CAJ | 학술논문

目的：探讨患者版目标管理手册在社区高血压管理中的应用效果。方法选取2012年1月-2013年6月在我科住院的并于出院后长期居住在我院社区服务范围内的高血压患者140例，按患者住院号的单双数分为两组：对照组67例，试验组73例。对照组患者仅给予常规社区管理；试验组患者除给予常规社区管理外，在社区工作者的指导下使用患者版目标管理手册进行高血压自我管理，两组均干预6个月。比较两组患者干预前后血压下降值及血压控制率；干预6个月后采用自我效能量表及自我管理行为量表评估两组患者的自我效能及自我管理行为水平。结果试验组患者干预前后收缩压下降值〔（12.5±7.8） mm Hg〕、舒张压下降值〔（9.1±5.8） mm Hg〕及血压控制率〔63.0%（46/73）〕均高于对照组〔（7.1±4.6）mm Hg、（3.8±4.3）mm Hg、31.3%（21/67）〕（P é0.05）。试验组患者自我效能及自我管理行为各项得分均高于对照组（P é0.05）。结论使用患者版目标管理手册可以进一步降低患者的血压，提高血压控制率和患者的自我效能及自我管理行为，值得在社区高血压管理中推广应用。
목적：탐토환자판목표관리수책재사구고혈압관리중적응용효과。방법선취2012년1월-2013년6월재아과주원적병우출원후장기거주재아원사구복무범위내적고혈압환자140례，안환자주원호적단쌍수분위량조：대조조67례，시험조73례。대조조환자부급여상규사구관리；시험조환자제급여상규사구관리외，재사구공작자적지도하사용환자판목표관리수책진행고혈압자아관리，량조균간예6개월。비교량조환자간예전후혈압하강치급혈압공제솔；간예6개월후채용자아효능량표급자아관리행위량표평고량조환자적자아효능급자아관리행위수평。결과시험조환자간예전후수축압하강치〔（12.5±7.8） mm Hg〕、서장압하강치〔（9.1±5.8） mm Hg〕급혈압공제솔〔63.0%（46/73）〕균고우대조조〔（7.1±4.6）mm Hg、（3.8±4.3）mm Hg、31.3%（21/67）〕（P é0.05）。시험조환자자아효능급자아관리행위각항득분균고우대조조（P é0.05）。결론사용환자판목표관리수책가이진일보강저환자적혈압，제고혈압공제솔화환자적자아효능급자아관리행위，치득재사구고혈압관리중추엄응용。
Objective To investigate the application effect of the patient version of target management handbook on hypertensive patients enrolled in community management. Methods 140 hypertensive patients who had hospitalized in our hospi-tal from January 2012 to June 2013 and dwelled in the community in the charge of our hospital were selected and divided into two groups by the admission number(odd or even):control group(n = 67)and test group(n = 73). Patients in the control group only received routine community management and the test group was not only given the routine community management,but also taught to take self - management with the help of patient version of target management handbook under the guidance of the commu-nity medicine workers. The intervention process lasted 6 months,then compare the decrease value and control rate of blood pres-sure before and after intervention and evaluate the self - efficacy and self - management behavior by the self - efficacy scale and self - management behavior scale. Results The decrease value of systolic blood pressure〔(12. 5 ± 7. 8)mm Hg〕and diastolic blood pressure〔(9. 1 ± 5. 8)mm Hg〕,the blood pressure control rate of patients in test group〔63. 0% (46 / 73)〕were all higher than those in the control group〔(7. 1 ± 4. 6)mm Hg,(3. 8 ± 4. 3)mm Hg,31. 3% (21 / 67)〕(P é 0. 05). The test group patientsˊ self - efficacy and self - management behavior scores were higher than those of the control group(P é 0. 05). Conclusion The use of the target management handbook of patient version can help patients decrease blood pressure,improve blood pressure control rate and their self - efficacy and self - management behavior. It is worthy of spreading the application in the process of community hypertension management.