正常高值血压患者认知行为干预效果评价

Effect of cognitive behavior intervention in patients with high-normal blood pressure

目的：探讨对正常高值血压患者进行认知行为干预的治疗效果。方法将2011年4月~2011年10月体检时发现正常高值血压患者60例作为对照组，将2011年11月~2012年4月体检时发现的60例正常高值血压患者作为干预组。对照组采用常规护理，干预组在常规护理的基础上通过电话进行为期1年的认知行为干预，内容包括改变患者生活习惯、鼓励患者低盐低脂饮食、禁烟限酒，适当增加运动等，并分别于第2年体检时通过问卷调查患者对正常高值血压治疗性生活方式相关知识的知晓率、生活方式改变等情况。同时收集两组患者干预前后的体检报告，内容包括：血压、空腹血糖、血脂、测量当日身高、体重等指标，评价两组患者认知行为干预的效果。结果通过1年系统的认知行为干预，与对照组比较，干预组正常高值血压治疗性生活方式相关知识知晓率较高（90% vs.73.3%，P＜0.05），同时高盐饮食（23.3%vs.46.7%，P＜0.05）、高脂饮食（13.3% vs.35.9%，P＜0.05）、吸烟人数（25.0 vs.48.3%，P＜0.05）、饮酒人数（30.0%vs.36.7%，P＜0.05）均减少，而坚持运动的人数增加（86.7%vs.50.0%），同时血脂、血糖也获得了改善，差异均有统计学意义（P＜0.05）。结论通过系统的认知行为干预可纠正正常高值血压人群不良生活方式，改善患者代谢水平。

Objective To explore the curative effect of cognitive behavior intervention in patients with high-normal blood pressure. Methods The patients （n=60） were chosen from Apr. 2011 to Oct. 2011 as control group, and the patients （n=60） were chosen from Nov. 2011 to Apr. 2012 as intervention group. Control group was given routine nursing, and intervention group was given, besides of routine nursing, cognitive behavior intervention by telephone for one year. The content of intervention included changing life habits, proposing low-salt low-fat diet, banning smoking, limiting alcohol and increasing exercises. The awareness on lifestyle-related knowledge during the treatment and lifestyle changes were surveyed through questionnaire on the 2nd year. The medical examination reports were collected from two groups before and after intervention, and the content included blood pressure, fasting plasma glucose （FPG）, blood fat, and measured height and weight on that day. The patients were followed up for one year and the effect of cognitive behavior intervention was reviewed in two groups. Results After systemic cognitive behavior intervention for one year, the awareness on lifestyle-related knowledge during the treatment was higher （90%vs. 73.3%, P〈0.05）, and population of high-salt diet （23.3%vs. 46.7%, P〈0.05）, high-fat diet （13.3%vs. 35.9%, P〈0.05）, smoking （25.0 vs. 48.3%, P〈0.05） and drinking （30.0%vs. 36.7%, P〈0.05） decreased, and population of insisting exercises （86.7%vs. 50.0%） increased in intervention group compared with control group. At the same time, the indexes of blood fat and FPG were improved （P〈0.05）. Conclusion The systemic cognitive behavior intervention can correct unhealthy lifestyle and improve metabolism level in the patients with high-normal blood pressure.