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自我护理教育对高血压成年人生活方式改变、药物依从性和血压的影响:随机对照临床试验。

Effect of self-care education on lifestyle modification, medication adherence and blood pressure in hypertensive adults: Randomized controlled clinical trial.

作者信息

Golshahi Jafar, Ahmadzadeh Hamid, Sadeghi Masoumeh, Mohammadifard Noushin, Pourmoghaddas Ali

机构信息

Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2015 Sep 28;4:204. doi: 10.4103/2277-9175.166140. eCollection 2015.

Abstract

BACKGROUND

Self-care management has recently been suggested as an effective approach for secondary prevention of hypertension. This study was conducted to examine whether self-care behaviors could modulate blood pressure levels and also comparing the different training methods of self-care on patients' adherence and controlling hypertension.

MATERIALS AND METHODS

This study was a prospective randomized controlled clinical trial, conducted on 180 hypertensive patients referring to four centers in Isfahan, Iran, between July and December 2013. Block randomization method were applied to divide eligible subjects into four equal groups, including group A in which the patients and their family were educated by cardiology resident about self-care behaviors through eight sessions, group B and group C were obtained self-care education through four pamphlets or eight short message services (SMS), respectively and group D were obtained only usual care of hypertension without any training about self-care management.

RESULTS

Increasing vegetable intake and frequency of subject who took antihypertensive medication regularly and the reduction in the frequency of subjects who consumed high salt were significantly more in group A than the others (P = 0.001, P < 0.001 and P < 0.001, respectively). The systolic and diastolic blood pressure had significantly more reduction in the group A than the other groups (-8.18 ± 18.3 and - 3.89 ± 4.1; P < 0.001, respectively).

CONCLUSIONS

The self-care management education integration into the usual care along with using SMS and other educational materials may improve the efficient and effective adherence strategies.

摘要

背景

自我护理管理最近被认为是高血压二级预防的一种有效方法。本研究旨在探讨自我护理行为是否能调节血压水平,并比较不同的自我护理训练方法对患者依从性和控制高血压的影响。

材料与方法

本研究是一项前瞻性随机对照临床试验,于2013年7月至12月在伊朗伊斯法罕的四个中心对180例高血压患者进行。采用区组随机化方法将符合条件的受试者分为四组,每组人数相等。A组患者及其家属由心内科住院医师通过八次课程接受自我护理行为教育;B组和C组分别通过四本宣传册或八条短信获得自我护理教育;D组仅接受高血压常规护理,未接受任何自我护理管理培训。

结果

A组蔬菜摄入量增加、规律服用降压药的受试者频率增加以及高盐摄入受试者频率降低的情况均显著高于其他组(分别为P = 0.001、P < 0.001和P < 0.001)。A组收缩压和舒张压的降低幅度显著大于其他组(分别为-8.18±18.3和-3.89±4.1;P < 0.001)。

结论

将自我护理管理教育融入常规护理,同时使用短信和其他教育材料,可能会改善有效且高效的依从性策略。

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