作者：李顶峰1 ，邵振莉2 ，陈蕊1 ，刘君1 ，尹海宁3

单位：

1.212001江苏省镇江市，江苏大学附属医院心内科　2.212001江苏省镇江市，江苏大学附属医院护理部　 3.212013江苏省镇江市，江苏大学医学院

Units：

1.Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China 2.Nursing Department, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China 3.School of Medicine, Jiangsu University, Zhenjiang 212013, China

关键词：

高血压；中年人；青年人；跨理论模型；健康管理

Keywords：

Hypertension; Middle aged; Young adult; Transtheoretical model; Health management

CLC：

R 544.1

DOI：

10.12114/j.issn.1008-5971.2023.00.318

Funds：

江苏省科技项目（BK20181227）；江苏大学临床医学专项基金项目（JDLCHL202007）

摘要：

目的　分析基于跨理论模型（TTM）的中青年高血压患者健康管理方案的应用效果。方法　选取2021 年7月—2022年1月在镇江市城区有代表性的社区卫生服务中心（按照所辖区域的范围、服务数量等情况遴选，包括健 康路社区卫生服务中心、京口区大市口社区卫生服务中心、黎明社区卫生服务中心）建档的中青年（19～60岁）原发 性高血压患者240例为研究对象。采用随机数字表法将患者分为对照组和观察组，各120例。对照组采用常规社区健康 管理方案进行干预，观察组在对照组的基础上采用基于TTM的中青年高血压患者健康管理方案进行干预，共干预6个 月。比较两组一般资料及干预前、干预6个月后高血压知识水平量表（HK-LS）评分、高血压病人自我效能评价表评 分、高血压控制率。结果　干预过程中对照组5例患者失访，观察组4例患者失访，最终对照组纳入115例患者，观察 组纳入116例患者。干预6个月后，观察组HK-LS评分高于对照组（P＜0.05）；对照组、观察组干预6个月后HK-LS评 分分别高于本组干预前（P＜0.05）。干预6个月后，观察组高血压病人自我效能评价表评分高于对照组（P＜0.05）； 对照组、观察组干预6个月后高血压病人自我效能评价表评分分别高于本组干预前（P＜0.05）。干预6个月后，观察组 高血压控制率高于对照组（P＜0.05）；对照组、观察组干预6个月后高血压控制率分别高于本组干预前（P＜0.05）。 结论　基于TTM的中青年高血压患者健康管理方案可有效提高中青年高血压患者高血压知识水平、自我效能水平、高 血压控制率。

Abstract：

　Objective To analyze the application effect of health management program for young and middle-aged hypertensive patients based on transtheoretical model (TTM) . Methods A total of 240 young and middle-aged (aged 19-60) patients with primary hypertension who were registered at representative community health service centers in the urban area of Zhenjiang City (selected based on the scope and quantity of services within the jurisdiction, including Jiankanglu Community Health Service Center, Dashikou Community Health Service Center of Jingkou District, Liming Community Health Service Center) from July 2021 to January 2022 were selected as the research subjects. The patients were divided into control group and observation group using a random number table method, with 120 cases in each group. The control group was intervened with the conventional community health management plan, while the observation group was intervened with health management program for young and middle-aged hypertensive patients based on TTM on the basis of the control group. The intervention lasted for a total of 6 months. The general data, Hypertension Knowledge-Level Scale (HK-LS) scores, Self-efficiency Assessment Scale for Hypertensives scores and hypertension control rate before intervention and after 6 months of intervention were compared between the two groups. Results During the intervention process, 5 patients in the control group were lost to follow-up, 4 patients in the observation group were lost to follow-up, and finally, 115 patients were included in the control group and 116 patients were included in the observation group. After 6 months of intervention, the HK-LS score of the observation group was higher than that of the control group (P < 0.05) . The HK-LS scores of the control group and the observation group after 6 months of intervention were higher than those before intervention respectively (P < 0.05) . After 6 months of intervention, the Self-efficiency Assessment Scale for Hypertensives scores in observation group were higher than those in control group (P < 0.05) . After 6 months of intervention, the Self-efficiency Assessment Scale for Hypertensives scores in control group and observation group were higher than those before intervention respectively (P < 0.05) . After 6 months of intervention, the hypertension control rate in the observation group was higher than that in the control group (P < 0.05) . The hypertension control rate of control group and observation group after 6 months of intervention was higher than that before intervention respectively (P < 0.05) . Conclusion The health management program for young and middle-aged hypertensive patients based on TTM can effectively improve the knowledge level of hypertension, self-efficacy level and hypertension control rate of young and middle-aged hypertension patients.

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