健康教育对中老年原发性高血压患者出院后服药依从性的影响

Effect of health education on drug compliance from discharged elderly patients with essential hypertension

目的:评价针对中老年原发性高血压患者实施的住院期间健康教育与出院后病情追踪、反馈和干预等一系列健康教育手段对该患者群体出院后服药依从性的影响。方法:运用前瞻性干预研究的方法,选取2014年1-12月在台州市肿瘤医院神经内科住院的中老年原发性高血压患者77例作为干预组,实施关于原发性高血压概念、症状、预防保健康复知识、用药等内容的健康教育,并做好出院后的病情追踪、反馈与干预工作;将干预组患者人口学资料、高血压分级和合并症情况分层,运用分层配比原则确定对照组患者80例,行常规护理。分别在出院后1个月、6个月进行调查,比较两组患者服药依从性情况,并分析干预组患者MASS评分随时间衰减情况。结果:两组中老年EH患者出院后服药依从性比较,差异均有统计学意义(P<0.05)。对干预组患者出院后服药依从性得分随时间的衰减情况的分析显示,"一个月期"随访MASS总分与"六个月期"随访MASS总分差异有统计学意义(P<0.05)。结论:针对中老年EH患者实施的住院期间健康教育和出院后病情追踪与进一步干预,对提高出院后服药依从性具有促进作用,出院后1个月到6个月期间,服药依从性衰减较快,应在此时期进一步增强干预频率。

Objective To evaluate the impact of health education on the drug compliance of elderly patients with essential hypertension after discharge from hospital, including health education during hospitalization, follow--up of disease, feedback and intervention. Methods A prospective study was conducted in 157 elderly patients with essential hypertension who were hospitalized in Department of Neurology of Tumor Hospital in Taizhou city from January 2014 to December 2014. The patients were assigned into intervention group（n= 77）and control group（n= 80）by hierarchical matching on demographic data, hypertension grading and complications. Health education was carried out for intervention group about the concept of essential hypertension, symptoms, knowledge of prevention and health rehabilitation, medication as well as follow-up, feedback and intervention after discharged from hospital. The patients in the control group received routine nursing. Drug compliances of two groups were compared in one month and six months after discharge, and how the MASS level of intervention group decreased with time was an- alyzed. Results There was statistically significant difference（P〈0.05） between the two groups in terms of the drug compliance of elderly patients with EH after discharge. There was significant difference between the one-month follow-up scores of MASS and the six-month follow-up scores of MASS（P〈0.05）. Conclusions Health education and follow-up after hospitalization for elderly EH patients can improve the drug compliance after discharged from hospital. The drug compliance decays rapidly after one month to six months after discharge. The frequency of intervention should be further increased during this period.