摘要
目的探讨医院-社区综合管理模式对高血压患者治疗效果和治疗依从性的影响,为建立高血压有效控制模式提供科学依据。方法收集2013年1月至2014年12月佛山市禅城区中心医院提供社区服务的20个居委收治的1 050例高血压患者作为研究对象,将其按照分层随机抽样法分为干预组500例和对照组550例,干预组给予医院-社区综合管理模式干预,对照组给予常规门诊治疗,观察1年。统计两组患者干预前后血压控制效果、疾病知晓率、服药依从性以及生活方式的变化。结果两组干预1年后,干预组随访成功率为95.60%,对照组为92.91%,差异无统计学意义(P>0.05);干预组干预前的收缩压/舒张压为(158.21±11.46)/(94.54±9.98)mmHg,对照组为(159.60±11.59)/(94.20±9.80)mmHg;干预后1年后,干预组的收缩压/舒张压改善至(134.22±10.82)/(79.81±8.98)mmHg,对照组为(144.66±11.43)/(83.95±9.29)mmHg,均较干预前显著降低(P<0.05),且干预组下降幅度较对照组明显(P<0.05);干预组干预后的血压控制率、疾病知晓率以及服药依从性分别为61.30%、94.77%、92.26%,均较干预前显著提高,且高于对照组的50.10%、88.26%、88.06%(P<0.05);两组干预后的不良生活方式均明显改善,且干预组改善效果更为明显(P<0.05)。结论医院-社区综合管理模式在高血压患者中的应用,在显著提高高血压治疗效果和治疗依从性的同时,还能改善患者生活中的不良生活方式,可作为现有高血压管理模式的补充。
Objective To explore the effect of hospital community integrated management mode on the treatment effect and treatment compliance of patients with hypertension, and to provide scientific basis for the establishment of effective control mode of hypertension. Methods Central Hospital of Foshan Chancheng District provided community services in 20 residential committees, where 1 050 cases of hypertension patients were admitted as research object from January 2013 to December 2014. According to stratified sampling method, they were divided into intervention group(500 cases) and control group(550 cases). The intervention group was given the hospital community integrated management mode of intervention, and the control group was given routine outpatient treatment. After 1-year medical intervention, statistics before and after the intervention and the effect of blood pressure control, disease awareness, medication compliance and lifestyle changes were observed. Results One year after the treatment, the follow-up success rate was 95.60% in the intervention group, 92.91% in the control group. The difference was not statistically significant(P>0.05). The systolic/diastolic blood pressure of intervention group before intervention was(158.21±11.46)/(94.54±9.98) mm Hg, and the control group was(159.60±11.59)/(94.20±9.80) mm Hg. 1 year after the intervention, the efficacy of blood pressure control improved significantly in both groups(P<0.05), the systolic/diastolic blood pressure of the intervention group was(134.22±10.82)/(79.81±8.98) mm Hg, the control group was(144.66±11.43)/(83.95±9.29) mm Hg, and the intervention group decreased more significantly compared with the control group(P<0.05). The intervention group patients blood pressure control rate, awareness of the disease and medication compliance were 61.30%, 94.77%, 92.26%, which was increased significantly compared with that before the intervention, and were higher than those of the control group(50.10%, 88.26%, 88.06%, P<0.05). Unhealthy lifestyle intervention in the two groups were significantly improved, and the intervention group improved more obviously(P<0.05). Conclusions In the application of hospital community integrated management system, the treatment of hypertension and treatment compliance improved significantly at the same time, and also improve their unhealthy lifestyle in life. Therefore, the hospital community integrated management system can be used as a supplement to the existing hypertension management mode.
出处
《中华临床医师杂志（电子版）》
CAS
2017年第7期1075-1078,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
广东省医学科研基金项目(A2013691)
关键词
高血压
治疗依从性
医院-社区综合管理模式
临床疗效
Hypertension
Treatment compliance
Hospital community integrated management model
Clinical efficacy
