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自用家庭血压监测对高血压基层医疗患者的影响:一项定性研究。

The influence of self-owned home blood pressure monitoring (HBPM) on primary care patients with hypertension: a qualitative study.

机构信息

Department of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

BMC Fam Pract. 2011 Dec 30;12:143. doi: 10.1186/1471-2296-12-143.

Abstract

BACKGROUND

Home blood pressure monitoring (HBPM) is gaining popularity among hypertensive patients. This study aimed to explore the influence of self-initiated HBPM on primary care patients with hypertension.

METHODS

Six in-depth interviews and two focus group discussions were conducted, taking into consideration the experiences of 24 primary care patients with hypertension. These patients had been using HBPM as part of their hypertension management. The overriding influences were grouped under themes which emerged from analyzing the data using the grounded theory approach.

RESULTS

There are both positive and negative influences of self-initiated HBPM. Patients used the readings of their HBPM to decide on many aspects of their hypertension management. The HBPM readings both influenced their adherence to diet and exercise and provided certain reassurance when they experienced symptoms. In addition, the act of discussing their HBPM readings with their health care providers resulted in an enhanced doctor-patient therapeutic relationship. Nevertheless, HBPM created confusion at times in some patients, particularly with regard to the target blood pressure level and the need for medication. This led to some patients making their own medical decisions based on their own standards.

CONCLUSIONS

HBPM is becoming an integral part of hypertension management. Primary care patients who self-initiated HBPM reported being more self-efficacious, but lack of participation and guidance from their doctors created confusion, and hindered the true benefit of HBPM.

摘要

背景

家庭血压监测(HBPM)在高血压患者中越来越受欢迎。本研究旨在探讨自我启动 HBPM 对初级保健高血压患者的影响。

方法

考虑到 24 名高血压初级保健患者的经验,进行了 6 次深入访谈和 2 次焦点小组讨论。这些患者一直在使用 HBPM 作为其高血压管理的一部分。使用扎根理论方法分析数据后,将主要影响因素分为主题。

结果

自我启动 HBPM 既有积极影响,也有消极影响。患者根据 HBPM 的读数来决定高血压管理的许多方面。HBPM 读数既影响他们的饮食和运动依从性,又在他们出现症状时提供一定的安慰。此外,与医疗保健提供者讨论他们的 HBPM 读数增强了医患治疗关系。然而,HBPM 有时会在某些患者中造成混淆,特别是在目标血压水平和药物治疗需求方面。这导致一些患者根据自己的标准做出自己的医疗决策。

结论

HBPM 正在成为高血压管理的一个组成部分。自我启动 HBPM 的初级保健患者报告说自我效能感更高,但缺乏医生的参与和指导会造成困惑,从而阻碍 HBPM 的真正益处。

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