Nursing Intervention On Hypertensive Patients In The Community

ObjectiveTo explore the effect of nursing intervention on hypertensive patients in thecommunity.Methods1. We designed the intervention plan according to the reviewed literature of homevisits and Omaha system about hypertension. Seventeen experts were purposefullyselected to participate in a Delphi survey consisting of two rounds.2.130eligible hypertensive patients were separated in two groups randomly as thecontrol group (n=65) and intervention group (n=65), respectively. The interventiongroup was administered behavior intervention in accordance with the plan. Theassessment of the score of treatment compliance and home visit were conducted at thebeginning and6months after the study.Results1. The experts were enthusiastic to be involved in the study, the Cj were100%and93.75%, Cr were0.8603and0.852. Kendall’s W was0.498(x2=156.810，P＜0.001）in the second round.2. There were significant differences in systolic pressure of two group. The bloodpressure was reduced by6mmHg in the intervention group after6months. There werestatistical differences between two groups. Intergroup differences were foundsignificantly as well.3. Significant differences were not reported in treatment compliance. The interventiongroup have14points increased totally6months later. Behavior of following doctors’advices and medicine compliance were evaluated as1point, daily behaviormanagement compliance were9points. There were statistical differences betweentwo groups except tobacco and alcohol behavior.4. Problems ranked top5were circulation （n=122，15.50%）, medicationregimen(n=114，14.48%), health care supervision（n=108，13.72%）, nutrition（n=91，11.56%）and physical activit（yn=82，10.42%）. As to the choice of intervention means, healthcare education, guidance, and enquiry accounted for100%, the biggestproportion, treatments and procedures4.76%, case management7.94%, andsurveillance79.37%.5.The psychosocial domain: for the aspect of interpersonal relationship, circulation,nutrition, physical activity, health care supervision and medication regimen, theknowledge, behavior and status were significantly different in two groups at thebefore and after intervention. However, for the aspect of mental health, complication,sleep and rest patterns and substance use, there was only different in the knowledge.For the aspect of bowel function was different in knowledge and behavior.6. Three factors had significant relationships with knowledge effect for home visit.They were intervention (X7), age (X10) and education (X8). The linear regressionequation was as follows: Y1=0.511X7+0.222X10+0.188X8. Another three factorswere significantly associated with behavior effect for home visit as well. They wereintervention (X7), education (X8) and medical insurance (X5). The linear regressionequation was like this: Y2=0.793X7+0.201X8+0.135X5. Intervention (X7),education (X8) and medical insurance (X5) also had significant relationship withstatus effect for home visit. The linear regression equation was: Y3=0.691X7+0.254X8+0.140X5.Conclusions1. Nursing home visiting intervention program was scientific, applicable and available,which is suitable for patients with hypertension.2. Nursing home visiting intervention program was helpful for lowering the systolicpressure and enhancing patients’ compliance to doctors.3. Nursing home visiting intervention program was favorable in the following aspects,such as finding healthcare problems, designing individual medical treatment, andhelping patients recover better at psychosocial domain, physiological domain andhealth-related behaviors domain.4. The intervention, education, age, medical insurance were significant predictors ofhome visit effect.