The Intervention Study Of Interaction Model Of Client Health Behavior In The Self-management Of Young And Middle-aged Hypertensive Patients

Objective Select young and middle-aged hypertensive patients in a city in Inner Mongolia to understand the current status of their self-management level;to explore the effect of self-management based on interaction model of client health behavior on the lifestyle and behavior、self-efficacy in hypertensive patients、medication adherence、service satisfaction and objective indicators(BMI and blood pressure)of young and middle-aged hypertensive patients in this urban;to study the feasibility of IMCHB in self-management of young and middle-aged hypertensive patients and provide a reference for enriching the forms and approaches of self-management of middli-aged and young hypertensive patients.Methods A convenience sampling method was used to select 112 young and middle-aged hypertensive patients from the Department of Cardiology of a tertiary hospital in Inner Mongolia from January to March 2022.Hypertensive patients aged 35-60 years were strictly selected according to the inclusion criteria.The random number table method was used to group the samples.A sample of 112 cases was randomly divided into two groups of 56 cases each.The control group was given an educational intervention with usual care.The intervention group implemented an intervention based on the Cox health behavior interaction model on the basis of the control group.Factors influencing patient health behavier were determined based on patient background and dynamic variables.Through nursung-patient interaction,the patient’s internal and external motivation,cognitive evaluation and emotional response were intervened.The content of health education was the same as that of the control group.Before the intervention,the patient’s self-managment behavior level,self-efficacy,medication compliance and service satisfaction were evaluated again 6months after the intervention,and blood pressure and BMI objective indicators were remeasured after 6 months of intervention,which were compared with the control group.The intervention effect of IMCHB-based self-management on self-management behavior level,self-efficacy,medication compliance,service satisfaction,blood pressure control level and BMI in young and middle-aged hypertensive patients in this city was analyzed.The data collected in this study were statistically analyzed using SPSS24.0 software.Results(1)When the final data was collected,3 samples were lost in the intervention group and 2 in the control group,with a final sample size of 107.(2)No significant differences in general social data between the two groups,objective data,self-management behavior level,self-efficacy,medication compliance and service satisfaction between the two groups before intervention(P>0.05),the two groups were comparable.(3)Comparison of scores of hypertension self-management behavior evaluation scale:After the intervention,the total scores of self-management behavior level in the control group and the intervention group were improved compared with those before the intervention,and the differences were statistically significant(P<0.05).The score of diet management dimension in the control group was higher than that before the intervention(P<0.05).The scores in all dimensions of the intervention group were higher than before the intervention(P<0.05).There was a statistically significant difference between the intervention group and the control group in the score of all dimensions and overall score(P<0.05).(4)Comparison of self-efficacy scores in hypertensive patients:After the intervention,there was a statistically significant difference between the intervention group and the control group(P<0.05).The scores of the intervention group were higher than before the intervention(P<0.05).(5)Comparison of medication adherence scores:After the intervention,there was a statistically significant difference between the intervention group and the control group(P<0.05).The scores of the intervention group were higher than before the intervention(P<0.05).(6)Comparison of nursing work service satisfaction scores:After the intervention,there was a statistically significant difference between the intervention group and the control group in the score of all dimensions(P<0.05).(7)Comparison of objective data:After the intervention,there was a statistically significant difference between the intervention group and the control group in the systolic blood pressure,diastolic blood pressure and BMI(P<0.05).The SBP,DBP and BMI in the intervention group were significantly improved compared with before the intervention(P<0.05).Conclusion(1)The self-management behavior level of young and middle-aged hypertensive patients in a city in Inner Mongolia was low,self-efficacy and medication compliance were at a moderate level,the BMI of the overall study subjects exceeded the normal range accounted for61.68%,and more than half of the study subjects were overweight or obese.(2)The nursing intervention based on IMCHB can significantly improve the level of self-management behavior,self-efficacy,medication compliance and service satisfaction of young and middle-aged patients with hypertension,and can effectively improve the blood pressure control level and BMI of patients.(3)Through the analysis of the results of evaluation of the characteristics of young and middle-aged hypertensive patients,the intervention program based on IMCHB is more effective and feasible than the conventional health education intervention for self-management of young and middle-aged hypertensive patients.