The Evaluation Of Self-management Club For Hypertension Patients In Gushan Town, Fuzhou

Objective Conducting self-management club for hypertension patients in urban and rural area Gushan town, Fuzhou.To know the feasibility and influencing factors of hypertension patients self-management program conducted in urban and rural area,Fuzhou.And to look for hypertension patients self-management model which is suit for Chinese national conditions.Method1. Research object:33 hypertension patients in Gushan town Samp(?)ed by convenience.2. Research method:Conduct hypertension patients self-management club, consist of theory course,practice course and self-management.3. Evaluation method3.1 Quantity evaluation indexMeasure and record general index(blood pressure,height,weight, BMI, waistline) regularly,and evaluate the hypertension control rate. Evaluate the patients' consciousness of hypertension according to the Hypertension Consciousness Scale. Evaluate the patients' medication adherence according to the Medication Adherence Scale. Evaluate the patients' physical condition by Health Status Scale of Traditional Chinese Medicine. 3.2 Qualitative interviewPenetrating interview with 7 club trainees,5 community health center staff in Gushan town,l Health Bureau personnel in Jin An district,2 persons in charge of health education in tertiary hospitals.To know the effect of individual health attitude and behavior due to self-management club. To know the influencing factors of hypertension patients self-management program conducted in urban and rural area. To search for community health management model which is suit for hypertension patients in urban and rural area.Result1. Quantity evaluation result1.1 the shift situation of the patients' medication adherenceThere were 25 patients' medication adherence in good situation,and 7 in bad situation before interference.While there were 29 patients and 1 patient partly after interference. Compared with the situation before interference,the patients'medication adherence demonstrated improvement after interference (P<0.05)1.2 the shift situation of the patients' hypertension consciousness1.2.1 the correct answer rate of hypertension consciousnessThere were high correct answer rates of "normal pressure value"and "should take take medicine under supervision of a physician to control high blood pressure" both before and after interference.And there were no statistical differences (P>0.05). Compared with the rates before interference situation,the correct answer rates improved after interference about "Should measure blood pressure annually", "High blood pressure can cause stroke", "High blood pressure can cause coronary heart disease", "Should regulate diet to control blood pressure ", "Should maintain stable emotions to control blood pressure", "Should be preferably motion to control blood pressure", there were statistical differences.1.2.2 rates of regular blood pressure measureWhile diagnosed with high blood pressure, there were 51.51% patients measuring blood pressure weekly at least,30.03% monthly,6.06% three months one time,and 3 patients (9.38%) didn't remember the situation before interference.After interference all the patients measured blood pressure monthly at least,and 90.32% patients weekly at least,the ratio improved,and there were significant differences (P<0.01)1.2.3 measures taked to control blood pressureThere were 93.94% and 90.32% patients respectively taking drug administration as one of the measures to control blood pressure before and after the intervention.And there were not statistical differences (P>0.05).The proportion of other blood pressure control measures after intervention improved than before intervention.1.3 health conditions changeThe overall health conditions of the patients were better after than before intervention. And only "energy" item's score improved after intervention (P<0.01),while other items'score were no difference compared before and after the intervention.1.4 high blood pressure control rates changeThere were 16 cases(48.50%) who were in "systolic pressure<140mmHg & diastolic pressure<90mmHg" before intervention,while 19 cases(61.30%) after intervention. The hypertension control rate raised,while there were not statistical differences (P>0.05)2. Qualitative interview resultAnalyses of qualitative interview data:the hypertension patients self-management club in Gushan town, Fuzhou can make hypertension patients'"Knowledge Attitude And Practice" change,can increase patients' Chronic disease prevention knowledge,can Improve patients'health beliefs, promote the forming of health behavior,and improve the quality of life. Also it can be one of basic feasible modles for community health center to conduct health education, In order to expand health education focusing. The main Influence factors for health education in urban and rural area:primary level administrative institution gave insufficient attention to chronic disease education. People give few approval to the work of grass-roots medical institution.And there are some factors due to residents in urban and rural area,such as the time for health education, past medical experience,the weather condition, poor cooperation, health education language, dominant interests, wide option. Meanwhile it demonstrates the requirements of residents in urban and rural area and basic-level medical institutions to conduct health education in the modle of chroic self-management club with tertiary hospitals' help.Conclusion1. Health education in community can make hypertension patients' "Knowledge Attitude And Practice" change, improve patients' hypertension consciousness, improve patients' health conditions, while there are no significant changes of the blood pressure control rate2. Self-management club is suitable for hypertension patients in urban and rural area.lt can improve the effect of chroic patients self-management,and improve community medical institution's health education level.