社区高血压患者综合健康管理认知、遵医行为及需求的调查

The study on cognition,compliance behavior and demand of integrated health management of hypertensive patients in community

目的了解高血压患者综合健康管理的认知、遵医行为及需求情况,分析影响认知及遵医行为的主要因素,为完善高血压综合健康管理服务模式提供依据。方法运用整群随机抽样方法,选取上海市某社区高血压患者300名,采用自制问卷对其进行调查,共获得有效问卷259份。结果患者对高血压诊断标准的认知度较高,为56.4%,对高血压中医范畴、自身辩证分型、适宜的膳食原则、茶饮、食疗方法及体穴按压点认知度不高,分别为15.5%、5.4%、14.7%、10.4%、8.1%、5.0%。患者在不饮酒、不吸烟、遵医嘱按时服药、定期测量血压方面依从性较好,分别为86.9%、83%、79.9%、79.8%,但在遵照中医健康教育处方摄入适宜饮食、坚持养生锻炼、进行体穴按压方面依从性较差,分别为33.6%、30.9%、14.3%。单因素分析和logistic回归分析结果表明,高文化程度的患者认知度和遵医行为较好,风阳上扰型、高收入的患者认知度较高,女性、高就诊频率、主动选择中医门诊的患者,遵医行为较好,差异均有统计学意义(P<0.05)。在服务需求方面,除了心理疏导外,其他服务项目的需求度均超过了50%。结论目前,高血压患者对西医健康管理的认知水平和遵医行为程度较高,对中医健康管理认知和遵医行为情况较差,患者对各项服务的需求度较高。建议加大宣传力度,加强人才培养,完善绩效考核指标体系,为提高患者的认知水平和自我健康管理水平提供支持。

Objective To investigate the cognition, compliance behavior and demand of integrated health management of hypertensive patients. The analysis of the main factors affecting the cognition and compliance behavior provided reference for improving the integrated health management service was conducted. Methods Cluster random sampling and question- naire survey were used to investigate 300 outpatients with hypertension from some community in Shanghai. 259 effective questionnaires were obtained. Results The cognition degree of diagnostic criteria was high, that＇ s 56.4%. The cognitions of Category of traditional Chinese medicine （TCM） , syndrome differentiation, proper diet principle, tea, diet therapy method and the points of Traditional Chinese acupressure were low. The degrees of their cognition were 15.5% ,5.4% , 14.7%, 10.4%, 8. 1% ,5.0%, respectively. The compliance behaviors of hypertensive patients with no drinking, no smoking, taking the medicine according to the instruction on time and measuring blood pressure regularly, were good. The levels of them were 86.9% ,83.0% ,79.9% ,79.8%. The compliance behaviors of taking reasonable diet , exercise and Traditional Chinese acupressure according to the TCM health education prescription were poor. The levels of them were 33.6% ,30.9%, 14.3%. The results of single factor analysis and logistic regression analysis showed that the cognition and compliance behavior in hypertensive patients with a higher level of education were better. The scores of cognitions of patients in the type of wind-yang up-boring or with high income were higher. The compliance behaviors of the female were better than that of the male. The higher the frequency of the community visits, especially these choosing TCM clinic doctor actively, the higher the scores of compliance behavior. The differences were all statistically significant（ P 〈 0.05 ）. The de- mands for all kinds of services already exceeded 50% except for psychological guidance. Conclusion The degrees of cognition and compliance behavior of western health management were better. But those of TCM health management were worse. The demands for all kinds of services were high. We advise to strengthen propaganda and talent training and to improve performance indicator system so as to provide support for improving the level of cognition and health self-management of hypertensive patients.