基于跨理论模型动机访谈改善老年高血压患者自我效能及疗效的研究

Research on Improving Self-efficacy and Efficacy of Elderly Hypertensive Patients Based on Trans Theoretical Model Motivation Interview

目的探讨基于跨理论模型(TTM)动机访谈(MI)改善老年高血压患者自我效能及疗效。方法将286例60～75岁社区老年高血压患者随机分为对照组和观察组,每组各143例,对照组给予社区分层分级管理干预,观察组在社区分层分级管理的基础上开展基于跨理论模型动机访谈干预,两组干预时间均为18个月。干预前后分别测评自我效能、自我管理、血脂水平、血压治疗及控制情况和生存质量,采用t检验和χ2检验比较两组自我效能、自我管理、血脂水平、血压治疗及控制情况和生存质量。结果干预前,两组自我效能、自我管理、血脂水平、血压治疗及控制情况和生存质量之间差异均无统计学意义(P>0.05);干预18个月后,观察组自我效能、自我管理、高密度脂蛋白、血压治疗及控制情况和生存质量较对照组均有显著改善(P<0.05)。结论基于TTM的动机访谈是有效的认知、行为改变技术,有助于提高患者自我效能和自我管理水平,改善高密度脂蛋白、血压治疗及控制情况和生存质量,值得在社区推广应用。

OBJECTIVE To evaluation motivational interviewing （MI）based on the transtheoretical mode （TTM）to improve self-efficacy and efficacy in elderly hypertensive patients. METHODS 286 aged 60-75 year old hypertension patients were randomly divided into control group and observation group, with 143 cases in each group. The control group was given community stratified management intervention. On the basis of the stratified management of the community, the observation group can＇ied out the interviewing intervention based on the cross theoretical model. The intervention of the two groups was 18 months, and the intervention was measured before and after the inter- vention, respectively. The level of self-efficacy, self management, blood lipid level, blood pressure treatment and control and quality of life were evaluated. T test and X2 test were used to compare the level of self-efficacy, self management, blood lipid level, blood pressure treatment and control and quality of life in the two groups RESULTS Before intervention, there was no significant difference between the two groups of self-efficacy, self management, blood lipid level, blood pressure treatment and control and quality of life （P〉0.05）. After 18 months of intervention, the self-efficacy, self-management, high density lipoprotein, blood pressure treatment and control and qual-ity of life were significantly improved in the observation group （P〈0.05）. CONCLUSION Motivational interview based on the TTM was an effective cognitive and behavioral change technique, which helped to improve the patient＇ s self-efficacy and self-management, improve the treatment and control of HDL-C, blood pressure, and the quality of life. It was worth promoting in the community.