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目的探索高校社区有效可行的高血压自我管理模式。方法按照社区随机对照试验研究设计,将226名自愿参加该项目的高血压患者,随机分为自我管理组(实验组)和三级管理组(对照组)。实验组接受高血压自我管理健康教育课程。课程讲授不单纯是面授,还建起专题学习网站,供工作太忙无法参加面授学习的患者及家属,尤其是青中年患者上网学习。全部课程完毕,发放效果评价调查表和知识测评答卷,了解到学习已达到预期效果。在学习同时还进行自我管理小组活动,以后长期坚持,完成三个方面的有关任务。对照组接受常规的高血压三级管理。比较两组患者在项目实施1年之后各评价指标的变化。结果实验组生活不良行为高盐饮食、过量饮酒、缺乏运动平均下降值大于对照组(P(0.05),服药依从性、血压、血脂控制均好于对照组(P(0.01),差异均有统计学意义。结论社区高血压自我管理模式较传统的高血压三级管理在改善患者不良生活行为,提高服药依从性,血压、血脂控制方面效果更好。
Objective To explore the effective and feasible hypertensive self-management model in college community. Methods According to the community randomized controlled trial design, 226 hypertensive patients who volunteered to participate in the project were randomly divided into self-management group (experimental group) and tertiary management group (control group). The experimental group received hypertension self-management health education course. Course teaching is not simply a face to face, but also set up special study sites for those who work too busy to participate in face-to-face learning of patients and their families, especially young middle-aged patients online learning. After the completion of the course, the evaluation questionnaire on performance evaluation and the questionnaire on knowledge assessment were released and it was learned that the learning has reached the expected result. At the same time, we also conduct self-management group activities while continuing to carry out the tasks in three aspects after a long period of time. The control group received routine tertiary hypertension management. The changes of each index in two groups after one year of project implementation were compared. Results The adverse reactions in the experimental group were higher than those in the control group (P <0.01), the high-salt diet, excessive alcohol consumption, and the lack of exercise decreased more significantly than those in the control group (P <0.05) Significance of community hypertension self-management model than the traditional three-level management of hypertension in improving the bad behavior in patients with improved medication adherence, blood pressure, blood lipid control better.