| BackgroundHypertension can be controlled only as an incurable chronic non-communicable diseases, with a three year low three is not characteristic, namely "high prevalence, mortality, high morbidity; awareness is low, the treatment rate, control is low; not uncomfortable no medicine, no regular medication, do not love drug "and therefore can not effectively control the disease progression in patients treated with medication.2004global survey showed that men with hypertension, hypertensive patients currently in therapy, blood pressure control was still not satisfactory, China is only28.8%.Our long-standing hypertension management methods are:comprehensive prevention and control of high blood pressure medicine, high blood pressure level management, self-management of hypertension and the latest standardized manage ement approach. Through this study intends to explore the effects of high blood pressure medicine outpatient management standardization achieved.ObjectivesThis study was to investigate the effect of interference in internal medicine standardized management of patients with hypertension and evaluated, provide recommendations for the prevention and control of high blood pressure, provide a theoretical basis for the further promotion of standardized management of hype rtension.ObjectUnder the principle of informed consent and freedom of choice from January2012to December2012in a nursing home medical cadres in Guangzhou City, was diagnosed with hypertension and patients met the inclusion criteria and exclusion criteria, a total of652people.MethodsUsing the method of randomization, the652patients were divided into groups allied health management, standardized management group,general health manage ement group and the control group of four groups, and the use of interventions to per form statistical analysis of the double-blind design of grouping people do not know the situation. After a year of health management, analysis of patients in each group be fore and after the intervention and post-intervention rate of change between the groups of patients with hypertension control rate, taking the rate, the incidence of car dio-cerebral vascular diseases. Using the current application is more mature."Hyper tension treatment compliance Scale","hypertension self-management beha vior eval uation scale","hypertensive patients treated attitudes and beliefs rating scale" to assess the patient’s treatment compliance, self-management behavior ability and trea tment attitudes and beliefs of patients in each group after each intervention and the difference between the pre-intervention scores for intervention effect evaluation.Results After a year of health management, four groups of patients healthy once again and to analyze the treatment of hypertension in patients after the intervention rate in each group, the difference control rate, taking the rate, the incidence of cardio vascular and cerebrovascular diseases between. The results showed that after a year of health management, the differences between the four treatment groups were statistically significant rates of hypertension (χ2=42.072, P<0.001), the differences between the four groups of patients with hypertension control rate was statistically significant (χ2=135.801, P<0.001), the differences between the four groups were statistically significant dose rate (χ2=77.237, P<0.001), the differences between the four groups of hypertensive patients with cardiovascular and cerebral vascular disease incidence was not statistically significant (χ2=5.949, P=0.114).After6months the difference between the intervention and the intervention effect12months after, respectively, with scores of patients with hypertension (intervention six months ratings-pre-intervention scores, intervention12months ratings-pre-intervention rates) said. The results show that compliance, increased significantly before the self-management skills and treatment attitudes and beliefs three scores than the intervention; prompt treatment compliance in patients with hypertension, self-management capacity and attitudes and beliefs in the treatment gradually increased intervention the effect is obvious.Self-management behaviors in patients with hypertension, the first standardized management and general internal medicine and health management two kinds of intervention in patients with hypertension self-management capacity rating no interaction (P=0.592), further analysis revealed that the standardization of the management of patients with medical self-management capacity of the main effect was statistically significant (P<0.001), general health management of the main effects of self-management capacity in patients with no statistical significance (P=0.211); combined effect of the statistical description of the value of the in tervention, the results show less accepted medical standard management the recipient can significantly improve the patient’s ability to self-management behaviors.Hypertensive patients treated attitudes and beliefs, the first analysis of standardized management and general internal medicine and health management groups intervention treatment approach for patients with hypertension and beliefs interact score (P<0.001), further analysis revealed that the standardized management of medical treatment of patients with hypertension individual attitudes and beliefs effect was statistically significant (P<0.001), general health management attitudes and beliefs of individual treatment effects in patients with hypertension also statistically significant (P<0.001); combined effect of the statistical description of the value of the intervention, the results showed less accepted medical standard management accepted medical standard management can significantly improve the treatment of patients attitudes and beliefs, to accept the general health management compared to the general health administration does not accept the same treatment can improve the patient’s attitudes and beliefs, while receiving two health manage ement has obvious joint action.By factorial analysis of variance, with the extension of time for the treatment of patients with intervention adherence, self-management skills and attitudes and beliefs to improve the treatment of the more obvious effects of the intervention on the patient’s interaction with the intervention time there may be prompted to standardized management and general internal medicine and health management to further analyze the interaction depth exploration of intervention effects processing factors, further repeated measures analysis of variance for different interventions before and after treatment of patients in the intervention, after six months of intervention, intervention12months of treatment adherence of repeated measures analysis of variance score showed that patients with treatment adherence, self-management capacity, the effect of therapeutic intervention attitudes and beliefs of the existence of time effect (P<0.001), that is the time to intervene with increasing patient compliance with treatment, self-management capacity, treatment attitudes and beliefs are gradually increased.Conclusions1. Standardized management for improved medical treatment of hypertension patients taking control rate and the rate had a significant effect.2. Standardized medical management of patients with hypertension treatment adherence, self-management capacity and treatment attitudes and beliefs have a significant improvement. General health management of patients with hypertension treatment compliance has improved effect on the attitudes and beliefs of patients needed treatment after the intervention period (6months) can only reflect the effect of the intervention.3. No significant difference between the intervention group and the standardization of the Joint Health Management manager.4. The effect of the intervention factors are present time, namely the time of the intervention in patients with increasing treatment compliance, self-management and treatment capacity gradually improved attitudes and beliefs. |
PDF Full Text Request