基于扎根理论的高血压患者家庭血压监测行为影响因素模型构建

Construction of a model on influencing factors of home blood pressure monitoring behavior in hypertensive patients based on the grounded theory

目的探索高血压患者家庭血压监测行为的影响因素,为构建针对性的干预方案提供参考。方法采用目的抽样、理论抽样和滚雪球抽样法选取18例高血压患者进行半结构化访谈,通过开放式编码、轴心编码、选择性编码构建高血压患者的家庭血压监测影响因素模型。结果患者相关因素直接影响其家庭血压监测行为,疾病与治疗相关因素为内部情境因素,医疗服务系统因素和社会经济因素为外部情境因素,对家庭血压监测行为起调节作用。结论医护人员应及时评估影响患者血压监测的阻碍与促进因素,加强医患沟通并完善随访体系,制定个体化的干预措施改善患者的家庭血压监测行为,优化血压管理。

Objective To explore the influencing factors of Home Blood Pressure Monitoring(HBPM)behavior in hypertensive patients,in order to provide a reference for developing targeted intervention.Methods A total of 18 hypertensive patients were selec-ted using purposive sampling,theoretical sampling and snowball sampling methods to conduct semi-structured interviews,then a model on influencing factors of HBPM in hypertensive patients was constructed through open coding,axial coding and selective coding.Results Patient-related factors directly affected their HBPM behavior,disease and treatment-related factors were internal situational factors,medical service system factors and socioeconomic factors were external situational factors,which played a regulatory role in HBPM behavior.Conclusion Medical staff should evaluate the barriers and enablers affecting patients′HBPM behavior in time,strengthen physician-client communication and improve the follow-up system,formulate individualized intervention mea-sures to improve patients′HBPM behavior,and optimize blood pressure management.