| Objectives Guided by the improvement of sleep and emotional state of patients with hypertension,and based on the framework of cognitive behavioral theory,(1)to understand the current sleep and emotional state of patients with hypertension;(2)to understand the cognition of hypertension patients on knowledge related to blood pressure,sleep and emotion;(3)develop a remote AI sleep emotional intervention program for rural hypertension patients.Methods(1)Three administrative villages were selected from taomiao town and quanyang town in jieshou city.Respondents who met the inclusion criteria were recruited for questionnaire survey.(2)The survey included status quo survey,qualitative interview survey and intervention text messages rating survey.The survey included the Pittsburgh sleep scale,the self-rating anxiety scale and the self-rating depression scale.Qualitative interview survey is to interview patients according to the interview outline drawn up in advance to understand their cognition of knowledge related to hypertension,sleep and emotion.The score survey of intervention text messages is to evaluate the content of sleep and emotional intervention text messages designed by literature review method and cross-field consultation meeting method,and then to further improve the intervention content according to the above survey and develop a remote AI intervention program.(3)Spss16.0 and NVivo 11 Plus qualitative analysis software were used to analyze the survey results.Frequency,rate,arithmetic mean and standard difference were used to describe the status quo of sleep,anxiety,depression and intervention messages score.Analysis of variance,multiple linear regression and multiple logistic regression were used to analyze the score of patients on the sleep,anxiety and depression scale.Analysis of variance was used to analyze the score of patients with different demographic characteristics on their understanding of text messages.Results(1)The total average score of the PSQI scale is 8.88.The average scores of the seven dimensions of the scale from high to low are sleep efficiency(2.05 ± 1.19),time to sleep(1.72 ± 1.13),sleep disorders(1.43 ± 0.59),sleep time(1.39 ± 1.23),sleep quality(1.21 ± 0.94),daytime dysfunction(1.02 ± 1.09),hypnotic drugs(0.07 ± 0.59).Patients with different gender,age,education level,years of medication,and complications have statistically significant differences in the overall average score or seven-dimension score of PSQI.(2)Among the patients with hypertension,16.36% have anxiety and 17.09% have depression.12% of the patient have little time to feel like a useful person.12.36% of the patients sometimes have thoughts that others would be better off if they died.20% of patients have little time to feel interested in something they were interested in before.There are statistically significant differences in anxiety and depression scores among patients with different genders,ages,years of medication and complications,and there are statistically significant differences in depression scores among patients with different educational levels.The influencing factors of sleep state include gender,anxiety state and depression state.Sleep and depression were the factors affecting anxiety,and age and anxiety were the factors affecting depression.(3)The average comprehension level of knowledge sleep intervention messages is 1.70,and the average score of "blood pressure affects sleep" is the highest.The overall average of behavioral sleep message comprehension is 1.81,and the average score of "hot feet before bed" is the highest.The average score for sleep message approval is 2.89,while the average score for useful information is 2.82,both close to the full score of 3.The average score for the feasibility of behavioral sleep texting is 2.61,with the highest score being "maintaining the sleep environment."(4)The total score of knowledge-based emotional intervention messages is 1.60,with the highest score is "emotion fluctuation management".The total score of the approval of emotional messages is 2.95,and the total score of the useful messages is 2.99,all of which are close to the full score of 3.The comprehension level of behavioral emotional messages is 1.65,with the highest score being "confiding and releasing emotions".The average score for the feasibility of behavioral emotional messages is 2.85,with the highest score being " concession coping problems ".(5)Hypertension patients have relatively little knowledge about hypertension and a simple way to acquire knowledge.They have a willingness to improve their sleep and emotion state but do not know how to improve it,and have a good evaluation on the voice blood pressure meter.(6)The initial intervention measures include: remote message intervention,remote We Chat public account intervention,smart sphygmomanometer broadcast voice message intervention,production of leaflet intervention,patient-side web page intervention and remote human-machine coupling follow-up feedback.Conclusion The overall sleep status of hypertension patients is poor,and there are many poor sleep behaviors and misunderstandings.In the future,more attention should be paid to sleep efficiency,difficulty in falling asleep,easy waking at night and early waking.There is a significant positive correlation between anxiety and depression and sleep status,and the patients' ability to identify their own psychological problems is poor,and the improvement methods are few.The patients have a poor understanding of the professional words in the sleep emotional message,and a good understanding of the message of action instructions.Knowledge related to hypertension is scarce,and the methods to improve sleep emotional problems are relatively simple.Combined with the theoretical guidance and the investigation results of this study,a comprehensive intervention program is initially developed to improve the sleep emotional state of patients with hypertension and thus control their blood pressure. |
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