Ozpancar Nurhan, Pakyuz Sezgi Cinar, Topcu Birol
Department of Nursing, School of Health, Namık Kemal University, Tekirdag, Turkey.
Department of Nursing, School of Health, Celal Bayar University, Manisa, Turkey.
Rev Esc Enferm USP. 2017;51:e03291. doi: 10.1590/s1980-220x2017016903291. Epub 2018 Mar 15.
Objective The aim of this study was to determine the effect of case management on hypertension management and on adherence to antihypertensive medication and chronic disease care of patients with hypertension. Method This study was conducted as an experimental and randomized controlled study. The sample of the study consisted of randomly selected patients with hypertension who did not have communication problems, who used antihypertensive medication treatment and whose treatment had been continuing for at least six months. The study group was given individual training (Hypertension causes, the risk factors, significance, unwanted side effects, medication treatment, changes in life style) and was applied case management model in hypertension - joint care protocol but no intervention was offered to the control group. Data was collected using the adherence to antihypertensive medication scale, the patient assessment of chronic illness care in the first and six months later interview. Results There was no significant difference between the study and control group according to adherence to antihypertensive medication and patient assessment of chronic illness care in the first interview. Otherwise, there were significant differences between the study and control group according to blood pressure, adherence to antihypertensive medication and patient assessment of chronic illness care in the six months later interview. The adherence to antihypertensive medication total score and the patient assessment of chronic illness care total score were significantly higher in the study group compared with control group in the six months later interview. Conclusion The case management plays an important role the in control of hypertension, and can improve adherence to antihypertensive medication and chronic illness care.
目的 本研究旨在确定病例管理对高血压管理以及高血压患者抗高血压药物依从性和慢性病护理的影响。方法 本研究作为一项实验性随机对照研究进行。研究样本由随机选取的无沟通问题、正在使用抗高血压药物治疗且治疗持续至少六个月的高血压患者组成。研究组接受了个体培训（高血压病因、危险因素、意义、不良反应、药物治疗、生活方式改变），并应用了高血压联合护理方案中的病例管理模式，而对照组未接受任何干预。使用抗高血压药物依从性量表、在首次访谈以及六个月后的访谈中对慢性病护理的患者评估来收集数据。结果 在首次访谈中，根据抗高血压药物依从性和慢性病护理的患者评估，研究组和对照组之间没有显著差异。否则，在六个月后的访谈中，根据血压、抗高血压药物依从性和慢性病护理的患者评估，研究组和对照组之间存在显著差异。在六个月后的访谈中，研究组的抗高血压药物依从性总分和慢性病护理患者评估总分显著高于对照组。结论 病例管理在高血压控制中发挥着重要作用，并且可以提高抗高血压药物依从性和慢性病护理水平。
