The Investigation Quality Of Life And Community Health Care Supplies And Demands Of The Hypertensive Patients In NanChang City

Objective:The subject of the use of qualitative research and quantitative research method of combining quality of life in patients with essential hypertension in Nanchang, the community care supply and demand and its influencing factors for investigation and analysis, complete service projects in Nanchang, service system integrity community hypertension nursing practice to provide a reference, in order to meet the needs of hypertensive patients in our city growing community care, improve and enhance their quality of life.Methods:In this study, Nanchang five urban study site, from March to November of2012, using a combination of quantitative and qualitative research methods, thefollowing investigations:1. Community hypertensive patients:456hypertensive patients were randomlyselected by multi-stage stratified simple random sampling method from5Community Service Center,to investigate their quality of life and community careneeds.2. Community nurses: Use of Stratified sampling method selected40community service agencies (center/station), cluster sampling method to extract the197community nurses the hypertension community care services status quo survey.3. Using the phenomenological method. we selected and interviewed fivemanagers and eleven nurses in the community health center,together with othertwenty-six hypertensive patientswith a semi-structured questionnaire.Questionnaire data collected the establishment of a database application SPSS18.0statistical software for statistical analysis. Count data using frequencycounts and percentages, measurement data using mean and standard deviation.Descriptive statistics analysis, single-factor t test, ANOVA, multiple linear stepwise regression analysis, Pearson ’s correlation analysis and other statistical methods. The interviews use of QRS NVivo9.0software to organize, usingColaizzi method to analyze data.Results:1.(1) The life quality of Nanchang hypertensive patients:(1) Nanchang hypertensive patients overall quality of life score and domain scores were lowerthan the national norm(P <0.05), the field of physiological score (12.15±1.92); The score ofpsychological field (11.98±1.89); Score in the field of social relations(12.07±2.70); The environmental field (11.84±2.04); Overall quality of life score (11.82±1.97).(2)By the multiple linear stepwise regression analysis, the main factors effected the physical score of hypertension patients in Nanchangcity were the existing symptoms,complications, physical exercise, monthly income, regular medication, age; psychological factors in the field were the existing symptoms, monthly income, physical exercise; The field of social relations factors were age, physical exercise, complications; environmental factors in the field were monthly income, regular measurement of blood pressure, age; quality of life score factors were complications, monthly income, physical exercise, course of the disease.2. The demand of community care of the hypertensive patients:(1) Thecare needs of the community hypertensive care patients were at a medium level in Nanchang city (scored3.27±0.63), the need of personal knowledge and skills were highest.(2) The top five of the patients with hypertension community care needs of the project: periodic health examination (84.4%), health records established hypertension (79.6%), The individualized medication safety guidance(77.9%), hypertension basic knowledge (75.2%), to provide freeblood pressure and places (74.3%). Among them, the personal knowledge and skills, patients with the highest demand is to provide individualized medication safety guidance project (77.9%); community support services, the needsof patients is to provide regular health examination (84.4%).(3) The main factors of the impact of high blood pressure in patients with community care needs: education level, monthly income, comorbidities, age. The main factors affect the personal knowledge and skills requirements were existing symptoms,educational level, comorbidities; community support service needs of the main factors were monthly income, educational level, comorbidities.(4) Quality of life and care needs was a negative correlation, the worse the quality of life of the patients, the higher the care needs of their communities in the field.3. Hypertension community care situation:(1) The community nurses average age in Nanchang city (29.1±10.4), the majority of nurses titles and secondary and tertiary education, type of employment contract-based, community-based care is shorter, the current work environment and treatment satisfaction low.(2) From the operating frequency, more than50%of community nurses often do free blood pressure measurement services (68.0%), periodic health examination (67.5%), establishment of health records (57.9%), regular follow-up (51.3%), blood pressure and other self-monitoring and technical guidance (50.8%); project is Not more than half were family bed (55.8%), hypertension Club (52.8%).(3)More than50%of community nurses can master the knowledge and skills were Free blood pressure measurement service (75.6%), the establishment of health records (72.1%), blood pressure self-monitoring and technical guidance (71.1%), periodic health examination (61.4%);most unskilled project were a family bed (62.9%), hypertension Club (50.2%).4. Interview: The service demand side factors,the service provider factors,external environment factors were the influencing factos of hypertension community nursing service.Conclusion:The quality of life of hypertensive patients in Nanchang were lower thanthe national norm, the main factors affecting the existing symptoms, complications, physical exercise, monthly income, medication compliance, age, self-monitoring of blood pressure, duration.Their community care needs were in the middle level, the diversification of demand for community care projects. The community nurses structure in Nanchang was irrational human resources, Nanchang community nurses structure is irrational human resources, the hypertension community care services there is a gap between supply and demand.Therefore, recommends that the Government give priority support policy to further increase investment in community and improve relevant laws and regulations security system; rational allocation of the community care human resources, stable community care team; strengthen the standardized management of the Community hypertensive patients, the establishment of patients with hypertension needs of community care service delivery model to promote the patient ’s trust and support of community care services in order to improve their quality of life.