电话结合微信健康教育对低学历高血压人群服药依从性影响

Effect of telephone combined with WeChat health education on the compliance of low degree patients with hypertension

目的随着诊断及治疗手段的不断进展,我国高血压的治疗率和控制率均得到提高,但形势依然严峻,治疗率和控制率相较发达国家仍有很大差距。其中,服药依从性差是导致血压控制率低的主要原因之一。健康教育作为高血压健康管理的内容之一,能够很好地提高患者服药依从性。本研究通过对比普通健康教育及电话结合微信的健康教育对低学历高血压人群服药依从性、血压控制情况及生活方式的影响,探讨电话结合微信的健康教育在低学历高血压人群治疗过程中的应用价值。方法选取2016-01-06-2016-12-11于锦州市凌西街道社区卫生服务中心就诊的初中及以下学历的既往患有高血压病且依从性差的220例患者作为研究对象,按照性别、年龄、病程组间匹配的原则,分为观察组和对照组,每组110例。对照组给予普通健康教育,观察组给予电话结合微信的健康教育。均随访1年,观察两组服药依从性、血压控制和生活方式改善情况。结果干预随访期间,两组共213例患者完成研究,其中观察组107例,对照组106例。干预1年后,观察组治疗依从性好的占有率为63.6%,高于对照组的42.5%,χ2=9.517,P=0.002;观察组血压达标率为52.3%,高于对照组的31.1%,χ2=9.843,P=0.002;观察组收缩压控制水平为(132.9±12.5)mm Hg,优于对照组的(143.2±12.4)mm Hg,t=-6.061,P<0.001;观察组舒张压控制水平为(80.7±8.4)mm Hg,优于对照组的(86.5±7.1)mm Hg,t=-5.339,P<0.001;对于生活方式的改善情况,对照组吸烟人数的占有率为31.1%,高于观察组的23.4%,χ2=1.621,P=0.203;对照组饮酒人数的占有率为43.4%,高于观察组的29.0%,χ2=4.800,P=0.028;对照组经常参加体育锻炼人数的占有率为32.1%,低于观察组的48.6%,χ2=6.038,P=0.014。结论电话结合微信健康教育能显著提高低学历人群高血压患者的服药依从性、血压控制水平及达标率,有效促进患者形成健康的生活方式,提高非药物治疗的疗效。将电话结合微信的健康教育充分应用到低学历高血压人群的健康管理中,可有效提升其健康管理效率。

OBJECTIVE With the development of diagnosis and treatment methods,the treatment rate and control rate of hypertension in China have been improved,but the situation is still severe.The treatment rate and control rate are still far from the developed countries.Poor medication compliance is one of the main reasons for the low blood pressure control rate.As one of the contents of health management of hypertension,health education can improve the patient's medication compliance.The effect of health education through the contrast of general health education and the combination of WeChat and phone for people with high blood pressure with low degree of treatment compliance,blood pressure control and lifestyle to explore application value of health education in the patients with hypertension through WeChat and phone in the treatment process.METHODS Patients diagnosed as hypertension from January 6,2016to December 11,2016 in Ling Xi community health service center from the junior high school education with and poor adherence of 220patients as the research object,according to gender,age,and duration of disease,it is divided into observation group and control group,with 110cases in each group.The control group was given general health education,and the observation group was given the health education of WeChat and telephone.RESULTS During the treatment follow-up period,a total of 213patients completed the study,107in observation group and 106in control group,respectively.After 1year of intervention,the occupational compliance rate of the observation group was 63.6%,which was significantly higher than 42.5%of the control group,χ2=9.517,P=0.002.The blood pressure compliance rate of the observation group was 52.3%,which was significantly higher than 31.1%of the control group,χ2=9.843,P=0.002.The systolic blood pressure control level of the observation group was(132.9±12.5)mm Hg,which was better than that of the control group(143.2±12.4)mm Hg,t=-6.061,P<0.001;the diastolic blood pressure control level of the observation group was(80.7±8.4)mm Hg,which was better than that of the control group(86.5±7.1)mm Hg,t=-5.339,P<0.001.About the improvement of lifestyle,the occupation rate of smoking in the control group was 31.1%,and the observation group was 23.4%,χ2=1.621,P=0.203.The occupancy rate of the control group was 43.4%,which was higher than the observation group's 29.0%,χ2=4.800,P=0.028.The occupation rate of the exercise group who participated in physical exercise was 32.1%,which was lower than 48.6%of the observation group,χ2=6.038,P=0.014.CONCLUSIONS This study found that telephone combined with WeChat health education can significantly improve medication compliance of hypertensive patients with low educational background,thereby further improving blood pressure control and blood pressure compliance rate of hypertensive patients with low education.It can also effectively promote the patients to form a healthy lifestyle and improve the curative effect of non-drug treatment.It can effectively improve the health management efficiency by applying the telephone and the health education of WeChat to the health management of people with low degree and high blood pressure.