梁会 谷嘉明 沈艳 胡建伟

摘 要 目的：觀察社区健康干预及个性化护理在老年高血压患者中应用的效果。方法：选取2016年2月至2017年1月在上海市杨浦区大桥社区卫生服务中心建立健康档案的老年高血压患者221例，随机分为观察组与对照组，对照组患者109例，其中男性54例，女性55例，年龄中位数73.2岁，病程中位数10.7年；观察组患者112例，其中男性53例、女性59例，年龄中位数73.3岁，病程中位数10.5年。对对照组患者实施常规护理，对观察组患者在常规护理的基础上进行社区健康干预和个性化护理，比较两组患者干预前后的管理效果。结果：干预后观察组患者的收缩压、舒张压的平均水平均低于对照组，差异均有统计学意义（P<0.001）；高血压知识知晓率、服药依从性、不良生活方式改变、血压控制效果均优于对照组，差异均有统计学意义（P<0.01）。结论：社区健康教育和个性化护理干预有助于提高老年高血压患者的服药依从性和血压控制水平。

关键词 高血压；健康干预；个性化护理；效果

中图分类号：R544.1 文献标志码：A 文章编号：1006-1533（2018）16-0041-03

Application of community health intervention and personalized nursing in elderly hypertensive patients

LIANG Hui1， GU Jiaming1， SHENG Yan1， HU Jianwei2（1.Department of Cardiology of Daqiao Community Health Service Center of Yangpu District， Shanghai 200090， China； 2. Department of Urology of the First Rehabilitation Hospital of Shanghai 200090， China）

ABSTRACT Objective： To exam the application effect of community health intervention and personalized nursing on elderly hypertensive patients. Methods： From February 2016 to January 2017， 221 elderly hypertensive patients whose health records were established in Daqiao Community Health Service Center of Yangpu District， Shanghai were selected and randomly divided into an observation group and a control group. The control group had 109 patients， including 54 males and 55 females， with a median age of 73.2 years and a median disease duration of 10.7 years. There were 112 patients in the observation group， including 53 males and 59 females with median age of 73.3 years and median disease duration of 10.5 years. The patients in the control group were given routine nursing and the patients in the observation group were given community health intervention and personalized nursing on the basis of routine nursing. The effect of hypertension management before and after intervention was compared between the two groups. Results： After intervention， the mean systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group and the difference was statistically significant（P<0.001）. The awareness rate， medication compliance， unhealthy lifestyle changes and blood pressure control effect in the observation group were better than those in the control group（P<0.01）. Conclusion： Community health education and personalized nursing intervention help to effectively control blood pressure and improve compliance in elderly hypertensive patients.

KEY WORDS hypertension； health intervention； personalized nursing； effect

2005年美国高血压学会（ASH）提出高血压是一个由许多病因引起，并处于不断进展状态的心血管综合征，可导致心脏和血管的功能和结构改变[1]。高血压患者若不注意控制很可能诱发脑卒中、心肌梗死等严重的病症[2]。本文旨在观察社区健康干预和个性化护理在老年高血压患者中应用的效果。

1 对象与方法

1.1 对象

以2016年2月至2017年1月在上海杨浦区大桥社区卫生服务中心建立健康档案的老年高血压患者为研究对象。入组标准：生活能够自理；智力正常；能够与医护人员正常语言交流。排除有脑梗死、痴呆、恶性肿瘤、严重精神疾病者。共入组患者237例。

入选患者按照受试者入选的先后顺序，通过随机对照表分为观察组和对照组；……