中国医疗卫生人员高血压防治观念和防治知识调查

A survey on perception and knowledge of Chinese health care professionals in prevention and control of hypertension

目的 了解我国医疗卫生人员高血压防治观念和防治知识的认知水平 ,为心血管病健康教育提供指导。方法 于 1998年按国家级专科、省部、地县、乡村四个级别选取医疗卫生人员共16 0 9人 ,采用自填封闭式问卷进行集中调查辅以个案访问。其中资料完整的 15 73人。结果 至少有33 1%的医疗卫生人员不知道抗高血压治疗的目的是为了预防心血管事件 ,只有 5 5 2 %的医疗卫生人员认知单纯收缩期高血压是心脑血管的独立危险因素 ,仅 2 5 4 %的医疗卫生人员自述对所有患者测量血压 ,只有 30 8%的医疗卫生人员选择≥ 14 0 / 90mmHg(1mmHg =0 133kPa)为高血压诊断标准 ,而选择血压 <14 0 / 90mmHg作为血压控制目标的占 6 0 8% ;几乎所有的医疗卫生人员没有危险分层的概念 ;正确选择JNCⅥ推荐的开始非药物治疗标准的医疗卫生人员只有 9 5 % ;自述对所有高血压患者建议非药物治疗措施的医疗卫生人员仅占 34 5 % ;正确选择JNCⅥ推荐的开始药物治疗标准的医疗卫生人员占 13 6 % ,“药物治疗不足”和“药物治疗过度”均普遍存在 ;其自身高血压知晓率和治疗率尚不如美国一般公众高。上述情况随医院级别的降低而明显降低。结论 我国医疗卫生人员的高血压防治观念和检出、诊断、评估、非药物和药物治疗以及控制目标等?

Objective To understand Chinese health care professionals′ current perception and knowledge in prevention and control of hypertension and to provide guidance to the further health education training program in health care professionals (HCP). Methods Totally 1722 potential participants were selected from one national level cardiovascular disease hospital, 14 provincial general hospitals, 26 county hospitals, and 192 basic health stations or clinics to participate in the survey using a self administrated close questionnaire. 1609 subjects took part in the survey and 1573 had complete data for analysis. Results There were at leas t 33 1% of HCPs who did not understand that the aim of anti hypertensive treatment is to prevent cardiovascular events such as coronary heart disease and stroke; and there were 55 2% who didn′t recognize that isolated systolic hypertension is an independent cardiovascular risk factor. There were at most a quarter of HCPs who reported measurement of blood pressure for every patient. Only 30 8% of HCPs selected blood pressure≥140/90 mm Hg as the diagnostic criteria of adult hypertension, and 60 8% selected <140/90 mm Hg as the goal for control of hypertension. Almost all HCPs didn′t have any conception of risk stratification for hypertensive patients. Only 9 5% of HCPs selected the JNC Ⅵ recommended level of blood pressure to start non pharmaceutical treatment correctly, and only 34 5% reported giving non pharmaceutical treatment to every hypertensive patient. There were only 13 6% of HCPs selected the JNC Ⅵ recommended level of blood pressure to start pharmaceutical treatment correctly, and both “over” and “under” pharmaceutical treatment existed commonly The lower the level of hospitals they served, the worse the above status in HCPs. Conclusions Chinese HCPs did not hold the new advanced perception and knowledge in prevention and control of hypertension in many aspects, including the aim of anti hypertension, detection, diagnosis, evaluation, non pharmaceutical and pharmaceutical treatment levels, goal for treatment and so on, and thus had not possessed a due capacity in prevention and control of hypertension. The cardiovascular health education programs with HCPs as the target are urgently needed in China.