高血压患者的健康教育和管理研究

Health education and management research of patients with hypertension

目的：探讨健康教育对高血压患者行为习惯、血压控制和心理因素的影响。方法采取随机抽样的方法，选取鄢陵县医院门诊和病房高血压患者800例，采用数字表法随机分为管理组600例和对照组200例。两组均进行定期的高血压健康教育和随访，建立健康档案；管理组在此基础上进行个体化和一对一的健康教育和随访管理。干预6个月后评估两组患者行为依从性、血压控制情况和抑郁、焦虑自评量表评分。结果干预前两组行为习惯、血压情况和各组量表评分差异均无统计学意义（均 P ＞0．05）；干预6个月后，管理组低盐饮食、戒烟限酒、适当运动、合理用药、监测血压、定期复查依从性比例分别为92．6％、85．3％、90.3％、93．3％、89．6％、95．6％，对照组分别为56％、53％、63％、52．5％、49％、67％，两组差异均有统计学意义（χ2＝146．37、89．23、116．52、178．29、152．21、159．38，均 P ＜0．01）；管理组高血压知晓率、治疗率、达标率分别为94％、95．3％、89．6％，对照组分别为63％、51．5％、42．5％，两组差异均有统计学意义（χ2＝121．54、218.60、193．67，均 P ＜0．01）；管理组抑郁自评量表、焦虑自评量表评分分别为（40．12±10．34）分、（39．20±7．78）分，对照组分别为（46．60±9．56）分、（44．54±8．96）分，两组差异均有统计学意义（t ＝7．84、20．64，均P ＜0．01）。结论高血压患者在药物治疗同时进行个体化的健康教育有助于改善患者的行为习惯，改善心理因素，提高血压达标率，从而改善预后。

Objective To explore the effect of health education on behavior,blood pressure control and psy-chological factors in patients with hypertension.Methods 800 patients with hypertension in Yanling County Hospital were selected and randomly divided into management group（n =600）and control group（n =200）according to ran-dom numerical table method.The patients of the two groups were carried out regular hypertension health education and follow -up,and the health records were established.The management group was carried out individually and one to one health education and management.6 months after intervention,changes in behavioral habits compliance,blood pressure control,depression and anxiety self -rating scale of the two groups were assessed.Results Before the intervention,there were no statistical differences between the two groups（all P 〉0.05）.After 6 months intervention, the compliance ratios of low salt diet,smoking cessation and limit alcohol,appropriate exercise,rational use of drugs,monitoring blood pressure,regular review in management group were 92.6%,85.3%,90.3%,93.3%,89.6%, 95.6%,and those of the control group were 56.0%,53.0%,63.0%,52.5%,49.0%,67.0%,the differences were statistically significant（χ2 =146.37,89.23,116.52,178.29,152.21,159.38,all P 〈0.01 ）.The awareness rate, treatment rate and compliance rate of hypertension in the management group were 94.0%,95.3%,89.6%,which of the control group were 63.0%,51.5%,42.5%,the differences were statistically significant（χ2 =121.54,218.60, 193.67,all P 〈0.01）.The self -rating depression scale and self -rating anxiety scale in management group were （40.12 ±10.34）points,（39.20 ±7.78）points,respectively,and those in the control group were （46.60 ±9.56）points, （44.54 ±8.96）points,the differences were statistically significant （t =7.84,20.64,all P 〈0.01 ）.Conclusion Individualized health education around drug therapy can improve patients＇behavioral habits and psychological factors, increase the rate of blood pressure,and thus improve the prognosis of patients with hypertension.