Application Of Nursing Intervention Based On Positive Psychological Theory In Self-Management Of Community Patients With Hypertension

ObjectiveTo investigate the status quo of disease knowledge,self-management behavior and subjective well-being in community patients with hypertension and analyze their influencing factors;To explore the effect of nursing intervention based on the theory of positive psychology on disease knowledge,self-management behavior,subjective well-being and blood pressure levels in community patients with hypertension and to provide reference for improving self-management ability of patients with hypertension in the community.Methods(1)A multi-stage sampling method was used.Firstly,cluster sampling method was used to select four communities from Hengyang,then 220 patients with hypertension were selected by random number table method.The status of hypertension knowledge,self-management behavior and subjective well-being were evaluated by general information questionnaire,hypertension knowledge scale,hypertension self-management behavior scale and general well-being scale.(2)Two communities were selected as the intervention group and the control group by lottery method.40 patients in each group who established health records in the two community health service centers were selected according to the random number table method.The control group received routine treatment and nursing,including hypertension knowledge,blood pressure monitoring,and guidelines for diet,medicine,and exercise.The intervention group received nursing intervention based on positive psychological theory on the basis of the control group.Use the general information questionnaire,hypertension knowledge scale,hypertension self-management behavior scale and general well-being scale to assess the level of disease knowledge,self-management behavior,subjective well-being and blood pressure.All analysis were performed using SPSS 19.0.Description statistics were calculated for means,standard deviations and composition ratio.Statistical analysis were performed by t-test,chi-square test,Mann-Whitney U test,One-way ANOVA test,multiple linear regression analysis and spearman correlation analysis.Results(1)The total score of self-management behavior was(67.30±10.41),and the scoring rate of index was 64.10% at a moderate level.29.09% of patients had a low level of self-management behavior,10.91% of patients had a high level of self-management behavior.The highest score was for the risk factor management dimension and the lowest score was for treatment management dimension.The score of hypertension knowledge was(5.77±2.54)and the subjective well-being score was(75.70±12.19).Spearman correlation analysis showed that the self-management behavior were positively correlated with hypertension knowledge(r=0.402,P<0.01)and subjective well-being(r=0.502,P<0.01).(2)One-way ANOVA test showed that the score of self-management behavior was significantly different between different age,occupation,education level,living condition,monthly income per person,medical payment,course of disease,hypertension level,and the number of complications(P<0.05).The multiple linear regression analysis showed that education level,age,hypertension level,medical payment,living condition were the main factors influencing the self-management behavior of community hypertensive patients.(3)Before the intervention,the control group and the intervention group had no statistical difference in demographic data,hypertension knowledge score,self-management behavior score,subjective well-being score,systolic and diastolic blood pressure scores(P>0.05).(4)After 6 months of intervention,the two groups had significant difference on the scores of hypertension knowledge,self-management behavior,subjective well-being,systolic and diastolic blood pressure(P<0.05).Compare two groups before and after intervention,the scores of hypertension knowledge and systolic blood pressure of the control group had significant difference(P<0.05),the intervention group had significant difference on the scores of hypertension knowledge,self-management behavior,subjective well-being,systolic and diastolic blood pressure(P<0.05).Conclusion(1)The self-management behavior of patients with hypertension in the community are generally at a medium level.Multivariate linear regression analysis showed that education level,age,hypertension level,medical payment and living condition could predict the patients' self-management behavior.The self-management behavior were positively correlated with the hypertension knowledge and subjective well-being.(2)Nursing intervention based on the theory of positive psychology could effectively improve the level of hypertension knowledge,self-management behavior,subjective well-being and blood pressure in community hypertensive patients.