| Objective Community intervention were implemented among essential hypertension(EH) patients in Shihezi city in order to change the lifestyle, promote the level of hypertension knowledge,attitude and behavior(KAB), raise the rate of awareness, treatment and control of hypertension, lower the complication of hypertension, provide a novel solution and theory support for the prevent and treatment of chronic disease and hypertension in Shihezi.Methods A cluster sampling was conducted in the 15 community service center in Shihezi city. In the end,757 patients with hypertension who also under archives management by community enrolled. Every patients enrolled in the study got a pamphlet on hypertension prevention and treatment and a cross-sectional study was conducted among them. After the cross-sectional interview study 390 patients with good compliance selected and assigned randomly into traditional three-class management mode(TM), self-management mode(SM) and family management mode(FM) intervention mode. All data were double managed and inputted with the software of Epidata3.1 to validate. Statistical analysis were performed using SPSS21.0, measurement data analyzed by t test, enumeration data analyzed by Chi-squared test, means compared using analysis of variance between groups, multiple factor analyzed using Logistic regression analysis with P<0.05 for the difference was significantly significant.Results 1. Finally, 250 males with an average age(67.98±9.83) years old and 507 females with an average age(66.95±8.55) years old, there were no significant difference between male and female of age with P>0.05. Age diagnosed hypertension of male and female are respectively(54.63±12.20)and(52.49±10.86)years old, there were significant diagnosed age difference between male and female with P<0.05. 2. Our investigation indicated that blood pressure target achievement rate of study population who under standard community management was 41.9%, there were no significant difference between male and female with P>0.05. However, patients with different age, BMI had different blood pressure target achievement rate. The older, the lower blood pressure target achievement rate. 3. Knowledge rate of hypertension of group with blood pressure target achievement was higher than group without blood pressure target achievement with P<0.05. Rate of medication compliance and regular blood pressure monitor of group without blood pressure target achievement was lower than that of group with blood pressure target achievement with P<0.05. 4. Daily salt intake in group with blood pressure target achievement was 7.84±3.79 g, in group without blood pressure target achievement was 9.87±2.81 g, there was significant difference between two group with(t=8.302,P<0.05). 5. Constituent ratio of smoking, drinking, passive smoking of male was higher than that of female but emotional stress and poor sleep quality male was lower than female. 6. Symptoms rate resulted by hypertension of dizziness, dysphoria, and headache of male was 47.1%, 7.6% and 17.6%,which of female was 56.9%, 17.6% and 25.5%. Complication rate of hypertension of myocardial infarction of male was 10.6% significantly higher than female with 4.6%( P<0.05). 7. With the implementation of three community hypertension intervention mode(traditional three-class management, self-management and family management mode), the knowledge rate of hypertension was significantly increased with P<0.05. And occurrence rate of dizziness, blurred vision, dysphoria, headache, TIA and angina in the SM mode decreased with P < 0.05. The symptoms of dizziness,TIA and angina also decreased significantly with P<0.05. However, all symptoms did not changed significantly in the TM mode with P>0.05. 8. After 6 months visits blood pressure decreased significantly compared with the beginning of intervention. In the self-management group DBP and SBP respectively decreased 8.50 mm Hg and 4.20 mm Hg. In the family management group DBP and SBP respectively decreased 5.10 mm Hg and 1.40 mm Hg. In the three-class management group DBP and SBP respectively decreased 3.30 mm Hg mm Hg and 0.8mm Hg. There were significant difference between three different group with P<0.05. 9. Also, after 6 months intervention behavior compliance improved and blood pressure target achievement rate increased. Blood pressure target achievement rate of self-management, family management and three-class management group were 75%, 67.3% and 67.9%. There were significant difference between three different group with P<0.05.And blood pressure target achievement rate of SM higher than FM and TM mode with P<0.0125.Conclusion 1. There were relatively higher blood pressure target achievement rate among patients who under community standard management. Our investigation shows it is 41.9%. While blood pressure target achievement rate was affected by age, BMI, knowledge of hypertension and behavior compliance. 2. Community intervention can improve knowledge of hypertension, increase blood pressure target achievement ratio and decrease complications and symptoms caused by hypertension. Our study shows that after 6 months intervention self-management mode can change behavior compliance, lower blood pressure, reduce complications caused by hypertension and increase ressure target achievement ratio better compared with the other two group(family management and three-class management group). |
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