任慧, 张伟, 张宝民, 荆丽梅, 傅华, 许菁, 盛新春. 社区高血压自我管理新模式效果评价[J]. 上海预防医学, 2016, 28(10): 707-712.
引用本文: 任慧, 张伟, 张宝民, 荆丽梅, 傅华, 许菁, 盛新春. 社区高血压自我管理新模式效果评价[J]. 上海预防医学, 2016, 28(10): 707-712.
REN Hui, ZHANG Wei, ZHANG Bao-min, JING Li-mei, FU Hua, XU Jing, SHENG Xin-chun. Evaluation on effect of new model of community-based hypertension self-management[J]. Shanghai Journal of Preventive Medicine, 2016, 28(10): 707-712.
Citation: REN Hui, ZHANG Wei, ZHANG Bao-min, JING Li-mei, FU Hua, XU Jing, SHENG Xin-chun. Evaluation on effect of new model of community-based hypertension self-management[J]. Shanghai Journal of Preventive Medicine, 2016, 28(10): 707-712.

社区高血压自我管理新模式效果评价

Evaluation on effect of new model of community-based hypertension self-management

  • 摘要: 目的 探索社区高血压自我管理新模式,针对上海市某区社区高血压患者加以干预并进行效果评价。方法 利用文献复习、专家讨论及相关利益方分析等方法,并结合当地实际探索社区高血压自我管理新模式。从知情同意,自愿参与干预的1.5万例高血压患者中随机抽取1 080例患者纳入干预组,并在各社区卫生服务中心高血压管理库中随机抽取未参与干预的588名患者作为对照组。通过协方差的秩和检验,比较干预组和对照组患者项目实施前和实施6个月之后在总体健康自评、获得卫生服务质量的评分等方面两次问卷调查数据的变化;通过协方差分析,比较两组患者血压的变化情况。结果 相较对照组,干预组患者总体健康自评有明显改善(P<0.05)。干预组血压维持在较稳定状态,对照组较干预前舒张压升高,干预前后差异有统计学意义(P<0.05)。干预组与对照组相比,获得高血压病卫生服务质量方面,个人主动性和卫生服务提供系统设计等维度的评分6个月的增加值差异有统计学意义(P<0.05)。结论 基于社区高血压自我管理新型模式的干预对改善高血压患者总体健康状况,稳定血压值,优化高血压服务质量有着积极的促进作用。

     

    Abstract: Objective To explore the new model of community-based hypertension self-management and to evaluate the intervention effect on the hypertension patients in a community in Shanghai. Methods To explore the new model of community-based hypertension self-management, through literature review and qualitative interviews with experts and stakeholders. Among 15 000 patients with informed consents and voluntary participation, 1 080 patients were randomly selected as the intervention group, and 588 patients were randomly selected from hypertension management database of community health service centers as the control group. Analysis of covariance based on rank scores was employed to compare the score changes in two survey questionnaires, before and after six months of the intervention project, and between the intervention group and the control group, on self-assessment of overall health status, and quality of health care services received in the community. Analysis of covariance was employed to compare the changes of blood pressure. Results The self-assessment of overall health status significantly improved for the intervention group, compared with the control group (P<0.05). The blood pressure of the intervention group remained stable, while the diastolic pressure for the control group increased as compared with that before intervention, the difference was statistically significant (P<0.05). During six months of the intervention project, as to the incremental value of scores in dimensions like initiative and design of health care service system, the difference between the intervention group and the control group was statistically significant (P<0.05). Conclusion The intervention based on the new model of community-based hypertension self-management has a positive role in improving the patients' overall health status, stabilizing the blood pressure, and optimizing hypertension health care services in community.

     

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