摘要
目的评价南京市社区高血压病患者自我管理模式对生命质量的影响。方法于2014年4—6月，采用多阶段分层随机抽样的方法，以街道/社区为单位随机抽取纳入基本公共卫生服务规范化管理的高血压病患者。分别在基线（活动前）和3个月后由培训合格的调查员以面对面询问的方式开展相同的问卷调查，以评估自我管理对生命质量的影响。结果共登记高血压病患者586例，完成6次小组活动的患者575例，应答率为98.1%。经过自我管理小组活动干预后，不同性别、年龄高血压患者SF-36量表8个维度转换分较活动前均有所增加，患者生命质量总分增加了（32.03±17.33）分。单身/离婚/丧偶者（OR=1.93，95%CI：1.06~3.52）、有并发症者（OR=1.96，95%CI：1.21~3.19）、自我感觉血压控制情况改善者（OR=1.79，95%CI：1.11~2.89）以及精神紧张情况改善者（OR=2.51，95%CI：1.59~3.97）生命质量改善情况更好。结论以患者自我管理小组的形式开展高血压病的社区防治，从生理、心理、社会生活等方面实施干预，提高患者高血压防治知识知晓率，改善患者的自我管理行为，可提高高血压病患者生命质量。
Objective To evaluate the effect of a community-based self-management model and the quality of life in patients with hypertension in Nanjing.MethodsFrom April to June 2014, multistage stratified random sampling was used to randomly select patients with hypertension from the standardized management of basic public health services among 11 districts in Nanjing. A baseline survey and a follow-up after 3 months were conducted by well-trained investigators through face-to-face interviews to estimate the effect of self-management on quality of life.ResultsThere were 586 patients investigated in the baseline survey. Among them, 575 patients finished group activities six times; the follow-up rate was 98.1%. After a self-management group intervention, the awareness of hypertension-related knowledge and six aspects of self-management behaviors were measured; the scores of all dimensions improved significantly, and SF-36 increased to 32.03±17.33. Multi-factor analysis results showed that those who were single and had complications felt improvement in their blood pressure control, experienced improvement in their stress conditions, and their quality of life improved. The OR （95%CI） values were 1.93 （1.06-3.52）, 1.96 （1.21-3.19）, 1.79 （1.11-2.89）, and 2.51 （1.59-3.97）.ConclusionCarrying out self-management group work with community patients with hypertension that is focused on prevention and control of physical, psychological, and social aspects of life can improve their quality of life.
作者
王琛琛
洪忻
周海茸
徐斐
Wang Chenchen;Hong Xin;Zhou Hairong;Xu Fei(Department of Chronic and Non-communicable Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China)
出处
《中华健康管理学杂志》
CAS
2018年第2期114-120,共7页
Chinese Journal of Health Management
关键词
高血压
生活质量
自我管理
Hypertension
Quality of life
Self-management
