Application Of Mindfulness Therapy In The Nursing Of Patients With Essential Hypertension

Objective:To explore the effect of mindfulness therapy on clinical blood pressure and anxiety symptoms,self-efficacy and mindfulness in patients with hypertension.Methods:The first part of the systematic evaluation and Meta-analysis.A computer-based search of medical and psychological databases was conducted to find randomized controlled trials of the effect of mindfulness therapy on clinical blood pressure values in the patients with hypertension.The basic information of the included literature was described,and the quality of its methodology was evaluated.Meta analysis was performed with RevMan5.3 software.The second part of the intervention study.This study was an interventional study.Eighty patients with essential hypertension who were admitted to the Affiliated Hospital of Yan'an University from May 2018 to October 2018 were selected for interventional study.80 subjects were divided into experimental groups using a random number table.With the control group,40 patients in each group.The control group received general hypertension health education and routine nursing.The experimental group implemented mindfulness therapy on the basis of general hypertension health education and routine nursing.Evaluation of anxiety in hypertensive patients by Self-Rating Anxiety Scale(SAS),General Self-Efficacy Scale(GSES),and Five Facet Mindfulness Questionnaire(FFMQ)Symptoms,self-efficacy,and the level of mindfulness were compared before the intervention,4 weeks after the intervention,8 weeks after the intervention,and 1 month follow-up.The clinical blood pressure,heart rate,SAS,GSES,and FFMQ scores were compared between the two groups.Results:The first part:systematic review included 7 studies,divided into the mindfulness group,the exercise group and the routine care group,a total of 625 subjects.Meta-analysis showed systolic blood pressure(SMD=-1.39 mmHg,95%CI(-2.28,0.51),P<0.01)and diastolic blood pressure(SMD=-1.31 mmHg,95%CI(-2.03,0.32),P<0.01)was lower than the control group,and the antihypertensive effect of the mindfulness group was better than that of the exercise group(P<0.001).Subgroup analysis showed that the antihypertensive effect of 13 weeks of mindfulness therapy was better than that of the 8-week control group.The antihypertensive effect of mindfulness therapy combined with drug therapy was better than that of the drug-only control group(P<0.01).The second part:the general demographic data,the characteristics of primary hypertension and the state of medication,the state of anxiety and the baseline level of the mindfulness background of the two groups in the intervention study were consistent,the difference was not statistically significant,and comparable.By comparing the clinical blood pressure values and heart rate of the two groups,the results showed that there was no difference between the systolic blood pressure of the experimental group and the systolic blood pressure of the control group after 4 weeks of intervention and 1 month of follow-up(P>0.05),but for the experimental group.After 8 weeks of intervention in mindfulness therapy,the systolic blood pressure of the experimental group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The diastolic blood pressure of the experimental group was low after 4 weeks,8 weeks,and 1 month of follow-up.In the control group,it was statistically significant(P<0.05).In addition,the comparis-on of FFMQ,SAS and GSES in the two groups showed that the total FFMQ score and GSES score of the experimental group were significantly higher than that of the control group after 4 weeks,8 weeks and1 month of follow-up,and the score of SAS was lower than that of the control.Groups,the differences were statistically significant(P<0.01).Data entry was performed using Epidata 3.1 and statistical analysis was performed using SPSS 22.0 software.The statistical description of the data uses the mean,standard deviation,etc.Statistical analysis uses two independent sample t test,?~2 test and so on.Conclusions:Mindfulness therapy can stabilize the clinical blood pressure level of the patients with mild to moderate primary hypertension,and appropriately extend the intervention time of mindfulness therapy,and the effect of mindfulness therapy combined with drug therapy on hypertensive patients is more significant.Mindfulness therapy can reduce blood pressure,reduce anxiety symptoms,and improve patients'mindfulness and self-efficacy.