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目的 评价在福州市鼓山镇城乡结合部开展高血压患者自我健康管理俱乐部的实施效果.方法 2010年7月至10月在福州市鼓山镇开展高血压患者自我健康管理俱乐部的健康教育项目,研究对象为社区高血压患者33例.在俱乐部设立理论课程和实践课程,自我健康管理干预前后,分别评定患者的高血压控制率,高血压意识情况,及患者的健康状况,比较干预前后的变化情况.结果 干预前收缩压＜140 mm Hg(1 mm Hg=0.133 kPa)且舒张压＜90 mm Hg的学员16例(16/33),干预后19例(19/31),高血压控制率提高,但干预前后比较差异无统计学意义(x2=1.058,P＞0.05).干预前后学员对“正常血压值”和“应按医嘱服药控制高血压”的正答率较高,分别为(27/33)例和(26/31)例,前后比较差异无统计学意义(x2=0.047、1.242,P＞0.05).其余“35岁以后每年应测1次血压”等各项的正答率干预后比干预前明显提高,差异有统计学意义(x2=10.810、4.280、4.039、14.249、10.573、14.539,P＜0.05).干预后所有学员至少每月测量1次血压,其中至少每周测量1次的学员为28例(28/31),与干预前相比有明显改善,差异有统计学意义(x2=11.532,P＜0.05).健康状况调查显示,干预后学员整体健康状况优于干预前,差异有统计学意义(Z=-2.034,P＜0.05).结论 社区健康教育的实施可提高患者高血压意识、改善患者健康状况,城乡结合部高血压患者自我健康管理俱乐部具有可行性,可推广应用.

Objective To evaluate the impacts of health self-management club on hypertensive patients who lived in Gushan town of Fuzhou.Methods Thirty-three community hypertensive patients who partitipated in health self-management club during July and October 2010 were enrolled in this investigation.Control and awareness of high blood pressure and patients' health condition were compared before and after the intervention.Results Normal blood pressure (systolic pressure ＜ 140 mm Hg (1 mm Hg =0.133 kPa),diastolic pressure ＜90 mm Hg) was found in 19 patients after intervention ((19/31 vs 16/33),x2 =1.058,P ＞ 0.05).Meanwhile,awearness rate of normal blood pressure and mediciation order-guided drug taking was increased to 27/33 and 26/31,respectively (x2 vales were 0.047 and 1.242,respectively ; both P ＞ 0.05).Other information inluding annual blood pressure measurement in ＞ 35 years old populations was well known by more participants (x2 vales were 10.810,4.280,4.039,14.249,10.573and 14.539,respectively; all P＜ 0.05).Since intervention,blood pressure was measured at least once a month in all the subjects,and 28/31 patients measured blood pressure weekly (x2 =11.532,P ＜ 0.05).Health condition of the patients were significantly improved after intervention (Z =-2.034,P ＜ 0.05).Conclusions Community health education could raise patients' awareness of hypertension and improve their health condition.Health self-management club may be feasible to hypertensive patients living at rural-urban fringe.