摘要
目的:2009年,国家将高血压患者管理纳入基本公共卫生服务,为评价高血压患者对基本公共卫生服务的利用及血压控制情况,在北京市部分社区开展了此项调查。方法:对北京市45家社区卫生服务中心管理的高血压患者4 520例进行问卷调查,了解患者血压控制现状,接受健康教育、不良生活方式干预、门诊随访以及血压监测情况,并分析基本公共卫生服务利用与血压控制的关系。结果:被调查对象男性占43.1%,女性占56.9%,平均年龄(69±9.6)岁。68.2%的患者采取服药治疗,61.7%参加社区健康教育活动,90%以上接受各种生活方式干预,77%进行家庭自测血压,90.4%获得4次以上门诊面对面随访。伴有心血管疾病患者与不伴有心血管疾病患者参加健康教育次数、健康管理小组以及门诊随访次数的差别有统计学意义,而家庭自测血压以及接受行为干预的差别无统计学意义。患者血压控制率为51.0%,调整相关影响因素后,门诊随访7次以上、每周家庭自测血压1~2次、阅读健康教育相关书籍或材料、不饮酒、规律体育锻炼以及戒烟或者不吸烟者血压控制不达标的危险显著降低。结论:北京高血压患者对基本公共卫生服务利用程度较高,有助于提高社区高血压患者血压控制率。社区应进一步提高患者门诊随访次数及依从性,指导患者正确实施家庭自测血压;提高患者疾病管理能力和血压控制率。
Objective： Examine medical care patterns in patients with hypertension attending primary care clinics, and identify medical care-related con＇elates of hypertension control. Methods： We conducted a cross-sectional survey of 4520 patients aged 〉 18 years with hypertension participating in the hypertensive man- agement intervention at 45 primary care clinics. Information on hypertension medical care pattern and its control were collected at the time of the interview. Results ： Of the 4520 patients [ mean age （69 ±9.6 ） ] who partici- pated, 43.1% were male and 56.9% were female. The majority of respondents （68.2%） took antihypertens- ive agency, 61.7% participated in health education activities more than one time per year, over 90% received unhealtly life style intervention. The prevalence rate of home blood pressure monitoring HBPM was 77.7%. The proportion of visited the community clinics more than 4 times per year was 90. 4%. There were significant differences between the patients with or without cardiovascular diseases in the frequency of health education, adherent to the health care management group activities, and frequency of attendance at community clinic. There were no differences between the two groups for performing the HBPM and adherence to health related ac-tivities intervention. The rate of blood pressure control was 53.4%, participants who reported have participated in the health care management group, who visited the community clinic more than 7 times per year, and who performing HBPM 1-2 times per week were more likely to have hypertension controlled, independent of other factors. Conclusion： The increase of frequency of attendance at community clinics and improvement for self- management behaviors appears to lead to good control of hypertension
出处
《心肺血管病杂志》
2017年第11期922-927,共6页
Journal of Cardiovascular and Pulmonary Diseases
基金
北京市卫生和计划生育委员会科技成果和适宜技术推广项目(TG-2015-33)
关键词
高血压
基本公共卫生服务
血压控制
Hypertension
Primary health care
Blood pressure control
