基层医生视角下叙永县高血压患者血压控制现状及影响因素分析

Blood Pressure Control Status and Influencing Factors Analysis of Hypertensive Patients in Xuyong County from Perspective of Grassroots Doctors

目的基于基层医生角度分析影响血压控制的相关因素,了解其防治能力状况,从高血压管理体制机制等方面探讨患者血压控制不达标的原因。方法定性调查采用半结构式访谈,定量分析采用多阶段分层随机抽样、质性访谈法展开调查,计数资料用构成比和率表示,多因素采用Logistic回归和二阶聚类分析法,检验水准α=0.05。结果52名基层医生76.9%具备医学相关专业背景;63.5%乡村医生高血压防治管理知识知晓及格,年龄偏小、知识知晓及格、工作开展细致的女性高血压控制率好;访谈结果发现,乡村医生工作任务繁重,管理高血压精力、知识不足,且缺少胜任力评价指标。结论加强乡村医生高血压专业知识和用药的专项培训,加强基层人才建设和经费投入,探索基层医生胜任力评价指标,从而提升基层高血压管理工作质量,进一步提高控制率。

Objective To analyze relevant factors affecting blood pressure control from the perspective of grassroots doctors,understand prevention and treatment capabilities,and explore the reasons for inadequate blood pressure control of patients from the perspective of hypertension management system and mechanism.Methods The paper carried on qualitative investigation by semi-structured interview,quantitative analysis with multi-stage stratified random sampling,and investigation by qualitative interview method.Data were counted with composition ratio and rate,test level showedα=0.05 based on multiple factors logistic regression and second-order cluster analysis.Results 76.9%of 52 grassroots doctors had medical related professional backgrounds;63.5%of rural doctors had passed knowledge of hypertension prevention and control management.Women with young age,qualified knowledge awareness,and careful work had a good hypertension control rate.The interview found,rural doctors had heavy work load,insufficient energy and knowledge in managing hypertension,and lacked competency evaluation indicators.Conclusion It is necessary to strengthenspecialized training on hypertension knowledge and medication of rural doctors,strengthengrassroots talent construction and funding investment,explore competency evaluation indicators of grassroots doctors,and improve quality of grassroots hypertension management work and control rates further.