So Ae-Young, Kim Yun-Mi, Kim Eun-Young, Kim Chang-Yup, Kim Cheol-Hwan, Kim Hee-Gerl, Shin Eun-Young, Yoo Weon-Seob, Yi Ggod-Me, June Kyung-Ja
Department of Nursing, Kangnung National University, Wonju, Korea.
J Korean Acad Nurs. 2008 Dec;38(6):822-30. doi: 10.4040/jkan.2008.38.6.822.
The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community.
The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence.
Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months.
The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.
本研究旨在分析一项针对社区高血压患者的社区病例管理项目的效果。
研究设计为单组前后测设计,有30名高血压患者同意参与2002年由国民健康保险机构的病例管理人员提供的为期8 - 12周的病例管理项目。在病例管理服务前后以及6个月后共收集三次数据。结果包括血压变化、高血压知识以及日常生活习惯,如饮酒、吸烟、运动和药物依从性。
重复测量方差分析和均值的事后检验显示,服务前后在收缩压、日常生活习惯(监测体重和血压、低盐低脂高蔬菜饮食以及减压措施)和运动方面存在显著差异。服务后达到了药物依从性目标。从基线到服务后6个月,饮食中的盐和蔬菜摄入量指标有显著改善。服务前后以及6个月时,高血压知识、饮酒或吸烟行为方面没有显著差异。
研究结果提供了初步证据,表明病例管理干预对高血压患者的血压控制、日常生活习惯、运动和药物依从性可产生积极效果。然而,需要额外的干预措施来维持长期效果。