摘要目的 探讨以社区护士为主导的自我效能干预对社区老年高血压患者自我管理行为的影响.方法 采用无相等对照组设计方法,选取两个社区卫生服务中心的社区老年高血压患者78例,其中干预组38例,对照组40例.对干预组患者进行为期3个月的自我效能干预,对照组不采取干预措施.采用慢性病自我管理行为测量表和身体测量指标对研究对象干预前和干预后3个月的干预效果进行评价.结果 干预组3个月内收缩压下降(5.11±12.30)mmHg,对照组患者收缩压下降(0.33±4.64) mm Hg,两组比较差异有统计学意义(t =2.248,P＜0.05);干预组体重指数下降(0.43±0.42) kg/m2,对照组体重指数比3个月前增加(0.39±1.26) kg/m2,两组差异有统计学意义(t =3.825,P＜0.01).两组患者3个月的自我效能、自我管理行为、健康状况比较差异均有统计学意义(P＜0.01);在卫生服务利用方面,干预组和对照组干预前后3个月的变化值进行比较差异均无统计学意义(P＞0.05).结论 自我效能干预可以增强社区老年高血压患者的自我效能,提高其自我管理行为,改善健康状况,对于减少卫生服务使用有一定作用,但需要要进行远期效果观察.

abstractsObjective To elucidate the effect of community nurse-led self-efficacy intervention on selfmanagement behaviors of hypertension in community elderly.Methods In this study,non-equivalent control group was designed,78 community elderly patients with hypertension were selected in the two community health service centers and divided into intervention group (38 cases) and control group (40 cases).The intervention group was treated with self-efficacy intervention for 3-month,and control group did not take any interventions.The “chronic disease self-management behavior measurement" (Stanford University research tool) and the measure of physical intervention study were used to valuate the effect of interference before and 3 months after intervention.Results Systolic blood pressure in intervention group was (5.11 ± 12.30) mm Hg and (0.33 ±4.64) mm Hg in control group,the difference was statistically significant ( t =2.248,P ＜ 0.05 ).BMI in intervention group was reduced by (0.43 ± 0.42 ) kg/m2,however,in control group was increased by ( 0.39 ±1.26) kg/m2,the difference has reached the statistical significance ( t =3.825,P ＜ 0.01 ).Self-efficacy,selfmanagement,health state in two groups were different ( P ＜ 0.01 ).Other factors in scale did not reach statistical significance in health service utility in two groups ( P ＞ 0.05 ).Conclusions The self-efficacy intervention can significantly enhance the community' s self-efficacy in elderly hypertensive patients,improve self-management behaviors and health,reduce health service use for a certain effect,but long-term effects need to be observed.