家庭医生签约模式下社区护士在高血压患者管理中地位

Status of community nurses in blood pressure management of patients with essential hypertension under the mode of family doctor

目的家庭医生通过签约方式对居民健康进行全方位维护,为慢性病防治提供专业化综合干预方案,可有效提高居民生活质量。本研究探讨家庭医生签约模式下社区护士对原发性高血压患者血压水平和自我管理水平控制效果。方法采用分层抽样法选取2017-01德州市6个社区188例签署《家庭医生式服务协议书》的原发性高血压患者为研究对象,根据不同护理方式分为对照组和干预组,各94例。对照组进行常规血压控制及电话随访,干预组采用家庭医生签约模式下社区护理干预措施,比较两组血压控制效果和自我管理水平。结果干预后6和12个月,干预组收缩压分别为(132.18±4.42)mm Hg和(120.31±2.62)mm Hg,低于对照组的(138.75±6.83)mm Hg和(130.25±4.59)mm Hg,差异有统计学意义,F=20.328,P<0.001;干预组舒张压分别为(100.33±7.24)mm Hg和(84.32±2.68)mm Hg,低于对照组的(105.36±7.89)mm Hg和(90.21±4.59)mm Hg,差异有统计学意义,F=12.730,P=0.001;干预组自我管理水平分别为(14.029±2.244)分和(23.463±1.383)分,高于对照组的(8.623±2.210)分和(18.115±1.294)分,差异有统计学意义,F=435.212,P<0.001。结论家庭医生签约模式下社区护士对原发性高血压患者进行护理干预,可以更好地改善其血压及自我管理水平。

OBJECTIVE Family doctors can effectively improve the quality of life of residents by signing contracts to maintain their health in an all-round way and provide professional comprehensive intervention programs for the prevention and treatment of chronic diseases.This study aims to explore the effect of community nurses on blood pressure and self-management in patients with essential hypertension under the "family doctor mode".METHODS A stratified sampling method was used to select 188 patients with essential hypertension who signed the Family Doctor Service Agreement in 6 communities of Dezhou City in January 2017.They were divided into control group and intervention group according to different nursing methods(each 94 cases).The control group was given routine blood pressure control and telephone follow-up.The intervention group was given community nursing intervention under family doctor mode.The effect of blood pressure control and self-management level were compared between the two groups.RESULTS At 6 months and12 months after intervention,the systolic blood pressure of the intervention group were(132.18±4.42)mm Hg and(120.31±2.62)mm Hg,which were lower than those of the control group(138.75±6.83)mm Hg and(130.25±4.59)mm Hg,respectively,F=20.328,P<0.001.The diastolic blood pressure of the intervention group were(100.33±7.24)mm Hg and(84.32±2.68)mm Hg,which were lower than those of the control group(105.36±7.89)mm Hg and(90.21±4.59)mm Hg,respectively,F=12.730,P =0.001.The self-management level of the intervention group were 14.029±2.244 and23.463±1.383,which were higher than those of the control group(8.623±2.210,18.115±1.294),respectively,F=435.212,P<0.001.CONCLUSION Nursing intervention of community nurses for patients with essential hypertension under the"family doctor mode"can better improve their blood pressure level and self-management level.