The Case Study Of Health Management For Hypertensive Patients In A Community,Chenggong District Of Kunming City

ObjectiveThe purpose of the study was to understand the hypertension-related knowledge, patients with the control of blood pressure and the compliance situation of the disease in a community. And learn the land use change on the influence of patients’health, life, work, etc. And according to the data available, analysis and explore the influence factors of community management of hypertension patients, provide a reference basis for hypertension control in community work.MethodThis study was a case study, with a self-administered questionnaire was conducted among hypertensive patients base on the health records at the health service center selected randomly, and the quantitative data collection on patients with high blood pressure in face-to-face. Using semi-structured interview outline, for group interview or key figures interviews the qualitative data collection. The data collected in the past of the community. The characteristics of the hypertensive patients and the predictors of participation were analyzed by chi-square test and by logistic regression. Using content analysis, using MAXQDA2007qualitative analysis software and Excel software input and organize the content of the interview.ResultsThere were a total of738people in this study, including230males and508females, its age range from18to92years, mean age65.2years (65.22±11.7years). Han residents, accounting for92.0%, the rest is Muslim. In the majority with primary school education, accounting for52.7%, followed by elementary school (27.1%), junior high school (16.1%), high school and above (4.1%). Married people accounted for78.7%, unmarried, divorced, separated and widowed accounted for21.3%. Professional agricultural labor predominantly, accounting for83.3%. Medical services of payment of the new type of rural cooperative medical care mainly accounted for99.6%, medical expense accounts for0.3%, commercial insurance accounted for0.1%. In the survey, family per capita monthly income of1000yuan accounted for36.0%, the per capita monthly income of1001-2500yuan for the majority,38.2%,25015000yuan accounted for2.0%, and23.8%refuse to answer.There were110patients in the interview. There were farmers, accounting for90%, rest were3teachers,2medical workers,2community cadres,2self-employed, and2people did community cleaning job.The survey knowledge pass rate was36.4%(269/738). By chi-square test show the hypertensive patients with different ethnic, age group, education level and income of the statistically significant difference in knowledge passing situations (P<0.05). Hui is considered slightly better awareness of hypertension in Han, patients over the age of70disease awareness is not ideal, patient-related knowledge mastery of junior high school education is much better. By logistic regression, the results showed that the level of education, health, self report and balance with diabetes are the main factors influencing the hypertension knowledge, with the higher cultural level, knowledge mastering of hypertension is higher. Patients with oneself in good health, disease knowledge were better. Can be thought of as both diabetic patients pay more attention to their own healthy body, the mastery of knowledge of disease also relatively sound (OR=1.400, P=0.001; OR=0.762, P=0.016; OR=2.058, P=0.002), but factors such as gender, ethnic and age, there is no statistical significance (P>0.05).There were634cases in the study were taking drugs for treatment of hypertension, that the treatment rate of85.9%. By logistic regression, the results showed that the self-reported health, doctors told disease and the influence factors of knowledge to pass the exam is patients taking blood pressure medication, that can be thought that self health good patient, taking blood pressure medication compliance. The doctor informed patient is ill urged patients taking effective factors. Hypertension related knowledge to master good patients can be more consciously taking blood pressure medication (P<0.05).In the survey using a unified standard blood pressure measurement of blood pressure, blood pressure is normal in248cases, the control was33.6%(248/738). Blood pressure control in patients with normal or not with nationality, age groups was statistically significant difference (P<0.05). By logistic regression, the results showed that gender, nationality, age group and educational level are main factors affecting hypertensive patients blood pressure control is normal or not (OR=0.690, P=0.045; OR=0.444, P=0.006; OR=0.731, P=0.000; OR=0.761, P=0.008). The hui’s blood pressure control is better than that of the han nationality. Women’s blood pressure control is better than that of male. Older good blood pressure control of the younger, more than80-year-old age group the highest blood pressure control rates. With the higher cultural level, the control of blood pressure is better.In the survey, there were16.1%patients smoking. By logistic regression, the results showed gender, nationality, age group is the main factors influencing the patients with high blood pressure smoking (OR=0.003, P=0.000; OR=0.015, P=0.367; OR=0.783, P=0.043). That can be thought more men than women smokers significantly. Hui smoke more than the han nationality. As the growth of the age, there were less smokers.In the survey, there were8.7%patients drinking. By logistic regression, the results showed gender, age group is the main factors affecting hypertensive patients drinking (OR=0.010, P=0.000; OR=0.734, P=0.017). That can be thought more men than women drinkers significantly. As the growth of the age, there were less drinkers.ConclusionThe community hypertension patients, mainly the elderly hypertension related knowledge level is not ideal. Literacy is the main factors influencing patients command of knowledge is, the junior middle school culture level of patients with high blood pressure to pass knowledge to master the best. Both patients with diabetes, the disease knowledge to master degree is better also. The medication compliance of hypertension patients in community is better, but poor blood pressure control rates. Smoking, drinking alcohol is a risk factor for hypertension, after investigation and the results suggest that community workers should focus on publicity and education on the ethnic differences.