南京市高血压病患者参加自我管理项目前后自我效能的改变情况及其影响因素

Impact of self-management group activities on self-efficacy and its influencing factors among patients with hypertension in Nanjing City

目的分析南京市社区高血压病患者参加自我管理小组活动前后自我效能改变情况,对影响因素进行分析,为高血压病社区防治和管理提供参考依据。方法于2015年4—6月,从南京市11区31个街道(乡镇)40个社区招募自愿参加高血压病患者自我管理小组活动的参与者;2015年9—10月,通过开展高血压病患者自我管理小组活动进行干预。分别在基线(活动前)和活动后6个月,以自身前后对照的问卷调查方法收集基本信息和自我效能得分情况,采用多重线性回归分析干预效果的影响因素。结果参加自我管理小组活动后自我效能总得分为(46.69±8.95)分高于活动前(40.29±11.50),差异有统计学意义(t=12.8,P<0.05)。文化程度高和家庭人均月收入高的高血压病患者活动干预前后自我效能总分增加幅度较大(F=3.906,P<0.05)、(F=3.273,P<0.05)。多因素分析结果显示,对小组活动总体评价、内容评价非常满意、社区医生经常/每次参加均是自我效能得分增加的正向影响因素。结论高血压病自我管理小组活动可以提高患者的自我效能,小组活动内容和社区医生的参与程度等是影响高血压病患者自我效能提高的因素。

[Objective] To analyze the changes in self-efficacy of community patients with hypertension before and after selfmanagement group activities in Nanjing City,analyze the influencing factors,and provide reference for community prevention and management of hypertension. [Methods]From April to June in 2015,the volunteers for the hypertension patient self-management group activities were recruited from 40 communities of 31 sub-districts/towns of 11 districts in Nanjing City. From September 2015 to October 2015,the intervention of hypertension patient self-management group activities was carried out. At baseline（before intervention） and 6 months after intervention,the questionnaire survey of self contrast was used to collect the basic information and self-efficacy scores. Multivariate regression analysis was performed to analyze influencing factors of intervention effect.[Results]The total score of self-efficacy after intervention of self-management group activities（46.69±8.95）was higher than that before intervention（40.29±11.50）,and the difference was statistically significant（t=12.8,P〈0.05）. The hypertension patients with higher education level（F=3.906,P〈0.05）and household per capita monthly income（F=3.273,P〈0.05）had the larger increase in total score of self-efficacy after intervention. Multivariate analysis results showed that satisfaction with the overall evaluation and content evaluation of the group activities,and regularly attendance of community physicians were positively associated with self-efficacy score improvement.[Conclusion]The self-management group activity could improve self-efficacy of hypertension patients. The activity content and participation degree of community physicians are major factors influencing self-efficacy of hypertension patients involved in the self-management group activities.