延续护理联合中医护理健康教育对高血压患者依从行为的干预性研究

发布时间：2018-03-17 00:33

本文选题：高血压　切入点：依从行为　出处：《中国中医科学院》2017年硕士论文　论文类型：学位论文

【摘要】：高血压是我国最常见的慢性疾病,也是心脑血管疾病最主要的危险因素,其主要并发症脑卒中、心肌梗死、心力衰竭及慢性肾脏病致残、致死率高。截止2010年,我国约有2亿高血压患者,但高血压控制情况不理想。研究显示,在高血压疾病的长期治疗中患者对其服药和对医生多种非药物治疗建议的依从性,对其诊治计划能否执行起到关键作用。因此,本研究通过延续护理模式与中医护理健康教育的联合干预,影响出院后高血压患者依从行为,达到提高患者依从行为水平和促进血压值达标的目的。目的:本研究旨在考察延续护理模式联合中医护理健康教育的干预效果,评价出院后高血压患者依从行为水平、高血压控制率及血压控制水平。方法:本研究为类实验性研究。选择符合纳入/排除标准的高血压出院患者100例,分为干预组和对照组,98例研究对象完成研究全过程。干预组和对照组均于出院当日通过健康宣教的方式,接受中医护理健康教育干预,对照组除此以外不作任何特殊干预,干预组在此基础上接受延续护理干预。干预期为12周。干预组和对照组均于干预前、干预12周后完成高血压患者依从行为量表评价;于干预前、干预8周后、干预12周后完成血压数值收集。数据采用SPSS17.0统计软件进行分析,P值0.05认为有统计学意义。结果:(1)依从行为:干预后,干预组依从行为总分为20.00±3.81,总体水平属于高水平;对照组总分为28.90±4.03,属于中等水平,两组依从行为总分比较差异有统计学意义(t=-11.225,P=0.000)。干预组,干预前依从行为总分为25.96±3.74,总体水平属于中等水平;干预后为20.00±3.81,属于高水平,干预前、后依从行为总分比较差异有统计学意义(t=7.896,P=0.000)。对照组干预前、后依从行为总分比较差异无统计学意义(P0.05)。(2)高血压控制率:干预组,干预前为54%,干预8周后为80%,干预12周后为94%;对照组,干预前为60%,干预8周后仍为60%,干预12周后为56%。(3)血压控制水平:按正常血压、正常高值血压、高血压分布统计,干预组,干预前依次为14%、40%、46%,干预8周后为14%、78%、8%,干预12周后为18%、76%、60%;对照组,干预前依次为8%、52%、40%,干预8周后为4%、56%、40%,干预12周后为8%、48%、44%。结论:(1)联合干预可以提高出院后高血压患者依从行为总体水平。(2)联合干预对促进出院后高血压患者血压值达标是有效的。
[Abstract]:Hypertension is the most common chronic disease and the most important risk factor for cardiovascular and cerebrovascular diseases. Its main complications are stroke, myocardial infarction, heart failure and chronic kidney disease. There are about 200 million patients with hypertension in China, but the situation of hypertension control is not satisfactory. Therefore, through the combined intervention of continuous nursing mode and health education of traditional Chinese medicine, the compliance behavior of hypertension patients after discharge was affected by the combined intervention of continuous nursing mode and health education of traditional Chinese medicine, which played a key role in whether the diagnosis and treatment plan could be carried out. Objective: to study the intervention effect of continuous nursing model combined with traditional Chinese medicine nursing health education to evaluate the compliance behavior level of patients with hypertension after discharge from hospital. Methods: this study was an experimental study. 100 patients with hypertension who met the criteria of inclusion / exclusion were selected. The intervention group and control group were divided into two groups: the intervention group and the control group received the health education intervention of traditional Chinese medicine by means of health education on the day of discharge, and the control group did not make any special intervention. The intervention group received continuous nursing intervention on this basis. The dry expectation was 12 weeks. Both the intervention group and the control group completed the evaluation of compliance behavior scale for hypertensive patients before intervention and 12 weeks after intervention, and 8 weeks after intervention before intervention. After 12 weeks of intervention, the blood pressure value was collected. The data were analyzed by SPSS17.0 statistical software (P < 0. 05). Results: after intervention, the total score of compliance behavior was 20.00 卤3.81, and the overall level was high. The total score of the control group was 28.90 卤4.03, which belonged to the medium level, and the difference between the two groups was statistically significant. In the intervention group, the total score of compliance before intervention was 25.96 卤3.74, the overall level was moderate, and after intervention it was 20.00 卤3.81, which belonged to the high level. There was significant difference in the total score of post-compliance behavior between the two groups. Before intervention, there was no significant difference in the total score of post-compliance behavior between the control group and the control group (P 0.05).) the hypertension control rate in the intervention group was 54 before intervention, 80 after 8 weeks, and 94 after 12 weeks; in the control group, there was no significant difference in the total score before and after intervention. It was 60 before intervention, 60 after 8 weeks of intervention, and 56 after 12 weeks of intervention.) the control level of blood pressure was as follows: normal blood pressure, normal high blood pressure, distribution of hypertension. The intervention group was 144404046,4646 before intervention; after 8 weeks of intervention, it was 140.78; after 12 weeks of intervention, it was 1876,7660; in the control group, it was 1876,6060 after 12 weeks of intervention; in the control group, Before the intervention, it was 8 + 522 + 40. After 8 weeks of intervention, it was 4. 56 and 40. After 12 weeks of intervention, it was 8. 48 and 44. Conclusion the combined intervention can improve the overall level of compliance behavior of the discharged hypertensive patients. 2) the combined intervention is effective in promoting the blood pressure of the discharged hypertension patients.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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