypertension history and improve awareness rate,drug-taking rate and control rate of hypertension patients.