社区护理干预在老年高血压患者中的效果

Effect of community nursing intervention in elderly patient with hypertension

目的探讨65岁以上高血压老年人群社区护理干预的效果,为社区建立有效的干预方案提供依据,有效提高高血压的治疗效果,预防和控制并发症的发生。方法收集2012年3月-2014年1月大连市某社区辖区的65岁以上高血压患者779例,采用随机抽样方法选择100例高血压老年患者,进行1年社区护理干预,建立社区健康档案,成立高血压慢病防治干预小组和高血压自我管理小组,健康教育,合理膳食,适量运动,控制体重,戒烟限酒,心理干预,服药干预及随诊管理等,比较干预前后治疗效果和疾病控制情况。结果实施社区护理干预前后,患者血压、体重指数、空腹血糖、三酰甘油、总胆固醇干预前分别为（164.00±13.42）mmHg/（89.49±9.34）mmHg（收缩压/舒张压,1 mmHg=0.133 kPa）、（26.11±3.72）kg/m^2、（6.73±2.16）mmol/L、（1.45±0.69）mmol/L、（5.16±1.10）mmol/L,干预后分别为（139.00±9.69）mmHg/（83.50±8.78）mmHg、（24.52±3.70）kg/m^2、（6.15±1.70）mmol/L、（1.33±0.36）mmol/L、（4.18±0.78）mmol/L,与干预前比较,干预后明显下降,差异均有统计学意义（P〈0.05）。结论实施社区护理干预能有效提高高血压知识知晓率、治疗率、控制率,减少并发症,达到防治高血压的基本目标。

Objective To investigate the effect of implementing community nursing intervention on the hypertensive patients older than 65 years-old for providing the basis for establishing effective community intervention programs to effectively enhance hypertention′s treatment effect, prevent and control the occurrence of complications. Methods From March 2012 to January 2014, there were 779 hypertensive patients aged over 65 in one of Dalian community. 100 elderly hypertensive patients were chosen by random sampling method, to conduct multiple kinds of one-year community nursing intervention, community health records was established, hypertention chronic disease prevention/treatment intervention group and hypertention self-management group were set up, the health education, reasonable diet, regular exercise, weight control, smoking quite and alcohol limit, psychological intervention, medication intervention and follow-up management were implemented, and the treatment effect and disease control condition before and after intervention were compared. Results Before and after conducting community nursing intervention, the patients＇ blood pressure, body mass index, fasting blood-glucose, triglyceride and total cholesterol before intervention were（164.00 ±13.42） mmHg/（89.49±9.34） mmHg（SBP/DBP, 1 mmHg=0.133 kPa）,（26.11±3.72） kg/m^2,（6.73±2.16） mmol/L,（1.45±0.69） mmol/L,（5.16±1.10） mmol/L, the data after intervention were（139.00±9.69） mmHg /（83.50±8.78） mmHg,（24.52±3.70） kg/m^2,（6.15±1.70） mmol/L,（1.33±0.36） mmol/L,（4.18±0.78） mmol/L, respectively. It decreased obviously and the difference between before and after intervention had statistical significance（P〈0.05）. Conclusion Implementing community nursing intervention can effectively improve hypertention awareness and treatment rate, control rate and decrease complication and finally achieve the basic goal of prevention and treatment of hypertention.