社区健康教育对老年高血压并发卒中影响的长期随访研究
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摘要
目的通过长期随访分析社区健康教育对老年高血压并发卒中的影响。方法 2016年1～4月在北京市城区所有社区中采用分层随机抽样法抽取高血压患者484例,采用随机数字表法分为两组,每组242例。对照组采取既往控制高血压的常规措施,干预组中开展如何控制高血压相关知识和行为的健康教育,随访1年后比较两组患者高血压相关知识及健康行为的问卷得分、干预前后血压值的变化、卒中的发病率等。结果社区健康教育后,干预组相关知识、健康行为得分[(95.47±9.63)分、(90.64±9.83)分]高于对照组[(81.45±9.47)分、(65.96±9.33)分],差异均有统计学意义(P<0.05);社区健康教育后,两组患者BP值较干预前均呈现下降趋势,但干预组下降幅度更大,SBP[(141.53±10.64)mmHg vs.(157.67±10.71)mmHg),1 mmHg=0.133 kPa]和DBP[(90.53±8.27)mmHg vs.(102.65±9.63)mmHg]均下降,差异均有统计学意义(P<0.05);在随访期间,干预组卒中发病率为2.48%,对照组为9.50%,差异有统计学意义(χ~2=10.60,P=0.00);二者的点二列相关系数显示,高血压相关知识的以及高血压健康相关行为的5个方面得分和总分与卒中的发生均呈负相关(P<0.05)。结论通过对老年高血压患者采取一系列的高血压健康教育,可有效促使其控制卒中相关高危因素,降低其收缩压和舒张压水平,降低卒中的发生风险。
Objective To study the effect of education on senile hypertension progression complicated with stroke by long-term follow-up observation. Methods From January to April 2016, 484 patients with hypertension were enrolled by stratified random sampling in all communities in Beijing. The subjects were divided into two groups by the random number table method with 242 cases each. The control group took conventional measures to control hypertension. In the intervention group, health education on how to control hypertension-related knowledge and behavior was conducted. After one year of follow-up, the questionnaire scores of hypertension-related knowledge and health behaviors, changes in blood pressure values before and after intervention, and incidence of stroke were compared. Results After community health education, the relevant knowledge scores of the intervention group was much higher than that of the control group(95.47±9.63 vs. 81.45±9.47). The health behavior score of the intervention group was much higher than that of the control group(90.64±9.83 vs. 65.96±9.33),and the differences were statistically significant(P<0.05). After community health education, the BP values of both groups showed a downward trend, but the BP value of the intervention group decreased more, the differences of SBP [(141.53±10.64)mmHg vs.(157.67±10.71) mm Hg, 1 mmHg=0.133 kPa] and DBP [(90.53±8.27) mmHg vs.(102.65±9.63) mmHg] were statistically significant(P<0.05). During the follow-up observation period, the incidence of stroke in the intervention group was2.48%, and that in the control group was 9.50%, the difference was statistically significant(χ~2= 10.60, P = 0.00). By calculating the point-two correlation coefficient, the scores and total scores of the five aspects of hypertension-related knowledge and the five health-related behaviors of hypertension were observed. There was a negative correlation between aspect score and total score and stroke(P<0.05). Conclusions Through a series of high blood pressure health education for elderly hypertensive patients, it can effectively promote the control of related high-risk factors, and reduce the blood pressure level of systolic and diastolic blood pressure and reduce the risk of stroke in patients at the same time.
Objective To study the effect of education on senile hypertension progression complicated with stroke by long-term follow-up observation. Methods From January to April 2016, 484 patients with hypertension were enrolled by stratified random sampling in all communities in Beijing. The subjects were divided into two groups by the random number table method with 242 cases each. The control group took conventional measures to control hypertension. In the intervention group, health education on how to control hypertension-related knowledge and behavior was conducted. After one year of follow-up, the questionnaire scores of hypertension-related knowledge and health behaviors, changes in blood pressure values before and after intervention, and incidence of stroke were compared. Results After community health education, the relevant knowledge scores of the intervention group was much higher than that of the control group(95.47±9.63 vs. 81.45±9.47). The health behavior score of the intervention group was much higher than that of the control group(90.64±9.83 vs. 65.96±9.33),and the differences were statistically significant(P<0.05). After community health education, the BP values of both groups showed a downward trend, but the BP value of the intervention group decreased more, the differences of SBP [(141.53±10.64)mmHg vs.(157.67±10.71) mm Hg, 1 mmHg=0.133 kPa] and DBP [(90.53±8.27) mmHg vs.(102.65±9.63) mmHg] were statistically significant(P<0.05). During the follow-up observation period, the incidence of stroke in the intervention group was2.48%, and that in the control group was 9.50%, the difference was statistically significant(χ~2= 10.60, P = 0.00). By calculating the point-two correlation coefficient, the scores and total scores of the five aspects of hypertension-related knowledge and the five health-related behaviors of hypertension were observed. There was a negative correlation between aspect score and total score and stroke(P<0.05). Conclusions Through a series of high blood pressure health education for elderly hypertensive patients, it can effectively promote the control of related high-risk factors, and reduce the blood pressure level of systolic and diastolic blood pressure and reduce the risk of stroke in patients at the same time.
引文
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[2]Thrift AG,Thayabaranathan T,Howard G,et al.Global stroke statistics[J].Int J Stroke,2017,12:13-32.
[3]Wang W,Jiang B,Sun H,et al.Prevalence,incidence,and mortality of stroke in China:results from a nationwide population-based survey of480 687 adults[J].Circulation,2017,135:759-771.
[4]Gabb GM,Mangoni AA,Anderson CS,et al.Guideline for the diagnosis and management of hypertension in adults-2016[J].Med J Aust,2016,205:85-89.
[5]耿丽苹.农村地区高血压患者综合强化健康管理的效果分析[J].北京医学,2016,38:74-75.
[6]Wang C,Lang J,Xuan L,et al.The effect of health literacy and selfmanagement efficacy on the health-related quality of life of hypertensive patients in a western rural area of China:a cross-sectional study[J].Int J Equity Health,2017,16:58.
[7]韩广华,樊博.李克特式量表语义差异对科学测量的影响[J].科技进步与对策,2017,34:6-11.
[8]Quijada-Manuitt MA,Escamilla Y,Vallano A,et al.Use ofα2-adrenergic agonists to improve surgical field visibility in endoscopy sinus surgery:a systematic review of randomised controlled trials[J].Clin Ther,2018,40:136-149.
[9]蔡端颖,耿桂灵,陆燕玲.城市社区老年高血压病人延续性护理需求调查及影响因素分析[J].全科护理,2018,2:257-260.
[10]刘凯,龚深圳,陈晓平.清晨血压的临床研究进展[J].中华高血压杂志,2017,25:92-94.
[11]Chawla RM,Shetiya SH,Agarwal DR,et al.Knowledge,attitude,and practice of pregnant women regarding oral health status and treatment needs following oral health education in pune district of Maharashtra:a longitudinal hospital-based study[J].J Contemp Dent Pract,2017,18:371-377.
[12]徐向东.社区H型高血压人群筛查与干预的效果分析[J].北京医学,2017,39:886-887.
[13]郭君怡,叶小聪,林海玉,等.温州市某社区居民脑卒中知信行现状调查[J].中华现代护理杂志,2018,24:407-410.
[14]罗一夫,何健,赵会晶,等.基于Apriori关联规则的脑卒中危险因素分析[J].中国数字医学,2017,12:85-88.
[15]李洪艳,胡智艳,巩尊科,等.认知训练在脑卒中认知障碍偏瘫病人运动功能恢复中的应用[J].护理研究,2017,31:232-234.
[16]杨孟霞.杭州市社区居民脑卒中患病情况及知信行调查[J].中国老年学杂志,2016,36:1477-1479.
[17]Boriani G,Proietti M,Laroche C,et al.Contemporary stroke prevention strategies in 11 096 European patients with atrial fibrillation:a report from the EURObservational research programme on atrial fibrillation(EORP-AF)long-term general registry[J].Europace,2018,20:747-757.
[18]Rudoler D,De OC,Jacob B,et al.Cost analysis of a high support housing initiative for persons with severe mental illness and longterm psychiatric hospitalization[J].Can J Psychiatry,2018,63:492-500.
[19]Spence JD,Yi Q,Hankey GJ.B vitamins in stroke prevention:time to reconsider[J].Lancet Neurol,2017,16:750-760.