| Objective To compare the management effects of Triangle hierarchical management model and psycho-cardiology management model in elderly patients with hypertension,and to further explore a comprehensive management model suitable for elderly patients with hypertension.The aim of this study is to standardize the management of patients,and finally achieve a reasonable allocation of medical resources,improve the treatment compliance of patients,and improve the prognosis and outcome of hypertension.Methods A total of 150elderly patients with essential hypertension who met the inclusion criteria in the outpatient department and inpatient department of a ClassⅲGrade A hospital from June 1,2021 to June1,2022 were selected.The basic data were collected,including age,gender,education level,marital status,living situation,average family monthly income,smoking and drinking habits,etc.Disease data:course of disease,family history,classification of hypertension,types and times of antihypertensive drugs,diabetes mellitus,coronary heart disease,hyperlipidemia,etc.According to the random number table method of statistical software,150 patients were divided into Triangle hierarchical management model group and psycho-cardiology management model group,with 75 patients in each group.The corresponding measures were used for intervention in each group.The blood pressure level,physical examination indexes,Hypertension Treatment Adherence Scale score,Morisky Medication Adherence Scale score,Hypertension Self-Management Behavior Scale score before intervention and 2、5 and 8months after intervention were compared between the two groups.The number of outpatient visits,emergency visits,hospitalization times and average length of stay due to hypertension,and negative emotion score(The anxiety and depression self-rating scales)after 8 months of intervention were compared between the two groups.The data were processed with SPSS26.0 software.Results After 8 months of intervention,The results of patients in the Triangle hierarchical management model group and the psycho-cardiology management model group were as follows:SBP(139.32±9.16 vs 142.46±5.80;F=13.24,P=0.00),DBP(78.38±4.34 vs82.98±7.26;F=11.33,P=0.00),the number of outpatient visits due to hypertension in the past8 months(4.22±1.89 vs 3.11±1.19;t=3.96,P=0.00),emergency department visits(0.23±0.43vs 0.37±0.55;t=-1.54,P=0.00),number of hospitalizations(0.20±0.40 vs 0.63±0.55;t=-4.99,P=0.00),average length of hospital stay(1.08±2.22 vs 2.38±2.66;t=-2.96,P=0.03),hypertension treatment adherence scale score(111.88±4.92 vs 85.65±11.33;F=178.16,P=0.00),Morisiky Medication adherence scale(42 vs 18:27 vs 38;x~2=10.22,P=0.00),Hypertension self-management scale(94.70±11.64 vs 76.80±8.26;F=250.65,P=0.00),and the incidence of anxiety and depression decreased(P<0.05).After 8 months of intervention,the SBP and DBP of the two groups were well controlled,and the number of emergency department visits,hospitalization and average hospitalization days were decreased.The level of the patients in the Triangle hierarchical management model group was lower than that in the psycho-cardiology management model group.The scores of three scales related to hypertension in the two groups were improved,and the scores of the Triangle hierarchical management model group were higher than those of the psycho-cardiology management model group.The anxiety and depression self-rating scale scores of the two groups were improved,and the incidence of anxiety and depression in the psycho-cardiology management model group was lower than that in the Triangle hierarchical management model group,and the differences were statistically significant(P<0.05).Conclusion(1)The Triangle hierarchical management model assists the comprehensive follow-up intervention of non-drug therapy and drug therapy,which can improve the trust between doctors and patients and improve the treatment compliance of elderly patients.At the same time,patients are encouraged to actively participate in the management of their own diseases,increase their initiative,and enable them to realize the identity transformation from treatment object to treatment participant.In terms of improving the treatment compliance,medication compliance and self-management ability of elderly patients with hypertension,the effect of Triangle hierarchical management model is better than that of psycho-cardiology management model.Hierarchical management can increase efficiency and save manpower and material resources.It has the characteristics of comprehensive,efficient and practical,and can be further applied in clinical practice.(2)Psycho-cardiology management model is more effective in improving anxiety,depression and other emotional problems in patients with hypertension.It can relieve the negative emotions of elderly patients with hypertension in a short period of time,reduce the incidence of anxiety and depression,and then reduce the fluctuation of blood pressure caused by negative emotions and psychological stress,so as to achieve the purpose of both psychological and physical. |
PDF Full Text Request