张源 刘莉 张复亮 彭淑颖 王剑波

摘 要 目的：探讨心理干预对社区老年高血压患者血压和情绪的影响，为建立有效的社区干预模式提供依据。方法：将64例社区老年高血压患者随机分为试验组和对照组。试验组31例，平均年龄（67.3±5 . 6）岁；其中男性15例，女性16例。对照组33例，平均年龄（68.7±4 . 8）岁；其中男性16例，女性17例。对照组按照国家基层高血压防治管理指南常规管理，试验组在此基础上进行心理干预。采用汉密尔顿焦虑量表（HAMA）及血压控制水平评价干预前后效果。结果：对照组干预后血压和HAMA评分明显下降，差异均有统计学意义（P<0.05）。结论：心理干预对于社区老年高血压患者的血压控制和情绪改善具有积极的作用。

关键词 高血压；心理干预；情绪；血压

中图分类号：R544.1 文献标志码：A 文章编号：1006-1533（2019）04-0049-03

Effect of psychological intervention on blood pressure and mood of elderly hypertensive patients in the community

ZHANG Yuan， LIU Li， ZHANG Fuliang， PENG Shuying， WANG Jianbo

（General Practice Department of Xujiahui Community Health Service Center of Xuhui District， Shanghai 20030， China）

ABSTRACT Objective： To explore the effect of psychological intervention on blood pressure and mood of elderly hypertensive patients in the community to provide evidence for establishing an effective community intervention mode. Methods： Sixty-four cases of elderly patients with hypertension in the community were randomly divided into an experimental group and a control group. There were 31 cases in the experimental group， with an average age of （67.3±5.6） years， including 15 male cases and 16 female ones. There were 33 cases in the control group， with an average age of （68.7±4.8） years， including 16 male cases and 17 female ones. The control group was routinely managed in accordance with the national guidelines for the prevention and treatment of hypertension in the grassroots， and the experimental group was given psychological intervention on this basis. Hamilton anxiety scale（HAMA） and blood pressure control level were used to evaluate the effect before and after intervention. Results： The blood pressure and HAMA score of the experimental group decreased significantly after the intervention， and the differences were statistically significant（P<0.05）. Conclusion： Psychological intervention has a positive effect on blood pressure control and mood improvement in elderly hypertensive patients in the community.

KEY WORDS hypertension； psychological intervention； mood； blood pressure

随着社会老龄化的到来，老年人作为社区的主体人群受到政府的关注，其生活质量和心理健康问题也日益得到重视[1]。高血压、糖尿病等慢性疾病发病率逐渐增高，严重影响了人们的预期寿命及生活质量。因此，控制慢性疾病、减少并发症、提高生活质量，已经成为近年来的研究热点[2]。本文旨在观察心理干预在社区高血压患者管理中应用的效果。

1 對象与方法

1.1 对象

入选标准：（1）上海市徐家汇街道社区的常住居民（>6个月）；（2）年龄≥60岁；（3）诊断标准符合《国家基层高血压防治管理指南》2017版[3]，即非同日3次测量（4周内复查2次），收缩压≥140 mmHg和（或）舒张压≥90 mmHg。排除标准：（1）晚期肿瘤患者和生活完全不能自理者；（2）有严重感染患者；（3）有严重肝肾功能不全患者。

共招募高血压患者64例，按患者在上海徐家汇街道社区卫生服务中心就诊顺序编号，采用随机数字表分为试验组31例和对照组33例。……