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目的：探讨团队式个体化健康管理对社区高血压患者健康素养及健康状况的影响。方法这次研究属于自身前后对照的实验研究，采用两阶段整群随机抽样方法，首先从德胜社区23个居委会中随机抽取2个居委会，然后从抽中的2个居委会获得高血压患者名单，在名单中每隔5个抽取1例，干预前共抽取470例，干预后共抽取444例作为研究对象，干预前后两组患者在年龄（岁）（67.2±9.8，66.5±10.5）、性别（男性占47.0%，44.1%）、民族（汉族占93.8%，92.3%）、婚姻状况（在婚者占91.3%，88.9%）等社会人口学特征方面具有可比性（t=1.447χ2=0.774、1.595、2.555，均有P>0.05）。自2013年7月德胜社区卫生服务中心对辖区高血压患者进行团队式个体化健康管理干预，1年后，比较干预前后高血压患者健康素养及健康状况的变化。结果健康管理干预后，高血压患者具备基本健康素养的比例由38.5%提高到53.4%：其中健康知识的平均知晓率由65.3%提高到75.3%；利用卫生服务技能的平均正确率由49.1%提高到70.9%；行为生活方式方面：饮食行为总均分由35.6提高到37.1，运动行为总均分由17.1提高到21.3，自我管理行为在自测血压、严格按医嘱服药、控制盐摄入等方面干预后（74.4%、87.6%、80.0%）高于干预前（61.3%、68.3%、62.2%），差异有统计学意义（χ2=16.813、48.295、52.058，P<0.05）。健康管理干预后，高血压患者自评健康状况明显好于干预前，血压控制率由72.9%提高到79.5%，差异均有统计学意义（P<0.05）。结论团队式个体化健康管理可明显提高社区高血压患者的健康素养水平，促进其健康状况的改善。

Objective To explore the effect of team-based individualized health management on health literacy and health status among hypertensive patients in community. Method This study was a self-controlled quasi-experimental design. A two-stage cluster random sampling method was used. Two neighborhood committees among 23 neighborhood committees in Desheng community were randomly sampled. The name list of hypertensive patients were obtained from the 2 sampled neighborhood committees, getting one from each five, 470 in total before intervention and 444 in total after. The two groups of patients before and after intervention had comparability in the social demographic characteristics as the age (67.16± 9.84, 66.47 ± 10.50 years), the gender (the male accounted for 47.00%and 44.10%), the ethnicity (the Han accounted for 93.80%and 92.30%) and the marital status(the married accounted for 91.30%, 88.90%)(t=1.447 χ2 =0.774, 1.595, 2.555, P>0.05). Since July 2013, Desheng community health service center intervened the hypertensive patients by team-based individualized health management. After one year, we compared the change of their health literacy and health status. Result After health management, the proportion of hypertensive patients with adequate health literacy increased from 38.50% to 53.40%, The average rate of health knowledge awareness among them increased from 65.30% to 75.30%. The average accuracy of health services utilization skills of them increased from 49.10%to 70.90%, lifestyle behaviors in dietary and in exercise the average increase was from 35.55, 17.07 to 37.05, 21.28 respectively, after the intervention the patients did better work in self management behavior, such as self-test of blood pressure, medication compliance and control of salt intake (74.40%, 87.60%, 80.00%) were obviously better than before intervention (61.30%, 68.30%, 62.20%), and the differences were statistically significant (χ2 =16.813, 48.295, 52.058, P<0.05). After health management, the self-report health was better among hypertensive patients. The proportion of them with normalized blood pressure increased from 72.90% to 79.50%, and the difference was statistically significant (P<0.05). Conclusion Team-based individualized health management could increase health literacy of hypertensive patients in community and improve their health status obviously.