患者版目标管理手册在社区高血压管理中的应用研究

Application of Patient Version of Target Management Manual to Community Hypertensive Management

目的探讨患者版目标管理手册在社区高血压管理中的应用效果。方法选取2012年1月—2013年6月在我科住院的并于出院后长期居住在我院社区服务范围内的高血压患者140例,按患者住院号的单双数分为两组:对照组67例,试验组73例。对照组患者仅给予常规社区管理;试验组患者除给予常规社区管理外,在社区工作者的指导下使用患者版目标管理手册进行高血压自我管理,两组均干预6个月。比较两组患者干预前后血压下降值及血压控制率;干预6个月后采用自我效能量表及自我管理行为量表评估两组患者的自我效能及自我管理行为水平。结果试验组患者干预前后收缩压下降值〔(12.5±7.8)mm Hg〕、舒张压下降值〔(9.1±5.8)mm Hg〕及血压控制率〔63.0%(46/73)〕均高于对照组〔(7.1±4.6)mm Hg、(3.8±4.3)mm Hg、31.3%(21/67)〕(P<0.05)。试验组患者自我效能及自我管理行为各项得分均高于对照组(P<0.05)。结论使用患者版目标管理手册可以进一步降低患者的血压,提高血压控制率和患者的自我效能及自我管理行为,值得在社区高血压管理中推广应用。

Objective To investigate the application effect of the patient version of target management handbook on hypertensive patients enrolled in community management. Methods 140 hypertensive patients who had hospitalized in our hospi-tal from January 2012 to June 2013 and dwelled in the community in the charge of our hospital were selected and divided into two groups by the admission number（odd or even）：control group（n = 67）and test group（n = 73）. Patients in the control group only received routine community management and the test group was not only given the routine community management,but also taught to take self - management with the help of patient version of target management handbook under the guidance of the commu-nity medicine workers. The intervention process lasted 6 months,then compare the decrease value and control rate of blood pres-sure before and after intervention and evaluate the self - efficacy and self - management behavior by the self - efficacy scale and self - management behavior scale. Results The decrease value of systolic blood pressure〔（12. 5 ± 7. 8）mm Hg〕and diastolic blood pressure〔（9. 1 ± 5. 8）mm Hg〕,the blood pressure control rate of patients in test group〔63. 0% （46 / 73）〕were all higher than those in the control group〔（7. 1 ± 4. 6）mm Hg,（3. 8 ± 4. 3）mm Hg,31. 3% （21 / 67）〕（P é 0. 05）. The test group patientsˊ self - efficacy and self - management behavior scores were higher than those of the control group（P é 0. 05）. Conclusion The use of the target management handbook of patient version can help patients decrease blood pressure,improve blood pressure control rate and their self - efficacy and self - management behavior. It is worthy of spreading the application in the process of community hypertension management.