Influence Of Protection Motivation Intervention Model On Self-management Behavior Of Middle-aged And Elderly Patients With Hypertension In Community

Objective:(1)To understand the status quo and related factors of self-management behavior in middle-aged and elderly patients with hypertension in community.(2)Based on the protection motivation theory,to evaluate the effects of protection motivation intervention on self-management behavior,self-management efficacy,blood pressure and BMI of middle-aged and elderly patients with hypertension in community.Method:The first stage was a cross-sectional study,361 middle-aged and elderly patients with hypertension selected from two community health service centers in Hefei by convenience sampling from May to October in 2015 were investigated,and analyzed the related factors of the self-management behavior.The second stage was a quasi-experimental research,based on the first stage,126 middle-aged and elderly hypertensive patients whith standardized score below 80 were recruited and assigned into intervention group and control group according to their community by cluster randomization.60 individuals in the control group only received routine community care while 66 individuals in the intervention group were given protection motivation intervention.Self-management behavior,self-management efficacy,blood pressure and BMI were assessed before and after 6 months of intervention.Results: First stage:(1)The score of self-management behavior in the middle-aged and elderly patients with hypertension was(115.77±22.07),and the standardized score was69.98.Medication management behavior got the highest score which was 80.90 while disease surveillance behavior got the lowest score which was 57.85.(2)Multivariate stepwise regression analysis showed that age,history of hospitalizaion,smoking and BMI were the main relevant factors associated with self-management behavior of middle-aged and elderly hypertensive patients in community.Second stage:(1)After intervention the scores of self-management behavior and self-management efficacy in the intervention group were remarkably improved and significantly higher than those in the control group(P<0.05).(2)After intervention the level of systolic pressure,diastolic pressure and BMI in the intervention group were decreased and significantly lower than control group(P<0.05).Conclusions:(1)The self-management behavior of middle-aged and elderly patients with hypertension in community at the moderate level.Age,history of hospitalization,smoking and BMI are the main relevant factors for self-management behavior of middle-aged and elderly patients with hypertension in community.Primary care workers should be concerned with the patients who are relatively younger and have no history of hospitalization and analyze the reasons for maintaining smoking habits,overweight and obesity.Targeted interventions should be adopted to improve the self-management behavior of middle-aged and elderly patients with hypertension in community.(2)Protection motivation intervention can effectively improve selfmanagement behavior and self-management efficacy of middle-aged and elderly patients with hypertension in community,help patients control blood pressure and BMI better.