“4CH8”模式对高血压患者依从性等影响的研究

The Influence of “4CH8” Model on Treatment Compliance and Social Functions of Hypertension Patients

目的通过建立"4CH8"社区健康管理模式,评价该模式对社区高血压患者的治疗依从性和相关社会功能的影响。方法以社区为基础,分别随机抽取300名高血压患者进行研究,最终干预组288例患者接受"4CH8"管理模式,对照组262例患者接受三级管理。采用多因素方差分析比较两组干预前后治疗依从性和社会功能的变化情况,Wilcoxon符号秩检验进行单因素分析。结果多因素方差分析结果:一贯服药、调节饮食及体育锻炼、调节心理治疗依从性、生活自理能力和社会交流能力的组别与时间因素之间存在交互作用,而近30 d服药依从性、承担工作量变化情况的组别与时间因素之间无交互作用,组别对治疗依从性和社会功能指标的影响差异有统计学意义。单因素分析结果:干预组患者各项治疗依从性、社会功能指标干预前后的差异均有统计学意义,而对照组患者各项治疗依从性、社会功能指标干预前后的差异均无统计学意义。结论 "4CH8"社区健康管理模式能够提高患者治疗依从性和社会功能,可成为现有慢性病管理模式的补充,但仍需进一步研究其推广价值。

Objective To evaluate the influence of ＂4CH8＂ community hypertension management model on treatment com- pliance and related social functions of hypertension patients. Methods We investigated 300 hypertension patients by random sampling in 2 community service centers in Shanghai separately before and after the intervention. The numbers of patients involved in the research were 288 in intervention group and 262 in control group. We used Wilcoxon, and multi-way ANOVA to compare the scores of the two groups before and after the intervention. Results Multivariate analysis showed the interactions of group and time in medication adherence （MA） , dietary adherence （DA） , physical activity adherence （PAA） , emotion adjustment （ EA ） , per- formanee state and social communication skills, and no interactions of group and time in medication adherence （MA） nearly a month and workload change. The differences of every index in intervention group were significantly higher than those in control group. Single factor analysis showed that the differences of every index were significant before and after the intervention in inter- vention group,while no such significant difference was found in control group. Conclusion ＂4CH8＂ Model can improve hyper- tensive patients＇ treatment compliance and social functions, and therefore can be a supplementary model, which also need further research.