基于保护动机理论的综合护理干预在社区老年高血压患者中的应用

Application of comprehensive nursing intervention based on protection motivation theory in community elderly patients with hypertension

目的：运用保护动机理论，促进社区老年高血压患者建立健康行为，控制高血压，提高患者生活质量。方法采用随机数字表法将144名社区老年高血压患者随机分为两组。研究组在接受基于老年高血压保护动机理论的综合护理干预，对照组接受常规干预。采用生理指标、健康行为、自制老年高血压保护动机问卷进行评价。结果干预前两组患者各生理指标、健康行为得分及保护动机各维度得分比较差异均无统计学意义（P＞0．05）；干预6个月后，研究组收缩压为（136．85±15．32）mmHg，舒张压（80．78±10．54）mmHg，胆固醇（4．49±0．83）mmol/L，服药依从性得分为（7．69±0．76）分，自我效能得分为（18．03±1．75）分，易感性得分为（18．32±3．04）分；对照组分别为（139．28±13．44） mmHg、（89．25±8．78）mmHg、（5．33±0．91）mmol/L、（7．24±1．04）分、（16．82±1．97）分、（16．56±4．22）分，两组比较差异均有统计学意义（t值分别为1．35，5．17，4．98，3．36，3．69，2．11；P＜0．05）；两组患者干预6个月后腹围、血压测量频次、定期复诊率、自测血压情况、自备血压计情况及保护动机问卷中严重性、内外部奖励维度得分比较差异均有统计学意义（P＜0．05）。结论基于保护动机理论的综合护理干预能有效地促进社区老年高血压患者形成保护动机，建立健康行为，控制高血压，提高患者生活质量。

Objective To apply the nursing intervention based on the protection motivation theory in community elderly patients with hypertension , in order to establish a health behavior and to control bloodpressure and enhance better quality of life .Methods Using the random number table method , 144 elderly patients with hypertension were randomly divided into control group and intervention group .The intervention group received comprehensive nursing intervention based on protection motivation theory .The physiological index, health behavior and the scores of protection motivation questionnaire for elderly patients with hypertension were compared between the control group and the intervention group .Results Before the intervention , the physiological index , health behavior and the scores of protection motivation questionnaire for elderly patients with hypertension between groups had no significant difference （P〉0.05）.For the intervention group after 6-month-intervention, the systolic blood pressure was（ 136.85 ±15.32 ） mmHg, the diastolic blood pressure was （80.78 ±10.54） mmHg, the cholesterol level was （4.49 ±0.83） mmol/L, the score of self-efficacy was （18.03 ±1.75） and the score of susceptibility was （18.32 ±3.04）.Those values and scores in the control group were （139.28 ±13.44）mmHg, （89.25 ±8.78） mmHg, （5.33 ±0.91） mmol/L, （7.24 ±1.04）, （16.82 ±1.97） and （16.56 ±4.22）.The differences between groups were statistically significant （t=1.35, 5.17, 4.98, 3.36, 3.69, 2.11, respectively;P 〈0.05 ）.After 6 months of comprehensive nursing intervention , the physiological index , health behavior and the scores of protection motivation questionnaire for elderly patients with hypertension were statistically significant （ P 〈0.05）.Conclusions Comprehensive nursing intervention based on protection motivation theory can promote the health behavior of community elderly hypertensive patients and can effectively control high blood pressure and improve patients ’ quality of life.