检索历史 清除

目的 探讨自我管理方法对高血压患者自我效能的影响.方法 2011年11月至2012年2月,在北京市14个区县中各选择2个中等规模且依从性较好的社区,采用实验流行病学中的社区试验方法,将社区中自愿参加自我管理小组的高血压患者以社区为单位随机分为干预组和对照组,其中干预组159例,对照组164例.干预组采用自我管理,对照组按照中国高血压防治指南采用高血压规范化管理.干预组和对照组均接受基线和6周之后的2次问卷调查.对计量资料采用秩和检验,对计数资料采用x2检验.调查结束后对干预组和对照组症状指标管理前后变化值及自我效能管理前后变化值进行比较.结果 干预组和对照组的平均年龄分别为(61.9±9.1)岁和(61.8±9.0)岁,两组在平均年龄、年龄分组、性别和文化程度构成方面具有可比性,差异无统计学意义(F=0.164,x2=0.649、0.782、2.093；P ＞0.05).通过对管理前后症状指标的差值进行比较发现,干预组无论是男性还是女性,疲劳程度、头疼程度、呼吸短促程度的分值有所下降,女性变化程度与对照组相比,差异有统计学意义(Z=-5.198、-3.873、-2.781,P＜0.05).干预组管理后比管理前自我效能得分有所增加,女性的症状管理自我效能和疾病共性管理自我效能增加值明显高于对照组的增加值,差异有统计学意义(Z=-2.958,-2.582; P＜0.05).干预组自我管理前后与医生交往能力得分的增加值较对照组的增加值高,但差异无统计学意义(P＞0.05).结论 社区高血压患者通过自我管理小组的活动和干预可以提高管理对象对疾病管理的自我效能.

Objective To evaluate the impact of hypertension self-management on self efficacy of community residents.Methods November 2011 to February 2012,twenty-eight medium-sized and better adherence to community was selected from fourteen districts and counties in Beijing.In this community-based randomized controlled trial,323 hypertensive patients were randomly assigned to the treatment group (n =159,receiving hypertension self-management) and the control group (n=164,receiving standard hypertension management).A questionary survey was completed at baseline and 6 weeks.Rank sum test or Chi-square test was used for data analysis.Results The average age of the treatment group or the control group was (61.9 ±9.1) vs (61.8 ±9.0) years old,respectively.No significant difference in mean age,gender and education level was found between the two groups (F =0.164,x2 values were 0.782 and 2.093,respectively ; all P ＞ 0.05).In the treatment group,the scores of fatigue,headache and shortness of breath were declined (when compared with the controlled females,Z =-5.198,-3.873,-2.781 ; P ＜ 0.05).Self-efficacy score of the treatment group was increased after the intervention.Women's symptom management self-efficacy and common disease management self-efficacy were significantly higher (Z=-2.958,-2.582; P ＜ 0.05).In comparison with the control group,before and after self-management,the added scores of communication ability with doctors were increased.But the difference was not statistically significant (P ＞ 0.05).Conclusion Six-week self-management program may improve self efficacy among hypertensive patients.