原发性高血压患者健康素养和自我管理的现状研究

发布时间：2018-05-19 21:27

本文选题：原发性高血压 + 自我管理　；参考：《大连医科大学》2017年硕士论文

【摘要】：目的:调研原发性高血压患者健康素养和自我管理行为的现状;分析影响原发性高血压患者健康素养和自我管理行为的人口变量学因素;探究健康素养与自我管理行为的关系,为临床高血压患者自我管理干预提供理论依据,更好地进行原发性高血压疾病的管理,达到有效控制患者血压的目的。方法:采用方便抽样,调查于大连市某三级甲等综合性医院高血压门诊就诊的419名原发性高血压患者。调查内容包括:自制一般资料问卷、慢性病病人健康素养量表、高血压病人自我管理量表。采用SPSS 20.0统计软件进行数据录入分析。结果:1.原发性高血压患者的健康素养总分为104.00(96.00,110.00),其中24.1%的患者不具备健康素养,各维度得分从高到低依次为信息获取能力、经济支持意愿、改善健康意愿和交流互动能力,其中交流互动能力得分不足;不同性别、年龄、学历、家庭人均月收入、医疗费用、患病年限、血压分级、合并症的患者在健康素养总分上存在统计差异(P0.05),不同吸烟状况的患者在改善健康意愿维度得分上存在统计差异(P0.05);而不同工作状态、婚姻状况和住院情况的患者于健康素养总分或各维度得分均未发现显著差异(P0.05)。2.原发性高血压患者的自我管理行为总分为(74.16±9.669),各维度得分从高到低依次为危险因素管理、饮食运动管理、治疗管理和生活习惯管理,其中治疗管理和生活习惯管理得分相对较低;不同学历、家庭人均月收入、医疗费用、血压分级、吸烟状况的患者在自我管理总分上存在统计差异(P0.05),不同学历的患者在治疗管理水平上存在统计差异(P0.05),不同年龄、学历、医疗费用的患者在饮食运动管理水平上存在统计差异(P0.05),不同性别、年龄、学历、家庭人均月收入、患病年限、血压分级、合并症的患者在生活习惯管理水平上存在统计差异(P0.05),不同学历、家庭人均月收入、患病年限、合并症、吸烟状况的患者在危险因素管理水平上存在统计差异(P0.05);而不同工作状态、婚姻状况和住院情况的患者在自我管理行为总分各个维度均未发现显著差异(P0.05)。3.健康素养总分和四个维度分别与自我管理行为总分呈正相关(P0.01),危险因素管理维度仅与健康素养的改善健康意愿维度呈正相关(P0.01)、与健康素养其他维度为弱负相关或不相关。结论:1.原发性高血压患者的健康素养水平良好,其中24.1%的患者不具备健康素养,四个维度中交流互动健康素养得分不足。女性、中老年、初中及以下学历、家庭人均月收入小于3000元、新农合、患病时间长、3级高血压、有合并症、吸烟患者的健康素养水平较低,需要特别注重对这一群体的指导帮助。2.原发性高血压患者的自我管理行为处于中等水平。初中及以下学历、家庭人均月收入小于3000元、新农合、3级高血压和吸烟患者的高血压自我管理总分较低,需要进一步提升。3.原发性高血压患者的健康素养与自我管理存在密切相关关系,应采取针对性措施提高患者的健康素养水平,以促进患者自我管理行为的形成。此外,需重点识别低学历、低收入、新农合及血压分级高患者的健康素养和自我管理水平,以健康宣教为基础,通过授权、动机教育和信息沟通反馈,有效促进的自我管理行为形成;强化家属及外界人员的支持,帮助中老年等健康素养低的患者提高认知和疾病管理能力;对于吸烟患者重点采取动机性访谈等方式,注重激励患者的改善健康意愿,提高患者参与疾病管理的积极性和意志力;给予男性、学历高、收入高的高血压患者更多的心理减压干预,缓解心理压力和不良情绪对病情的影响。
[Abstract]:Objective: To investigate the status of health literacy and self management behavior in patients with essential hypertension, to analyze the demographic factors affecting the health literacy and self management behavior of patients with essential hypertension, to explore the relationship between health literacy and self-management behavior, and to provide a theoretical basis for the self-management intervention of patients with hypertension and to better carry out it. Management of essential hypertension to achieve the purpose of effective control of the blood pressure of the patients. Methods: a convenient sampling was used to investigate 419 primary hypertension patients in a three grade first class hospital in Dalian. The contents included the self-made general data questionnaire, the health literacy scale of chronic patients, and the hypertension patients. I manage the scale with SPSS 20 statistical software. Results: 1. the total score of health literacy of patients with essential hypertension was 104 (96.00110.00), of which 24.1% of the patients did not have health literacy, and the scores of each dimension from high to low were the ability to obtain information, the willingness to support the economy, the improvement of the health will and the interaction and interaction. There was a statistical difference (P0.05) in the total score of health literacy (P0.05) in the patients with different smoking status (P0.05), and the differences in the health willingness dimension of the patients with different smoking status (P0.05). There was no significant difference between the total score of health literacy and the scores of all dimensions (P0.05). The total score of self-management behavior in.2. primary hypertension patients was (74.16 + 9.669). The order of each dimension from high to low was the management of risk factors, diet management, treatment management and living habits management, The score of treatment management and living habits management was relatively low; there were statistical differences in the total score of self management in patients with different educational background, family per capita income, medical expenses, blood pressure classification and smoking status (P0.05). Patients with different educational backgrounds had statistical differences (P0.05), patients of different ages, educational backgrounds and medical expenses. There were statistical differences (P0.05) in the diet management level. There were statistical differences between the different sex, age, education, family per capita income, age, blood pressure grade, and the standard of living habits Management (P0.05). Different educational background, family average monthly income, illness years, complication, smoking status were the risk factors There were statistical differences (P0.05) on the level of management, but there was no significant difference in the dimensions of the total score of self management behavior (P0.05). The total score of.3. health literacy and four dimensions were positively correlated with the total score of self management behavior (P0.01), and the management dimension of risk factors was only with the health factor. There was a positive correlation between the improvement of health willingness dimension (P0.01) and weak negative correlation with other dimensions of health literacy. Conclusion: 1. patients with primary hypertension have good health literacy level, 24.1% of them do not have health literacy, and the scores of communication and interaction health literacy in the four dimensions are insufficient. Women, middle and old age, junior high school and below, The per capita monthly income of the family is less than 3000 yuan, the new rural cooperation, the long time of the disease, the 3 grade hypertension, the complication and the low level of health literacy of the smokers, it is necessary to pay special attention to the guidance of this group to help the.2. patients with primary hypertension self-management at the middle level. Junior and below education, the per capita monthly income of the family is less than 3000 yuan. The total score of the self-management of hypertension and smoking of the 3 level hypertension and smoking patients is low. There is a close relationship between the health literacy and self management of the patients with.3. essential hypertension. The specific measures should be taken to improve the health literacy level of the patients so as to promote the formation of the self management behavior of the patients. The health literacy and self management level of patients with low education, low income, NCMS and high blood pressure are based on health education, through authorization, motivation education and information communication feedback, effective self-management behavior, strengthening support of family and outside people, and helping patients with low health literacy, such as middle and old age, improve cognition and The ability to manage the disease; to focus on motivational interviews with smoking patients, pay attention to encouraging patients to improve their health will, improve the patient's enthusiasm and willpower to participate in the disease management, and give more psychological pressure to the male, high education and high income hypertensive patients to relieve the effect of psychological pressure and bad mood on the condition.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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