CAJ | 학술논문

目的调查上海市徐汇区社区老年高血压患者知信行模式,分析其与降压达标的关系.方法 2011年5月至7月,以上海市徐汇区5个社区中纳入高血压规范化管理的47 572例高血压患者为目标人群,采用问卷调查方式,对老年高血压患者知信行模式进行调查.计算样本量后以简单随机抽样方法共发放问卷3800份,回收有效问卷3328份(应答率87.6％),其中老年人共计3036例.结果 3036例老年高血压患者平均年龄(76 ±7)岁,男性43.3％(1315例).对高血压相关知识的知晓率为88.5％～97.8％.社区全科医师门诊是其知识的主要来源(73.4％,2168/2954).81.9％(2378/2905)的患者曾接受过高血压知识健康教育,81.8％ (2333/2853)希望定期接受相关健康教育.67.2％者每周自测血压；89.6％者控制食盐摄入；66.8％者每周参加户外活动,且每周平均运动(5.6±2.1)次,每次平均(45±28) min.普通老年高血压患者降压达标率高于伴其他慢性病(糖尿病、冠心病或脑卒中)的老年高血压患者(62.3％比17.0％,x2=616.509,P＜0.01).普通老年高血压患者中知晓“血压升高与盐摄入量有关”(OR=3.364,P＜0.01)、“希望定期接受高血压健康教育”(OR=1.718,P＜0.01)者,伴其他慢性病(糖尿病、冠心病或脑卒中)的老年高血压患者中“每月自测1～2次血压”(OR =2.572,P＜0.01)者,降压更易达标.结论该社区老年高血压患者高血压相关知识知晓率高、态度积极,但相关健康行为改变滞后.现行健康教育方法通过改变老年高血压患者知信行模式,以促进降压达标的作用微弱.全科医生应针对不同人群开展个体化健康教育,注重最终的行为改变.
목적 조사상해시서회구사구노년고혈압환자지신행모식,분석기여강압체표적관계.방법 2011년5월지7월,이상해시서회구5개사구중납입고혈압규범화관리적47 572례고혈압환자위목표인군,채용문권조사방식,대노년고혈압환자지신행모식진행조사.계산양본량후이간단수궤추양방법공발방문권3800빈,회수유효문권3328빈(응답솔87.6％),기중노년인공계3036례.결과 3036례노년고혈압환자평균년령(76 ±7)세,남성43.3％(1315례).대고혈압상관지식적지효솔위88.5％～97.8％.사구전과의사문진시기지식적주요래원(73.4％,2168/2954).81.9％(2378/2905)적환자증접수과고혈압지식건강교육,81.8％ (2333/2853)희망정기접수상관건강교육.67.2％자매주자측혈압；89.6％자공제식염섭입；66.8％자매주삼가호외활동,차매주평균운동(5.6±2.1)차,매차평균(45±28) min.보통노년고혈압환자강압체표솔고우반기타만성병(당뇨병、관심병혹뇌졸중)적노년고혈압환자(62.3％비17.0％,x2=616.509,P＜0.01).보통노년고혈압환자중지효“혈압승고여염섭입량유관”(OR=3.364,P＜0.01)、“희망정기접수고혈압건강교육”(OR=1.718,P＜0.01)자,반기타만성병(당뇨병、관심병혹뇌졸중)적노년고혈압환자중“매월자측1～2차혈압”(OR =2.572,P＜0.01)자,강압경역체표.결론 해사구노년고혈압환자고혈압상관지식지효솔고、태도적겁,단상관건강행위개변체후.현행건강교육방법통과개변노년고혈압환자지신행모식,이촉진강압체표적작용미약.전과의생응침대불동인군개전개체화건강교육,주중최종적행위개변.
Objective To survey on the knowledge,attitude and practice about hypertention in elderly patients and its relation to blood pressure control.Methods A sampling survey on the knowledge,atitude and practice about hypertention were carried out in a target population of 47 572 elderly hypertensive patients from 5 communities in Xuhui District of Shanghai during May 2011 to July 2011.Total 3800 questionairres were distributed and 3328 responded with a response rate of 87.5％.Results Among 3328 responders,3036 were aged above 65 years with a mean age of (76 ±7) years and 43.3％ were males.The rates of knowledge about hypertension were 88.5％-97.8％.General practitioners in out-patient service were the major source of knowledge.Raults revealed that 81.9％ had received health education before;81.8％ requied a regular health education; 67.2％ had self-tested blood pressure weekly; 89.6％ controlled salt intake; 66.8％ attended outdoor activities weekly with (5.6 ±2.1) times a week and (45 ±28) min each time.The blood pressure control rate in uncomplicated hypertensive patients was higher than those complicated with diabetes,coronary heart disease or stroke (62.3 ％ vs.17.0％,P ＜ 0.01).Knowing "high blood pressure was related to salt intake" (OR =3.364,P ＜ 0.01),"hoping a regular health education about hypertension" (OR =1.718,P ＜ 0.01) were factors contributing to blood pressure control in uncomplicated hypertensive patients; while "self-testing blood pressure once or twice a month"(OR =2.572,P ＜ 0.01)was contributing factor to blood pressure control in complicated hypertensive patients.Conclusions Elderly hypertensive patients from communities in Shanghai have enough knowledge,positive attitude but lack practices.General practitioners should carry out personalized and stronger health education focued on behavioral changes for those patients.