广东省中山市小榄镇高血压病人社区干预管理模式建立及效果评估

详细信息    查看全文 | 推荐本文 |

英文篇名：Establishment and evaluation of the community-based intervention management mode for patients with hypertension in Xiaolan Town,Zhongshan City,Guangdong Province 作者：谭莹 ; 刘本坚 ; 雷志明 ; 李碧桃 ; 梁美玲 ; 詹纪云 ; 邓必森 英文作者：TAN Ying;LIU Benjian;LEI Zhiming;LI Bitao;LIANG Meiling;ZHAN Jiyun;DENG Bisen;Zhongshan Chenxinghai Hospital; 关键词：慢性病 ; 高血压 ; 社区干预管理 ; 效果评估 ; 依从性 英文关键词：Chronic disease;;Hypertension;;Community-based medical intervention;;Evaluation;;Medication compliance 中文刊名：YXDZ 英文刊名：Journal of Medical Pest Control 机构：中山市陈星海医院;小榄人民医院; 出版日期：2019-02-21 出版单位：医学动物防制 年：2019 期：v.35 基金：中山市科学技术局科技计划项目(2016B1101) 语种：中文; 页：YXDZ201904019 页数：4 CN：04 ISSN：13-1068/R 分类号：68-71

摘要

目的建立及评价高血压病人社区干预管理模式,为进一步开展有效的慢性病管理提供依据。方法采用分层随机抽样方法选取小榄镇15个社区630例高血压病人,将其分为对照组与干预组。对照组人群采用传统方式进行高血压干预;干预组人群在对照组的基础上进行社区干预管理。干预一年后分析干预效果。结果研究过程中因个人意愿、搬迁、疾病并发症等失访46例,最终有效随访584例,其中对照组290例,干预组294例。与对照组比较,干预后人群收缩压(127. 1±12. 2) mm Hg、舒张压(74. 3±10. 0) mm Hg、血压控制率91. 5%、高血压知识知晓率94. 6%,改善程度均优于对照组干预后人群的收缩压(135. 3±30. 6) mm Hg、舒张压(86. 3±12. 4) mm Hg、血压控制率83. 4%、高血压知识知晓率72. 1%,差异有统计学意义(t=2. 53、2. 15,χ2=3. 95、4. 23,P <0. 05);干预后人群吸烟率17. 0%、摄盐量适当率92. 5%、锻炼参与率73. 1%改善程度均优于对照组干预后人群的吸烟率29. 0%、摄盐量适当率73. 1%、锻炼参与率63. 4%,差异有统计学意义(χ2=4. 26、4. 87、5. 23,P <0. 05),体质量控制率47. 3%比对照组干预后人群有改善,但差异无统计学意义,饮酒率无改善;干预后人群遵嘱服药率88. 1%和随意减药率15. 3%,均优于对照组干预后人群的遵嘱服药率63. 4%和随意减药率23. 4%,但差异无统计学意义。结论采用社区干预管理模式对高血压病人进行健康教育干预,有利于控制高血压,并使病人自觉养成健康生活习惯,提高治疗的依从性。
        Objective To establish and evaluate a community-based medical intervention management mode for patients with hypertension,and provide a reference for further effective management of chronic diseases. Methods A stratified random sampling method was used to select 630 hypertensive patients from 15 communities in Xiaolan Town. They were divided into control group and intervention group. The control group was treated with a traditional hypertension intervention,while the intervention group was treated with a community intervention management on the basis of the control group. The result of intervention was analyzed one year later. Results Forty-six cases were lost due to personal willingness,relocation and complications. A total of 584 cases were followed up effectively,including 290 cases in the control group and 294 cases in the intervention group. The systolic blood pressure,diastolic blood pressure,control rate of blood pressure and knowledge of hypertension were( 127. 1 ± 12. 2) mmHg,( 74. 3 ± 10. 0) mm Hg,91. 5% and 94. 6% respectively among patients in the intervention group,and( 135. 3 ± 30. 6)mm Hg,( 86. 3 ± 12. 4) mm Hg,83. 4%,and 72. 1% respectively among patients in the control group. Compared with the control group,the situation of the intervention group was greatly improved. The difference was statistically significant( t = 2. 53,2. 15,χ2= 3. 95,4. 23,P < 0. 05). The smoking rate,salt intake rate and exercise participation rate in the intervention group were 17. 0%,92. 5%,and 73. 1% respectively,which were better than that of the control group( 29. 0%,73. 1% and63. 4%,respectively). The difference was statistically significant( χ2= 4. 26,4. 87,5. 23,P < 0. 05). The body mass control rate was 47. 3% in the intervention group,which was better than that of the control group. The difference was not statistically significant,there was no improvement of the drinking rate. The compliance rate and the random drug reduction rate were 88. 1%and 15. 3%,respectively,which were better than of the control group( 63. 4% and 23. 4%,respectively). There was no statistically significant difference. Conclusion The community-based intervention management mode could not only help manage the blood pressure of patients,but impels patients to have healthy habit consciously,and boost their medication compliance.

引文

[1]国家卫生和计划生育委员会疾病预防控制局.中国居民营养与慢性病状况报告(2015年)[M].北京:人民卫生出版社,2016.
    [2]国家心血管病中心.中国心血管病报告[M].北京:中国大百科全书出版社,2017.
    [3]沈勤.社区高血压病人健康教育干预的效果评估[J].中西医结合心脑血管病杂志,2015,13(10):1239-1241.
    [4]陈恩晃.探讨社区卫生服务在慢性非传染性疾病防治中的作用[J].深圳中西医结合杂志,2015,25(2):191-192.
    [5]中华人民共和国卫生部疾病预防控制局,高血压联盟(中国),国家心血管病中心.中国高血压防治指南(2010年修订版)[M]. 3版.北京:人民卫生出版社,2012.
    [6]郑旭煦.温州某社区居民高血压知识知晓情况调查分析[J].中国社区医师,2014,30(33):167-167,169.
    [7]姜婷,沈静,王晓婷.乌鲁木齐市居民高血压知识知晓现状调查[J].新疆医科大学学报,2015,38(12):1567-1569.
    [8]何伟,唐海沁,蒋品,等. 2013-2014年度高血压临床指南的现状分析及循证临床指南评价[J].中国临床保健杂志,2015,18(3):238-243.
    [9]陈伟伟,高润霖,刘力生,等.中国心血管病报告2013概要[J].中国循环杂志,2014,29(7):487-491.
    [10]沈干,胡世莲,吴蕾,等.电话及网络健康教育对中老年居民高血压干预效果评价[J].中国临床保健杂志,2014,17(6):563-566.
    [11]邓文彬,赵光虎,韩超,等.社区规范化管理高血压病的成本效果分析[J].国际中医中药杂志,2012,34(7):594-597.
    [12]代亚丽,由淑萍,王彦茹.乌鲁木齐南山牧区哈萨克族原发性高血压患者遵医行为调查及影响因素分析[J].中国实用护理杂志,2008,24(8):14-16.
    [13]闫安,穆颖,时治津.社区医疗干预对老年高血压患者生活质量的影响[J].中国临床保健杂志,2014,17(2):173-175.
    [14]苏华林,黄俊,赵琬,等.上海市闵行区高血压社区管理效果[J].中国慢性病预防与控制,2006,14(4):273-275.
    [15]练咏红,方来喜,徐晓婧.高血压社区管理对高血压患者血压控制效果分析[J].现代诊断与治疗,2016,27(7):1297-1298.
    [16]王伟,严非,薛曹怡,等.高血压患者社区管理依从性影响因素定性研究的系统评价[J].中国循证医学杂志,2010,10(4):429-432.