健康行为HAPA模型为指导提高老年高血压患者自我效能、心理健康和服药依从性的影响

Application of healthy behaviors based on HAPA model in improving self-efficacy,psychological health and medication compliance in elderly hypertension patients

目的:探讨以健康行为过程取向(HAPA)模型为指导在老年高血压患者自我效能、心理健康和服药依从性提高中的应用价值。方法:选取某院2018年5月-2020年5月96例老年高血压患者,按照随机数字的方法将患者分为两个组,观察组与对照组,每组各48例患者,对照组给予常规指导与健康教育,观察组实施基于HAPA模型构建的健康行为干预策略,比较两组血压控制情况、依从性、自我效能、自我管理能力、焦虑抑郁状态、心理韧性。结果:观察组干预后收缩压、舒张压水平均低于对照组(t=8.262、6.977,P<0.05);观察组干预后用药依从率、饮食控制率、戒烟戒酒、适量运动率均高于对照组(χ^(2)=7.207、8.491、5.031、5.042,P<0.05);观察组干预后自我效能评分高于对照组,自我管理评分低于对照组(t=7.815、3.326,P<0.05);观察组干预后焦虑与抑郁SAS、SDS评分均低于对照组(t=8.776、7.104,P<0.05);观察组干预后坚韧、乐观、自强及心理韧性总分均高于对照组(t=7.432、5.867、6.051、9.175,P<0.05)。结论:以健康行为HAPA模型为指导可有效提升老年高血压患者服药与健康生活行为依从性,提高患者自我效能和自我管理能力,减轻不良心理状态,提高心理韧性,有利于血压控制。

Objective:To explore the application value of healthy behaviors based on health action process approach(HAPA)model in improving self-efficacy, psychological health and medication compliance in elderly hypertension patients.Methods:A total of 96 elderly hypertension patients in the hospital from May 2018 to May 2020 were enrolled and divided into observation group and control group by random number table method, 48 cases in each group.The control group was given routine guidance and health education, while observation group was given healthy behaviors based on HAPA model.The blood pressure control, compliance, self-efficacy, self-management ability, anxiety, depression and psychological resilience were compared between the two groups.Results:After intervention, levels of systolic blood pressure and diastolic blood pressure in observation group were lower than those in control group(t=-8.262,-6.977;P<0.05).After intervention, medication compliance rate, diet control rate, quit smoking and drinking rate, and appropriate exercise rate in observation group were, higher than those in control group(χ^(2)=7.207,8.491,5.031,5.042;P<0.05).After intervention, score of self-efficacy in observation group was higher than that in control group, while score of self-management was lower than that in control group(t=7.815,3.326;P<0.05).After intervention, scores of SAS and SDS in observation group were lower than those in control group(t=8.776,7.104;P<0.05).After intervention, total scores of toughness, optimism, self-improvement and psychological resilience in observation group were higher than those in control group(t=7.432,5.867,6.051,9.175;P<0.05).Conclusion:The healthy behaviors based on HAPA model can effectively improve compliance of medication and healthy life behaviors in elderly hypertension patients, improve self-efficacy and self-management ability, alleviate adverse psychological status, improve psychological resilience, which is beneficial to blood pressure control.