Survey On Systematic Health Education For Hospitalized Patients With Hypertension

BackgroundWith the changes in disease spectrums, chronic psychosomatic diseases are serious threats to human health, such as Essential Hypertension (EH), Diabetes Mellitus (DM), and coronary heart disease (CHD). In China, hypertension has a high incidence of up to 18.8%, while the rate of blood pressure control is merely 28.8%. The prevalence rate of hypertension is increasing year by year, and the involving populations are becoming younger and younger. Hypertension can cause serious dysfunctions of the heart, brain, and kidney, which has become the first risk factor in acute cardiovascular events and strokes. Hypertension, related to ways of life, can not be cured for the current stage. Health education has become an indispensible measure, and nurses are the brunt of health education. Clinical health education in China lagged for absence of a systematic, standardized mode of health education. Lack of health recognition, and unhealthy cognition and living habits among hypertensive individuals affect blood pressure control and health seriously.Objective1. Learning the status in quo of hypertensive individuals' recognition, emotions and treatment compliance.2. By clinical systematic health education, improving hypertensive individuals' recognition, attitude and level of health behavior, reducing the patients' anxiety, obtaining the effective control of blood pressure, delaying the occurrence of complications, and improving patients' quality of life.3. Investigating the effect of the systematic health education on re-hospitalization rates, incidence of acute cardiovascular events and satisfaction of hypertensive individuals.4. Analysis of quantity was adopted to evaluate the effect of systematic health education on hypertensive individuals, and to provide evidence for setting up a systematic, standardized health education mode.Materials and MethodsThis study adopted a category test design and consists of three stages. Stagel Preparation for study:â‘ To prescribe the standard of selection and exclusion.â‘¡To form the evaluation tools Hypertension Patients' questionnaire, Self-evaluating Scale of Anxiety, Treatment Compliance Scale, Health Education Satisfaction Questionnaire.â‘¢Training of nurses in charge. Stage2:Specific implementation baseline assessment and analysis,Select 266 hospitalized hypertensive patients from our two Cardiac Medical Units (two groups), with the methods of the randomized sampling, and put up the descriptive analysis with the scales above.â‘¡Systematic health educational intervention, According results of the baseline survey, carry through the health education on patients of each group respectively with the systematic health education mode and conventional education mode.Stage3 Evaluation of effects:â‘ The short-term effects evaluation on patients of both groups when discharged. The medium-term effects evaluation on the phone in 6 monthsâ‘¢Do up the data and evaluate the long-term effects in 18 months. Analyse all data by SPSS 12.0.Main Results1. Facet of recognition: Hypertensive patients are commonly unaware of the diagnostic criteria of hypertension, laboratory tests, drugs' side-effects, measurement of blood pressure and easing tensions. After the systematic health education, patients in experimental group has apparently reinforced the recognition in diagnosis of hypertension, salt restriction, easing tensions, overweight, smoking, risk factors, hypertension grading, fundus examination, drugs' side-effects, exercise therapy, measurement of blood pressure and compliance behavior, compared to the control group. Education, gender, and disease duration are the main factors that affect the hypertensive patients' recognition, and the remaining factors have no evident relationship with health recognition scores.2. Facet of anxiety and emotions: The prevalence of anxiety exists among hypertensive patients. According to SAS evaluation, the implementation of psychological intervention and guidance accompanied with health education for patients of experimental group, has ameliorate their emotions prominently than the control group.3. Facet of blood pressure: Generally speaking, blood pressure control of hypertensive patients is not satisfactory. The experimental group with systematic health education, whose systolic and diastolic blood pressures are both well-controlled, show remarkable distinctions to the control group.4. Facet of behavior: The experimental group with systematic health education has progressed greatly at limiting salt intake, exercise, limiting alcohol and quitting smoking, weight control and monitoring blood pressure. The two groups involved have significant discrepancy. More and more people have corrected their bad habits and developed healthy manners.5. Facet of treatment compliance: The treatment compliance, especially the medical compliance, is the main factor that affects blood pressure control. Treatment compliance of the experimental group with systematic health education has improved significantly for the control group.Mono-factor and multi-factor Logistic regression analysis demonstrate that medication compliance of patients is mainly influenced by occupation, hypertension grading and duration, complications, comorbidities and recognition. Cultivation level and medical expenses have no significative relationship to compliance scores.Conclusions and Recommendations1. The recognition of hypertensive patients is vulnerable to gender, cultivation level, and disease duration. We should concern on patients' cultivation level when carrying out health education, should adapt better to patients of different cultivation level, and reinforce the education for the non-professional female populations. As for specialized fields, such as laboratory tests, fundus examination, drugs' side-effects and complications, we should strengthen education gradually.2. Anxious emotions, or even anxiety disorders, are commonly found in hypertensive patients, which have close relations with the prognosis of hypertension. Anxiety affects blood pressure control and the insufficient control of blood pressure in turns lead to worse emotions, which will form a vicious cycle. Psychological intervention and guidance accompanied with systematic health education can effectively relieve anxiety of patients, and are also helpful for blood pressure control. Two groups of patients have remarkable differences. The combination of health education and psychological intervention and guidance is an effective measure to relieve the anxiety of patients.3. Hypertensive patients have not enough recognition on health behavior and lifestyle. Through the systematic health education, patients can rectify their behavior in limiting salt intake, exercise, quitting smoking and limiting alcohol, and monitoring blood pressure. But that in weight control is not prominently different which indicates that it acquires further efforts to convert recognition into attitude, behavior and manners. So we should maintain continuity in systematic health education, and pay close attention to its long-term effects.4. Treatment compliance of hypertensive patients is always unsatisfactory. Medication compliance is mainly impressed by occupation, hypertension grading and duration, complications, comorbidities and recognition. Systematic health education can enhance patients' medication compliance, which is embodied by the significant distinction between the experimental and control groups.5. Mode of systematic health education is worthy to be popularized. The implementation of systematic health education in clinical nursing, can greatly reinforce patients' recognition, improve medication compliance, relieve patients' anxiety, change their lifestyle, form healthy manners and control blood pressure effectively. In a word, systematic health education is feasible and efficient.