The Study Of Self-efficacy Intervention Programme For Hypertensives In Community

ObjectiveTo describe the self-efficacy and treatment compliance in patients with hypertension in community and study the factors that affect self-efficacy. To explore the relationships between self-efficacy and treatment compliance. Our study is to improve the treatment compliance through the six months intervention, so that we can get the theory base for the further prevention of hypertension in community. Methods1. 185 hypertensive patients who met the study criteria were taken by convenient sampling from the result of the study of the sub-subject. Data were collected by the general information questionnaire, blood pressure disease knowledge questionnaire, hypertension psychosocial questionnaire, self-efficacy assessment scale for hypertesnives and the questionnaire of hypertension compliance. To descripe the status of general information, self-efficacy and compliance using descriptive statistical methods. To analyze the relationship between hypertension general information, disease knowledge of hypertension, psychological status and self-efficacy by multiple stepwise linear regression. To explore the correlation between self-efficacy and treatment compliance by spearman rank correlation.2. A nonrandom paired study was carried out in community hypertensives , taking age, sex, disease duration as paired condition. Volunteer participants after basic investigation were individually matched into intervention group (n=46) or control group (n=46). The intervention group received the self-efficacy intervention programme (SIP) while the control group received the brochures and regular nursing. Through the baseline survey and after 6 months intervention recollect the datas by evaluating questionnaire and compare the change of all the score indicators. Before the intervention ,x2 test was used to compare base constitute condition of the two groups. Nonparametric test was used to compare the differences of the self-efficacy, daily self-efficacy, compliance self-efficacy, treatment compliance and the blood pressure. Paired Wilcoxon test was used to anlyse the differences of the hypertensive knowledge, medication self-efficacy, health behavior self-efficacy, medication adherence and non-medication adherence between the two groups before the intervention. Paired Wilcoxon test was used to anlyse the differences of the hypertensive knowledge, self-efficacy and its four parts, compliance , medication adherence and non-medication adherence between the intervention group and the control and the two groups before and after. The blood pressure , body mass index and waist circumference change differences were analyzed by paired T test.Results1. The hypertension knowledge score was at the middle level. The minimum is zero, while the maximum is 10 points, with an average score of 5.84±2.82, and 0.54 out of ratio.2. The score of hypertensive patients's self-efficacy was 29.92±5.47 points, above average, while scoring index was 0.68. The self-efficacy score≤2 points more than half of the total number of projects is self-monitoring of blood pressure (70.27%), reasonable reasonable diet (74.62%), emotional control (50.81%), regular medication (49.19%). Single average score≤2 of the project are: self-monitoring of blood pressure (1.12±1.48), regular follow (1.98±1.26).3. The treatment compliance should be improved. 67.0% (124/185) in terms of drug compliance in patients with partial compliance, 36.2% (67/185) of patients in the non-compliance with aspects of medication non-compliance.4. The factors of self-efficacy in hypertensive were hypertension knowledge score, community resource utilization, whether the spouse with the hypertension, copsing style, living conditions, the current value of systolic blood pressure, while copsing style, living conditions, the current value of systolic blood pressure were the important factor. 5. The self-efficacy is positively correlated with treatment compliance, medication compliance and non-drug compliance. (r=0.750, 0.624, 0.726, p values were <0.01). The four kind of self-efficacy of hypertension and treatment adherence, medication compliance, non-drug compliance was positively correlated. (r=0.209～0.635, p values were <0.01).6. Apply the SIP to hypertensive patients in community.(1) Most hypertensive patients was in the middle to upper level. The score of intervention group of hypertension knowledge, self-efficacy and the four kinds of self-efficacy, treatment compliance, drug compliance and non-adherece intervention group were improved than before, the difference was significant (P﹤0.05).(2) After the intervention,The control group's hypertension knowledge had increased than before, the difference was significant (P﹤0.05). Systolic blood pressure values decreased than before intervention , the difference was significant (P﹤0.05).(3) The socre of self-efficacy and other three kinds self-efficacy, hypertension knowledge, treatment compliance, medication compliance , non-medication compliance were significant (P﹤0.05) between the two groups. Compared to the control group, the blood pressure values, body mass index and waist circumference decreased in the intervention group, differences exist in significant (P﹤0.05).Conclusions1. The level of disease knowledge about hypertension was general, self-efficacy in the medium level, and treatment compliance should be further improved.2. The main influencing factors of self-efficacy are hypertension knowledge score, community resource utilization, whether the spouse with the hypertension, copsing style, living conditions, the current value of systolic blood pressure, while copsing style, living conditions, the current value of systolic blood pressure were the important factor.Therefore, we should strengthen the health education of patients, effective use of community resources and foucs on family and social support, so that we can help patients to build confidence in the disease prevention and treatment in future.3. The self-efficacy and treatment compliance was significantly positive correlated. Therefore, we should improve self-effciacy of hypertensive patients so that the treatment compliance can be improved.4. The self-efficacy intervention programme can significantly enhance the level of self-efficacy and treatment compliancein community hypertensives. Community care should strengthen the suggested treatment compliance and self-efficacy of the intervention. It's meaningful for the community to effectively control hypertension and stalbe blood pressure, reduce BMI .The SIP got positive assessments..