Application Of Nursing Intervention Based On Common Sense Model In Self-management Of Rural Hospitalized Patients With Hypertension

Objective(1)To investigate and analyze the status quo of self-manangement and its influencing factors of rural hypertensive inpatients.(2)To explore the effect of nursing intervention based on Common Sense Model on the knowledge and cognition level,self-efficacy,self-management behavior,blood pressure,BMI of rural hypertensive inpatients,and provide a certain reference basis for improving the self-management ability of rural hypertensive patients.Methods(1)Conveniently selected 220 rural inpatients with hypertension who were hospitalized in the cardiovascular department of 4 general hospitals in Hengyang from April 2019 to May 2019 for investigation.Through the use of the following 4 research tools "General Information Questionnaire","Hypertension Knowledge Questionnaire","Hypertension Self-Efficacy Scale","Hypertension Patients Self-management Behavior Rang Scale",to understand the knowledge level of rural patients with hypertension,the status quo of self-efficacy and self-management behavior,and analyze the influencing factors of the self-management behavior of rural inpatients with hypertension.(2)Selected 80 rural hypertensive patients who were hospitalized in the Department of Cardiovascular Medicine of the Tertiary Hospital of Hengyang and randomly divided into control group and intervention group with 40 cases each.The control group was given routine hypertension nursing intervention,and the intervention group was given common sense model nursing intervention on the basis of the control group.Before the intervention,the "General Information Questionnaire","Hypertension Knowledge Questionnaire","Hypertension Self-Efficacy Scale" and "Hypertension Patients Self-management Behavior Rang Scale" was used to investigate the general information,knowledge level,Self-efficacy,self-management behavior,blood pressure and BMI,etc.Both groups were followed up by telephone and outpatient clinic for 3 months.After the intervention,the knowledge level,self-efficacy,self-management behavior,blood pressure control level,and BMI of the two groups were compared and analyzed.(3)SPSS 23.0 was used for statistical analysis.The median,quartile,mean,standard deviation,and constituent ratio have been used for statistical description.Statistical analysis was performedusing t test,2 test,non-parametric Mann-Whitney U test,Wilcoxon rank sum test,analysis of variance,multiple linear regression and pearman correlation.To be considered statistically significant was P<0.05.Results(1)The score of self-management behavior of rural hypertensive inpatients was(62.15±13.38),which was in the middle and lower level,and the middle and lower levels accounted for 89.5%.The standardized results of the scores in each dimension showed that the highest score was medication management,which was(67.77±24.27);the lowest score was disease monitoring,which was(56.27±21.50).The disease knowledge awareness rate of rural hypertensive inpatients was only 45%,and the self-efficacy score was(35.61±13.59).Pearson correlation analysis showed that the hypertension knowledge,self-efficacy and self-management behaviors of rural hypertensive inpatients was positively correlated(P<0.01).(2)The results of the single-factor study showed that the patient’s education level,occupation,monthly income,payment method of medical expenses,and classification of hypertension were the influencing factors of the self-management behavior of rural hypertensive inpatients(P<0.05).The five variables that were statistically significant in the above single factor analysis are subjected to multiple linear regression analysis.The results show that occupation,monthly income,payment method of medical expenses,and classification of hypertension were the main influencing factors in the self-management behaviors of rural hypertension inpatients(P<0.05).(3)Between the two groups of patients,there was no statistically significant difference in general information,hypertension knowledge,self-efficacy,self-management and control indicators(P>0.05).(4)After the intervention,the improvement effect of blood pressure,BMI,knowledge,self-efficacy and self-management behaviors of the intervention group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusions(1)The self-management of hospitalized patients with hypertension in rural areas was at a lower middle level.The main influencing factors were occupation,monthly income,payment method of medical expenses,and degree of hypertension classification.Self-management behavior is positively correlated with knowledge level and self-efficacy level.(2)Nursing intervention based on Common Sense Model can improve the cognitive level of rural inpatients with hypertension,enhance self-efficacy,improve self-management behavior,and improve the blood pressure level and BMI of inpatients with hypertension.