| ObjectiveBy exploring the application of ORTCC model nursing in perioperative blood pressure control level,hypertension self-management behavior,hypertension treatment compliance,hypertension treatment attitude and belief in patients with glaucoma complicated with hypertension,this study aims to obtain a better perioperative blood pressure management model for patients with glaucoma complicated with hypertension and improve the quality of blood pressure management.MethodsThis study adopts the kind of experimental research design.From January2017 to October 2019,100 patients with glaucoma complicated with hypertension were treated by selective operation in ophthalmology of a third Class A Hospital of Changsha City.According to the bed number filled in the patient's admission card,a non-randomized grouping method was used to uniformly stipulate that patients in the first ward were the control group and the second ward as the test group.48 cases in control group were given routine blood pressure management during perioperative period.On the basis of routine blood pressure management,52 cases in the test group applied ORTCC model nursing with fine management,standardized blood pressure management process and health education scheme were formulated from five levels: Objective,Rules,Training,Check and Culture.Before and after the intervention,the patients were investigated with self-management behavior scale,hypertension treatment compliance scale,hypertension treatment attitude and belief scale,and their admission blood pressure,perioperative blood pressure and discharge blood pressure were measured,and the effects before and after the intervention were compared.Excel 2016 is used for dataentry,SPSS20.0 is used for data analysis after double check,and the measured data is tested for normality first.If it meets the normality test,it is described as mean ± standard deviation,and the comparison between the two groups is tested.If it does not meet the normality test,it is expressed as median(Q25,Q75),and nonparametric Wilcoxon test is used.Comparison before and after intervention,such as matching normality test,using paired test,if not matching normality test,using signed rank test.The comparison between the two groups of counting data adopts the test,such as the theoretical frequency is too small,and one fifth of the lattice theoretical frequency is less than 5,so Fisher exact probability method is adopted;P < 0.05 is the difference with statistical significance.Results1.Baseline data comparison: The scores of general data,disease-related data,blood pressure control,hypertension self-management behavior,hypertension treatment compliance,hypertension treatment attitude and belief scores were not statistically significant(P >0.05),baseline was comparable.2.Blood pressure control: The comparison results in the group showed that the perioperative blood pressure and discharge blood pressure of the two groups were lower than those before intervention,and the difference was statistically significant(P < 0.05).Compared with the control group,the blood pressure in the test group was significantly lower than that in the control group,and the difference was statistically significant(P < 0.05).3.Hypertension self-management behavior: The total score that the total score of hypertension self-management behavior and the scores of each dimension in the test group after intervention were higher than those before intervention,and the Z values were-6.279,-6.603,-6.376,-6.389,-6.503,-6.442,-6.222,all of which were P < 0.05,the difference was statistically significant.The total score of hypertension self-management behavior and the scores of each dimension after intervention in the control group were higherthan those before intervention,respectively,and the Z values were-6.037,-6.538,-6.000,-6.081,-5.983,-5.848,-5.664,all of which were P < 0.05,the difference was statistically significant.The results showed that the scores of monitoring,diet management,exercise management dimension and total score were higher than those of control group,and the Z values were-4.217,-2.397,-2.740 and-3.581,all of which were P < 0.05,with statistical significance.After intervention,the scores of medication management,work and rest management and emotion management in the experimental group were higher than those in the control group,the Z values were-0.081,-1.952 and-1.679,but all of which were P > 0.05,with no significant difference.4.Hypertension treatment compliance: The comparison results in the group showed that the total scores and scores of all dimensions of hypertension treatment compliance in the test group after intervention were higher than those before intervention,and the Z values were-6.285,-6.133,-6.341,-6.407,-6.314,and the differences were all P < 0.05,with statistical significance.After intervention,the total scores and scores of all dimensions of hypertension treatment compliance of patients in control group were higher than those before intervention,and the Z values were-6.058,-4.602,-6.093,-6.547,-6.136,and the values were all P < 0.05.The results of comparison between the two groups showed that the total scores and scores of all dimensions of hypertension treatment compliance in the experimental group were higher than those in the control group,and the Z values were-6.237,-5.227,-3.985,-5.901,-5.961,and the values were all P < 0.05,with statistical significance.5.Attitudes and beliefs about hypertension treatment: The comparison results in the group showed that the total scores of attitude and beliefs about hypertension treatment in the test group after intervention were higher than those before intervention,with the Z values of-6.289,-6.401,-6.325,-6.384,-6.405,and the differences were all P < 0.05,with statisticalsignificance.After intervention,the total scores of attitude and belief in treatment of hypertension in the control group were higher than those before intervention,and the Z values were-6.039,-6.106,-6.608,-5.992,-5.938,and the values were all P < 0.05,with statistical significance.Compared with the control group,the dimension scores and total scores of the patients in the experimental group were higher than those in the control group,and the Z values were-4.416,-3.148,-2.418,-3.000,and the values were all P <0.05,with statistical significance.After intervention,the scores of the dimension of concern about continuous treatment in the experimental group were higher than those in the control group,with a Z value of-1.455,but a value of P > 0.05,with no significant difference.Conclutions1.ORTCC mode nursing can effectively improve the blood pressure of patients with glaucoma and hypertension during perioperative period,and has a positive effect on improving the quality of blood pressure management.2.ORTCC model nursing can effectively improve the attitude and belief of hypertension treatment in patients with glaucoma and hypertension during perioperative period,and improve the compliance of hypertension treatment and self-management behavior of hypertension,which has certain clinical feasibility. |
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