| Objective: This study aims to know the current situation of self-management ability of elderly community hypertensive patients in Liaoning province and their demand for community health education,and to construct a structured health education course for elderly community hypertensive patients by using Delphi Method,and to provide scientific basis for the development of health education for elderly community hypertensive patients.Methods: 1.The cross-sectional survey: Adopt the method of multistage sampling,according to the level of economics in Liaoning province,and choose 420 cases of senile hypertensive patients in six communities of three level cities,taking the blood pressure,blood sugar,blood lipid analyzer,general information questionnaire and investigation of hypertension self-management scale,to understand and analyze the biochemical indexes and the self management ability of community elderly patients with high blood pressure.Data analysis: Excel2013 and SPSS22.0 were used for data analysis.Frequency and composition were used to compare the general data of elderly hypertensive patients in the community for statistical description.Median and quartile were used for descriptive statistical analysis of biochemical indicators and self-management ability of elderly hypertensive patients in the community.2.Qualitative research: Develop two interview outlines of elderly patients with high blood pressure and the community staff through literature review and interviews.Based on principles of data saturation by purpose sampling,we choose a total of 13 elderly hypertensive patients and eight community work personnel in Shenyang,and adopt one-to-one in-depth interviews by using the method of half structured interview.After transcribing the interview recording data,We used content analysis method to analysis data and refine the theme.3.Delphi Method: Based on the current situation investigation and qualitative analysis,combining with domestic and foreign guidelines and literature,the consultation questionnaire of structured health education courses for elderly hypertensive patients in the community was formed.Fifteen experts in community nursing,elderly nursing,chronic disease management,nursing education and other related fields were selected,and two rounds of expert consultations were conducted by E-mail,paper questionnaires and WeChat.Thesoftware Excel2013 and SPSS22.0 were used for data statistics and analysis,and the expert consultation results were tested by using the expert positive coefficient,the expert authority degree,the expert opinion concentration degree and the expert opinion coordination degree.Results: 1.The results of the cross-sectional survey showed that the systolic blood pressure,diastolic blood pressure,blood glucose and total cholesterol of the elderly community hypertension patients in Liaoning province were 148(25)mmHg,82(14)mmHg,7.4(2.9)mmol/L and 4.91(1.63)mmol/L.The self-management score was 78(15),in an intermediate level.2.Qualitative research results show that: The qualitative interview results of elderly hypertensive patients in the community summarized two themes: knowledge needs for hypertension health education and personnel needs for hypertension health education.The results of qualitative interviews with community staff suggest that the health education of elderly hypertension patients in the community should emphasize five aspects: knowledge related to hypertension,drug treatment and management of hypertension,non-drug treatment and management of hypertension,health maintenance of traditional Chinese medicine,and peer education.3.Delphi expert consultation results: the expert positive coefficient of the two rounds of expert consultation were 100%,the expert authority degree was 0.942 and 0.917,and the Kendall'sW expert coordination coefficient was 0.212 and 0.312,respectively.According to the screening criteria of indicators,combined with expert opinions,and after discussion by the research group,the structured health education course for elderly hypertensive patients in the community developed in this study contains 45 teaching objectives and 41 teaching contents of 7 teaching modules.Conclusions: 1.Elderly community hypertensive patients in Liaoning province have higher systolic blood pressure,higher blood glucose level,moderate self-management ability,and lower management level of treatment management and diet and exercise management.It is suggested that the health education of hypertension patients with diabetes should be emphasized when constructing the structured health education curriculum for elderly hypertensive patients in the community,and pay more attention to the change of dietary habits,the effect of antihypertensive drugs and the introduction of side effects.2.Elderly hypertensive patients in the community have increasingly richdemand for health education knowledge,which is different from the content of health education carried out by community medical personnel.In addition,community health education methods should be diversified,focus on the knowledge that are easy to understand,emphasize the spirit of humanistic care.3.The structured health education course for elderly hypertensive patients in the community constructed in this study has the theoretical support of education.The content of the course is consistent with the connotation of structured health education,embodies the people-oriented concept,and is scientific and reliable. |
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