Research On The Application Of Multi-disciplinary Collaborative Intervention Based On The ITHBC In Elderly Hypertensive Patients

ObjectiveTo understand the status of disease knowledge,treatment compliance and quality of life in elderly hypertensive patients;to analyze the influencing factors of treatment compliance in elderly hypertensive patients;to explore the influence of nurse-led multidisciplinary collaborative intervention on disease knowledge,treatment compliance,quality of life and blood pressure level of hospitalized elderly patients with hypertension under the guidance of The Integrated Theory of Health Behavior Change(ITHBC),so as to provide scientific basis for improving treatment compliance of elderly patients with hypertension.Methods(1)During the period from November 2018 to March 2019,220 hospitalized elderly hypertension patients in a third-class hospital of Guilin were conveniently selected.The general information questionnaire,the score questionnaire on hypertension related knowledge,therapeutic adherence scale for hypertensive patients(TASHP),and China questionnaire of quality of life in patients with cardiovascular diseases(CQQC)were used as research tools to learn about the disease related knowledge level,treatment compliance and life quality level of elderly hypertension patients,and to analyze the factors affecting the treatment compliance of elderly hypertension patients.(2)It is convenient to select 85 elderly hypertension patients hospitalized in the department of cardiology from March to July 2019 as the intervention objects,and divide them into the control group and the intervention group according to the time of admission.42 patients in the control group received routine nursing,and 43 patients in the intervention group received multidisciplinary cooperative intervention led by nurses on the basis of the control group.Patients' disease knowledge,treatment compliance,quality of life and blood pressure level were evaluated before,at the end of 3 months,and at the end of 6 months.All data collected were processed by SPSS22.0 software.Description statistics were used for means,standard deviations,frequency distribution.Statistical analysis were used by t-test,chi-square,analysis of variance,H-test and multiple linear regression.Results(1)The total score of TASHP was(90.88±9.59),which was at a moderate level.The dimensions from high to low are medication compliance behavior(4.42±0.48),tobacco and alcohol management behavior(4.27±1.19),bad medication behavior(4.13±0.63),and daily management behavior(2.72±0.35).The total score of CQQC was(64.20±11.34),which was at a low level.The total score of knowledge was(5.22±3.08).Among them,the question "Is hypertension a lifelong disease?" gets the highest awareness rate(awareness rate is 76.4%),The rate of the question "Is hypertension related to insufficient physical activity?" is the lowest(awareness rate is 30%),suggesting that patients do not have a good grasp of disease knowledge.(2)The main factors influencing the treatment compliance of elderly hypertensive patients are education level,age,gender,knowledge about hypertension,medical payment method,hypertension classification and admission blood pressure value.(3)Before the intervention,there was no statistically significant difference between the intervention group and the control group in general demographic data,hypertension-related knowledge score,treatment compliance score,quality of life score,andadmission blood pressure value(P>0.05).(4)After the intervention,the total scores of disease-related knowledge,treatment compliance,and quality of life of the intervention group were significantly higher than that before the intervention(P<0.001);the systolic and diastolic blood pressure levels were significantly lower than that before the intervention(P<0.001).The total scores of disease-related knowledge and treatment compliance of patients in the intervention group were significantly higher than those of the control group(P<0.001),the total score of quality of life was higher than the control group(P=0.024),and the level of systolic blood pressure was significantly lower than that of the control group(P=0.007).Conclusions(1)The treatment compliance of elderly hypertensive patients is generally at a medium level,with education level,age,gender,knowledge about hypertension,medical payment methods,hypertension classification and admission blood pressure value are the main influencing factors.(2)The quality of life of elderly hospitalized elderly patients with hypertension is generally at a low level,and the knowledge about hypertension is not optimistic.(3)Under the guidance of The Integrated Theory of Health Behavior Change,multidisciplinary collaborative intervention led by nurses can provide patients with more professional and targeted health education guidance,which can effectively improve the disease-related knowledge level,treatment compliance,and the quality of life of elderly hypertensive patients and blood pressure control levels.