Hae-Ra Han, PhD, RN, FAAN Associate Professor, School of Nursing, Department of Community and Public Health, the Johns Hopkins University, Baltimore, Maryland. Hee-Jung Song, PhD Assistant Professor, College of Agriculture and Natural Resources, Department of Nutrition and Food Science, University of Maryland, College Park. Tam Nguyen, PhD, RN, MPH Research Associate, School of Nursing, Department of Community and Public Health, the Johns Hopkins University, Baltimore, Maryland. Miyong T. Kim, PhD, RN, FAAN Professor, School of Nursing, Department of Community and Public Health, the Johns Hopkins University, Baltimore, Maryland.
J Cardiovasc Nurs. 2014 Jan-Feb;29(1):55-67. doi: 10.1097/JCN.0b013e3182775fd1.
High blood pressure (HBP) self-care is critical for the control of HBP. Adequate measurement of HBP self-care is a necessary first step toward ameliorating the global pandemic of HBP.
The aims of this study were to identify, describe, and critique existing HBP self-care instruments. The degree of adequacy of these instruments was evaluated against well-established behavioral guidelines for HBP care.
This review was limited to articles published in English before October 2012. In addition, the following criteria were used: (1) the study described the validity and/or the reliability of a self-care/self-management instrument and (2) the study targeted patients with hypertension. Electronic database searches identified 1701 potentially relevant articles. Two authors reviewed the titles and the abstracts of all the retrieved articles independently. On the basis of the inclusion and the exclusion criteria, as well as cross-referencing, 29 articles were included in this review.
From the 29 articles, 19 unique HBP self-care instruments were identified (some were modified or translated versions of an original measure). Medication taking, a key domain of HBP self-care, was the main focus of 12 of the 19 instruments. Other key domains of HBP self-care were often missing or omitted. Seven instruments measured multiple dimensions of self-care; however, these either failed to capture all the main HBP self-care domains or had poor psychometric profiles. Nineteen of the 29 articles reported both validity and reliability, with varying degrees of rigor.
The current assessment tools do not capture all the critical elements of HBP self-care. The few instruments that attempted to measure the multiple behavioral dimensions of HBP self-care failed to report adequate levels of psychometric properties of those domains because of their incompleteness. Challenges remain in translating the HBP self-care guidelines into effective intervention and relevant assessment tools. Developing a valid and reliable instrument that captures the multidimensional nature of HBP self-care is urgently needed.
高血压（HBP）自我护理对于控制 HBP 至关重要。充分衡量 HBP 自我护理水平是改善 HBP 这一全球性大流行的必要前提。
本研究旨在确定、描述和评价现有的 HBP 自我护理工具，并根据 HBP 护理的既定行为准则来评估这些工具的充分程度。
本综述仅限于 2012 年 10 月前发表的英文文章。此外，还使用了以下标准：（1）研究描述了自我护理/自我管理工具的有效性和/或可靠性；（2）研究对象为高血压患者。电子数据库检索共确定了 1701 篇潜在相关文章。两位作者独立审查了所有检索文章的标题和摘要。根据纳入和排除标准以及交叉引用，共有 29 篇文章纳入本综述。
从 29 篇文章中确定了 19 种独特的 HBP 自我护理工具（其中一些是原始测量工具的修改或翻译版本）。药物服用是 HBP 自我护理的主要领域，其中 12 种工具主要关注这一领域。HBP 自我护理的其他关键领域往往缺失或被省略。有 7 种工具测量了自我护理的多个维度；然而，这些工具要么没有捕捉到 HBP 自我护理的所有主要领域，要么在心理测量学特性方面表现不佳。29 篇文章中有 19 篇报告了有效性和可靠性，但其严谨程度各不相同。
目前的评估工具没有捕捉到 HBP 自我护理的所有关键要素。少数尝试测量 HBP 自我护理多个行为维度的工具，由于其不完整性，未能报告这些领域足够的心理测量学特性水平。将 HBP 自我护理指南转化为有效的干预措施和相关评估工具仍面临挑战。迫切需要开发一种能够捕捉 HBP 自我护理多维性质的有效且可靠的工具。
