Kim Miyong T, Han Hae-Ra, Park Hyun Jeong, Lee Hwayun, Kim Kim B
School of Nursing, Johns Hopkins University, Baltimore, MD 21205-2110, USA.
J Cardiovasc Nurs. 2006 Mar-Apr;21(2):77-84. doi: 10.1097/00005082-200603000-00002.
Although significant progress has been made in the reduction of overall cardiovascular risk factors in the United States during the last decade, controlling high blood pressure (HBP) remains a difficult task for many individuals. In particular, socially disadvantaged groups, such as new immigrants, and ethnic minority groups, such as Korean Americans, continue to struggle with this chronic disease and suffer unnecessary complications. We conducted a quasi-experimental study to test the efficacy of a self-help intervention program for HBP control in first-generation Korean American seniors with HBP. The intervention consisted of 3 concurrently administered components: (1) structured behavioral education on HBP management, (2) home blood pressure (BP) monitoring, and (3) monthly support groups facilitated by a bilingual nurse. Of the 49 Korean American seniors (> or =60 years old) who agreed to participate, 31 received the intervention and completed the follow-up interviews at 6 months. Final analysis of BP outcomes using repeated measures and postintervention data suggested that the self-help intervention was effective in significantly improving the proportion of individuals who achieved BP control (<140/90 mm Hg) and in lowering both systolic and diastolic BP in the sample. Specifically, the BP control rate, which was 29% at baseline, increased at 6 months to 69%. Likewise, the mean systolic and diastolic BP values of 142.7 and 87.1 mm Hg at baseline decreased to 129.3 and 75.3 mm Hg, respectively, after 6 months of follow-up. This improvement of the HBP control rate in the sample highlights the clinical efficacy of the self-help intervention for this traditionally underserved immigrant group.
尽管在过去十年中，美国在降低总体心血管危险因素方面取得了显著进展，但对许多人来说，控制高血压仍然是一项艰巨的任务。特别是社会弱势群体，如新移民，以及少数族裔群体，如韩裔美国人，仍在与这种慢性病作斗争，并遭受不必要的并发症。我们进行了一项准实验研究，以测试一项自助干预计划对患有高血压的第一代韩裔美国老年人控制血压的效果。干预措施包括同时实施的三个部分：（1）关于高血压管理的结构化行为教育；（2）家庭血压监测；（3）由一名双语护士主持的每月支持小组。在同意参与的49名韩裔美国老年人（≥60岁）中，31人接受了干预，并在6个月时完成了随访访谈。使用重复测量和干预后数据对血压结果进行的最终分析表明，自助干预有效地显著提高了实现血压控制（<140/90毫米汞柱）的个体比例，并降低了样本中的收缩压和舒张压。具体而言，基线时的血压控制率为29%，6个月时升至69%。同样，随访6个月后，基线时收缩压和舒张压的平均值分别为142.7和87.1毫米汞柱，降至129.3和75.3毫米汞柱。样本中高血压控制率的提高突出了这种自助干预对这个传统上未得到充分服务的移民群体的临床疗效。
