连云港农村地区高血压患者综合干预效果评价

发布时间：2018-03-09 09:27

  本文选题：高血压　切入点：知识　出处：《安徽医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:通过药物治疗和健康教育相结合的方式对患者进行干预,评价综合干预措施对原发性高血压患者的认知、态度、行为(KAP)和血压控制的影响,为农村地区高血压的防治提供依据。方法:本研究采用前后自身对照的实验流行病学综合干预方法,调查人员分别在研究对象入组时和综合干预后从中国脑卒中一级预防(CSPPT)试验基地-连云港市东海县和赣榆县项目组中随机抽取45周岁及以上原发性高血压患者作为调查对象进行问卷调查,并对患者进行血压、体重及身高的测量。获得相关资料后,应用Epidata3.1建立数据库,进行双录入并检错,用SPSS16.0软件对资料进行描述性统计分析.结果:一、干预前后人口特征对比除年龄、婚姻状况、收入水平前后对比有差异外,其余各项的差异均无统计学意义,其差异可能由于人口年龄的自然增长和经济水平的发展导致。二、干预前后,大部分患者的体质指数都处在超重和肥胖的范围,患者的体质指数前后对比差异无统计学意义。三、干预前后,患者高血压知识来源排在前三位分别是医务人员、家人朋友和广播电视,通过其他途径获取高血压知识的人仅占一小部分。四、当地高血压患者KAP总得分及格率、知识得分及格率、态度以及行为得分及格率,分别由干预前的50.2%、48.9%、48.1%、37.2%提高到89.0%、78.2%、93.2%、71.7%。五、干预前患者平均前收缩压为(169±13.67)mm Hg、舒张压(95.75±9.39)mm Hg,干预后平均收缩压、舒张压为下降为(147.78±17.27)mm Hg、(84.09±11.16)mm Hg,前后对比差异有统计学意义,将血压控制在正常范围内的患高血压患者比例也由干预前的11.5%上升为干预后的49.2%,在血压仍偏高的患者中,Ⅰ、Ⅱ、Ⅲ级高血压患者的比例也均有下降,分别由干预前的42.7%、43.5%、2.5%下降为40.7%、9.8%、0.3%。六、高血压患者对高血压的知晓率、治疗率和控制率分别由干预前的67.3%、44.2%、11.5%提升到了96.3%、88.5%与49.2%。七、干预后与干预前相比,除吸烟在干预前后差异无统计学意义外(P0.05),患者的高血压知识、态度、行为改变以及高血压的控制均取得了令人满意的效果,差异有统计学意义(P0.05)。结论:以健康教育、生活方式干预和药物治疗相结合的三级综合管理干预模式对提高人群高血压KAP水平、改变不良生活行为、提高患者的依从性、治疗率和控制率,不仅是有效的,而且是切实可行的。为进一步控制高血压,预防脑卒中等心脑血管疾病的发生,我们应继续加强对居民健康教育,普及高血压知识,因地制宜的制定适合农村居民的高血压防控措施,有效地改善农村地区高血压人群的健康状况。
[Abstract]:Objective: to evaluate the effects of comprehensive intervention measures on cognition, attitude, behavior and blood pressure control in patients with essential hypertension through the combination of drug therapy and health education. Methods: in this study, the experimental epidemiology comprehensive intervention method was used to prevent and cure hypertension in rural areas. The investigators randomly selected essential hypertension patients aged 45 and above from the CSP PTT trial bases of China's primary stroke prevention group, Donghai County and Ganyu County, Lianyungang City, respectively, when the subjects were enrolled in the study group and after comprehensive intervention. A questionnaire survey was conducted for the subjects, After obtaining the relevant data, we use Epidata3.1 to set up a database, to do double input and error detection, and to use SPSS16.0 software to analyze the data. The results are as follows: 1. Before and after intervention, there were no significant differences in population characteristics except age, marital status and income level. The differences may be due to the natural growth of population age and the development of economic level. Before and after intervention, the body mass index of most patients was in the range of overweight and obesity, and there was no significant difference in body mass index before and after intervention. Third, before and after intervention, the first three sources of knowledge of hypertension in patients were medical personnel. Family, friends, radio and television, only a small proportion of people get knowledge of hypertension through other means. Fourth, the local hypertension patients total KAP score pass rate, pass rate of knowledge score, attitude and behavior score pass rate, The mean systolic pressure before intervention was 169 卤13.67 mm Hg, diastolic pressure 95.75 卤9.39 mm Hg, and after intervention the mean systolic pressure and diastolic pressure decreased to 147.78 卤17.27 mm Hg and 84.09 卤11.16 mm Hg, respectively. The proportion of patients with hypertension who controlled blood pressure within normal range also increased from 11.5% before intervention to 49.2 after intervention. Among the patients with high blood pressure, the proportion of patients with grade 鈪，

本文编号：1587945