Effects of a Stress Management Program Based on Psychological Risk Factors of Cardiovascular Disease after Retirement in an Underpopulated Area: A Pilot Study

Background: To develop an effective health education program to prevent cardiovascular disease in middle-aged residents after retirement in underpopulated areas, we explored the effects of a stress management program based on the type A behavior pattern. Methods: This study was carried out in a rural city in Japan recognized as underpopulated and participants were civil servants aged 45 - 64 who joined a stress management program offered as part of staff training. Learning materials for the program were developed based on the type A behavior pattern. Measures for the impact evaluation were Bloom’s learning domains and stage of change for stress management practice. Measures for the outcome evaluation were KG’s Daily Life Questionnaire (KG Questionnaire), the Hospital Anxiety and Depression Scale (HADS) and the Framingham 10-year cardiovascular risk score (CVD risk score). We statistically analyzed changes in each item between time points. Results: Eighteen participants completed questionnaire surveys at pre-, post-, and 4 weeks post-program and eleven had complete blood pressure and weight measurements at pre- and post-program. In the impact evaluation, the Friedman test found significant differences between the three time points in all of Bloom’s learning domain scores and stage of change for stress management. In the post hoc analysis, a significant increase was seen between pre- and post-program and between pre- and 4 weeks post-program in cognitive domain score, psychomotor domain score and stage of change for stress management. In the outcome evaluation, a significant decrease in systolic blood pressure was seen between pre- and post-program. Conclusion: The present study suggested that a stress management program using learning materials based on type A behavior could promote stress management practices and reduce the risk of cardiovascular disease. This stress management program is expected to be useful as a health promotion activity for middle-aged residents after retirement in underpopulated areas.

茂名市高新区农村居民高血压患者社区管理探讨

目的探讨农村居民高血压患者社区管理的效果。方法分析2008年1月～2010年1月在本院检出的农村居民高血压患者220例,对患者或家属进行健康教育,指导饮食、运动、坚持服药。结果血压控制率达到80.87%,无心脑等并发症发生。结论进行农村居民高血压社区管理可行有效。

彭州市蒙阳镇35～70岁人群高血压发病和治疗情况调查

目的：了解彭州市蒙阳镇农村居民的高血压发病和治疗情况，为农村居民的高血压慢性病管理提供参考依据。方法：在全镇28个村（社）中抽出12个村（社），包括35～70岁居民共计3600人，并按年龄段分为3组，分析该人群高血压的发病和治疗情况。结果：该区域农村35～70岁人群中高血压病发病率为15．42％，其中治疗率为61．80％，规范治疗率为35．27％。结论：彭州市蒙阳镇农村35～70岁人群的高血压发病率低于成都市疾控中心要求的农村成年人高血压发现建档率18．8％，规范治疗率低于成都市疾控中心要求的50％。

山区农村高血压患者健康管理的效果观察

目的为了了解健康管理对农村高血压患者血压控制效果的影响,为调整农村居民高血压患者健康管理干预措施提供依据。方法采用不设对照组的前后测试方法,观察兴山县榛子乡2013年1月—2014年12月纳入健康管理的528名高血压患者,比较健康管理前后患者高血压健康知识知晓率、采取控制措施人数及依从性和血压控制率的变化,评估农村居民高血压患者健康管理效果。结果农村居民高血压患者经过2年的健康管理干预后,患者高血压健康知识知晓率,血压控制率及控制措施采取人数和依从性均有明显改善。结论规范的健康管理对农村居民高血压患者控制达标,减少或减缓并发症的发生,提高自我管理和保健意识有明显效果。

南充市龙门镇嘉龙社区居民高血压管理现状的调查分析

目的:为进一步开展高血压患者社区健康促进工作及针对性的高血压综合管理提供科学依据。方法:根据相关文献制定《社区高血压综合管理调查问卷》,调查南充市龙门镇嘉龙社区的高血压病患者,采用χ2检验分析不同人群高血压知晓率、治疗率、控制率及影响因素。结果:共发放问卷550份,回收有效问卷532份,有效回收率为96.7%。受访者高血压相关知识的知晓率、高血压治疗率及控制率分别为38.0%、58.1%、51.7%。知晓率的主要影响因素是性别,男性受访者知晓率高于女性;治疗率的主要影响因素是年龄、文化程度、血压级别;控制率的主要影响因素是年龄、性别、吸烟、饮食、饮酒。结论:建议从加强健康教育、个体药物及非药物综合干预、基层医师培训、多方位合作等方面着手,完善社区居民高血压管理。