基于保护动机理论的护理干预对社区老年人心血管健康的影响
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摘要
目的探讨基于保护动机理论的护理干预对社区老年人心血管健康的影响。方法将85名老年人以居住地为界用抛硬币法分为干预组43名与对照组42名。对照组实施社区常规护理,干预组实施基于保护动机理论的护理干预。在干预前、干预后3个月、干预后6个月对两组老年人健康行为转变、生理生化指标及心血管健康评分进行评价。结果干预后6个月,干预组老年人低盐饮食和规律运动达标率显著高于对照组(均P<0.05);两组体重指数、收缩压、舒张压、心血管健康总分及心血管健康行为得分比较,组间效应、时间效应及交互效应差异有统计学意义(P<0.05,P<0.01)。两组胆固醇比较,组间效应、交互效应差异有统计学意义(P<0.05,P<0.01)。结论基于保护动机理论的护理干预可促进老年人健康行为的转变,降低老年人体重指数、血压和胆固醇,提高老年人心血管健康水平。
Objective To explore the effect of the nursing intervention based-on protection motivation theory on cardiovascular health in community older adults.Methods Totally 85 community older adults were divided into an intervention group(n=43) and a control group(n=42) using coin tossing according to living area. The control group received routine community nur-sing, while the intervention group received nursing intervention based on protection motivation theory.The health behavior change, the physiological and biochemical indexes and the score of cardiovascular health of the two groups were assessed before the intervention, 3 months and 6 months after the intervention.Results At 6 months after the intervention, the standard reaching rate of low salt diet and regular exercise in the intervention group were significantly higher than those in the control group(P<0.05 for both).The intervention effect, time effect and the intervention × time interaction effect in body mass index, systolic blood pressure, diastolic blood pressure, the total score of cardiovascular health and the score of cardiovascular health behavior were significant beween the two groups(P<0.05,P<0.01).The cholesterol was compared between the two groups, the intervention effect, the interven-tion × time interaction effect were significant(P<0.05,P<0.01).Conclusion The nursing intervention based on the protection motivation theory can promote healthy behavior change for older aults, reduce their body mass index, blood pressure and choleste-rol, and improve their cardiovascular health.
Objective To explore the effect of the nursing intervention based-on protection motivation theory on cardiovascular health in community older adults.Methods Totally 85 community older adults were divided into an intervention group(n=43) and a control group(n=42) using coin tossing according to living area. The control group received routine community nur-sing, while the intervention group received nursing intervention based on protection motivation theory.The health behavior change, the physiological and biochemical indexes and the score of cardiovascular health of the two groups were assessed before the intervention, 3 months and 6 months after the intervention.Results At 6 months after the intervention, the standard reaching rate of low salt diet and regular exercise in the intervention group were significantly higher than those in the control group(P<0.05 for both).The intervention effect, time effect and the intervention × time interaction effect in body mass index, systolic blood pressure, diastolic blood pressure, the total score of cardiovascular health and the score of cardiovascular health behavior were significant beween the two groups(P<0.05,P<0.01).The cholesterol was compared between the two groups, the intervention effect, the interven-tion × time interaction effect were significant(P<0.05,P<0.01).Conclusion The nursing intervention based on the protection motivation theory can promote healthy behavior change for older aults, reduce their body mass index, blood pressure and choleste-rol, and improve their cardiovascular health.
引文
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[14] 陈洁,吴茜,程小霁.对妊娠期糖尿病患者基于保护动机理论的护理干预[J].护理学杂志,2017,32(6):25-27.
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[18] 曾颖.老年人心血管风险评估与综合干预研究[D].长沙:中南大学,2012.
[19] 钱湘云,何炜,耿桂灵,等.基于保护动机理论的综合护理干预在社区老年高血压患者中的应用[J].中华现代护理杂志,2014,20(15):1791-1794.
[20] 周娜,侯爱和,刘丽,等.保护动机理论在糖尿病高危足干预中的应用[J].护理学杂志,2013,28(5):67-70.
[21] Gibbs B B,King W C,Belle S H,et al.Six-month changes in ideal cardiovascular health vs.Framingham 10-year coronary heart disease risk among young adults enrolled in a weight loss intervention[J].Prev Med,2016,86:123-129.
[22] Miao C,Bao M,Xing A,et al.Cardiovascular health score and the risk of cardiovascular diseases[J].PLoS One,2015,10(7):e01315.
[2] 戚常春,刘妍,陈朔华,等.理想心血管健康行为与因素对全因和心血管病因死亡的影响[J].中华高血压杂志,2013,21(11):1033-1039.
[3] Maclagan L C,Tu J V.Using opinion the concept of ideal cardiovascular health to measure population health:a review[J].Curr Opin Cardiol,2015,30(5):518-524.
[4] Lachman S,Peters R J,Lentjes M A,et al.Ideal cardiovascular health and risk of cardiovascular events in the EPIC-Norfolk prospective population study[J].Eur J Prev Cardiol,2016,23(9):986-999.
[5] 齐倩倩,杨巧芳,张艳,等.基于保护动机理论的自我管理教育对首次卒中患者疲劳及生活能力的影响[J].护理学杂志,2018,23(15):74-76.
[6] 中华人民共和国卫生部疾病控制司.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006:5-13.
[7] 中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志,2007,35(5):390-419.
[8] 中国高血压防治指南修订委员会.2004年中国高血压防治指南(实用本)[J].中华心血管病杂志,2004,32(12):1060-1064.
[9] 公共卫生与疾病控制中心,卫生部疾病控制司.中国糖尿病防治指南[M].北京:人民卫生出版社,2008:10-12.
[10] 孙丹.基于保护动机理论的护理干预对社区老年人心血管健康的影响[D].郑州:郑州大学,2017.
[11] Huffman M D,Capewell S,Ning H,et al.Cardiovascular health behavior and health factor changes (1988-2008) and projections to 2020:results from the National Health and Nutrition Examination Surveys[J].Circulation,2012,125(21):2595-602.
[12] 孙丹,孟雨姗,余珍,等.心血管病预防知识水平与老年人心血管健康的相关性[J].中国康复理论与实践,2017,23(6):714-719.
[13] 刘彩.保护动机理论在健康行为解释、干预与预测中的应用研究[J].医学与社会,2015,28(7):77-79.
[14] 陈洁,吴茜,程小霁.对妊娠期糖尿病患者基于保护动机理论的护理干预[J].护理学杂志,2017,32(6):25-27.
[15] Reddy K S.Cardiovascular health:China′s choices[J].J Am Coll Cardiol,2015,65(10):1026-1028.
[16] 中国疾病预防控制中心.中国居民营养与慢性病状况报告(2015年)[R/OL].(2015-08-05)[2018-10-06].https://wenku.baidu.com/view/b1159d96a26925c52dc5bf93.html.
[17] Cappuccio F P,Campbell N R.Population dietary salt reduction and the risk of cardiovascular disease:a commentary on recent evidence[J].J Clin Hypertens (Greenwich),2017,19(1):4-5.
[18] 曾颖.老年人心血管风险评估与综合干预研究[D].长沙:中南大学,2012.
[19] 钱湘云,何炜,耿桂灵,等.基于保护动机理论的综合护理干预在社区老年高血压患者中的应用[J].中华现代护理杂志,2014,20(15):1791-1794.
[20] 周娜,侯爱和,刘丽,等.保护动机理论在糖尿病高危足干预中的应用[J].护理学杂志,2013,28(5):67-70.
[21] Gibbs B B,King W C,Belle S H,et al.Six-month changes in ideal cardiovascular health vs.Framingham 10-year coronary heart disease risk among young adults enrolled in a weight loss intervention[J].Prev Med,2016,86:123-129.
[22] Miao C,Bao M,Xing A,et al.Cardiovascular health score and the risk of cardiovascular diseases[J].PLoS One,2015,10(7):e01315.