高血压患者的社区干预效果与治疗依从性

Effect and treatment compliance of community intervention in patients with hypertension

目的研究社区服务居民的高血压干预效果与治疗依从性。方法选择2013年12月至2014年12月首都医科大学附属复兴医院月坛社区卫生服务中心确诊高血压患者240例,男性126例,女性114例。将240例患者随机分为两组,干预组和对照组(各120例)。干预组常规治疗基础上进行社区干预,对照组仅采取常规高血压治疗。记录患者的高血压症状改善情况,分别在患者干预前后进行问卷调查,比较患者健康行为情况与治疗依从性。结果干预组采用社区干预,高血压控制的总有效率为98.3%,而对照组患者的总有效率仅为76.7%,干预组降压效果明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后干预组收缩压与舒张压均低于对照组,[(128.4±12.0)mm Hg vs.(138.2±16.1)mm Hg]、[(82.5±9.4)mm Hg vs.(92.2±10.7)mm Hg],差异具有统计学意义(P<0.05)。干预组的高血压认知、健康信念及健康行为明显优于对照组,两组比较差异具有统计学意义(P均<0.05)。干预组的依从性情况明显优于对照组,差异具有统计学意义(P均<0.05)。结论通过社区干预可以提升患者的高血压认知、健康信念以及改善健康行为,提高治疗依从性,血压得到有效的控制,值得临床广泛推广。

Objective To study the intervention effect and treatment compliance in community patients with hypertension. Methods The patients with hypertension（n=240, male 126 and female 114） were chosen from Yuetan Community Health Service Center from Dec. 2013 to De. 2014, and randomly divided into intervention group and control group（each n=120）. The intervention group was given community intervention on the base of routine treatment and control group was only given routine anti-hypertension treatment. The relieving states of hypertensive symptoms were recorded, and the questionnaire survey was carried out in patients for comparing their health behaviors and treatment compliance. Results The effective rate of hypertension control was 98.3% in intervention group and 76.7% in control group（P〈0.05）. The levels of systolic blood pressure and diastolic blood pressure were higher in intervention group than those in control group [（128.4±12.0） mm Hg vs.（138.2±16.1） mm Hg,（82.5±9.4） mm Hg vs.（92.2±10.7） mm Hg, P〈0.05]. The hypertensive cognition, health belief and health behaviors were superior in intervention group to those in control group（all P〈0.05）. The treatment compliance was higher in intervention group than that in control group（all P〈0.05）. Conclusion The hypertensive cognition, health belief and health behaviors can be improved through community intervention, treatment compliance is promoted, and blood pressure is controlled effectively.