综合干预对社区高血压患者心血管健康行为改善情况研究

摘要

目的：探讨综合干预措施对社区高血压患者心血管健康行为改善情况。方法选择2013年1月～2014年1月于北京市丰台区右安门社区卫生服务中心就诊的高血压患者120例，其中男性63例，女性57例，年龄41～75岁。在常规治疗基础上随机分为两组，观察组（60例）采用社区分级管理干预；对照组（60例）未采用社区综合干预。6个月后比较两组患者的血压控制情况和疗效，患者进行相应的健康知识考评，在干预前后进行问卷调查，比较患者的管理前后健康行为情况。结果与对照组比较，观察组收缩压与舒张压均下降分别为[（138.1±16.2）mmHgvs.（127.7±12.0）mmHg]，（1 mmHg=0.133kPa）[（92.3±10.8）mmHgvs.（81.3±9.5）mmHg]，差异有统计学意义（P均＜0.05）。对照组显效、有效、无效的比例为33.3%、40.0%、26.7%，观察组为40.0%、56.7%、3.3%。观察组总有效率高于对照组（96.7% vs.73.3%），差异有统计学意义（P＜0.05）。观察组对疾病预防知识掌握优良比例高于对照组，及格和较差比例低于对照组，为（61.7%vs.28.3%）、（36.7%vs.30.0%）、（35.0%vs.8.3%），差异有统计学意义（P均＜0.05）。结论社区高血压患者分级管理干预可以改善人群心血管健康行为，有效控制患者高血压。%Objective To study cardiovascular health behavior improvement by comprehensive intervention in community hypertension patients.Methods 120 hypertension patients (63 males and 57 females, 41~75 years old) collected from between 2013.01 and 2014.01, were divided into two groups randomly. The observation group includes 60 cases of the comprehensive community intervention, and the control group includes 60 cases with no comprehensive community intervention. The therapeutic effect, status of blood pressure control, the corresponding knowledge of health and health behavior were compared before and after the intervention.Results Compared to control group, systolic pressure [(138.1±16.2)mmHgvs. (127.7±12.0)mmHg] and diastolic pressure [(92.3 ±10.8)mmHgvs. (81.3±9.5)mmHg]were significantly decreased respectively (P<0.05). the percentage of excellence, improvement and failure in control group were 33.3%, 40.0% and 26.7%; while the percentage in observation group were 40.0%, 56.7% and 3.3% respectively. The total efficiency of observation group was significantly higher than control group (96.7%vs. 73.3%,P<0.05). The percentage of excellent of observation group is higher than control group (61.7%vs. 28.3%), while the percentage of pass (30.0%vs. 36.7%) and fail (8.3%vs. 35.0%) is lower than control group (P<0.05).Conclusion The comprehensive intervention on hypertensive patients in the community can improve cardiovascular health behavior, and control high blood pressure effectively.