Li-Hong Wan, PhD, RN Associate Professor, School of Nursing, Sun Yat-sen University, Guangzhou, China. Xiao-Pei Zhang, MSc, RN Head Nurse, Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. Li-Ming You, PhD, RN Professor, School of Nursing, Sun Yat-sen University, Guangzhou, China. Heng-Fang Ruan, MSc, RN Head Nurse, Department of Neurology and Stroke Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Shao-Xian Chen, PhD Professor, School of Nursing, Sun Yat-sen University, Guangzhou, China.
J Cardiovasc Nurs. 2018 Nov/Dec;33(6):509-517. doi: 10.1097/JCN.0000000000000496.
The health behaviors of hypertensive stroke patients in China are not satisfactory. In this study, we tested the effect of a Health Belief Model Comprehensive Reminder System on health behaviors and blood pressure control in hypertensive ischemic stroke patients after occurrence and hospital discharge.
A randomized, parallel-group, assessor-blinded experimental design yielded participation of 174 hospitalized hypertensive ischemic stroke patients. The intervention consisted of face-to-face and telephone health belief education, a patient calendar handbook, and weekly automated short-message services. Data were collected at baseline and 3 months after discharge.
Three months after discharge, the intervention group showed statistically, significantly better health behaviors for physical activity, nutrition, low-salt diet, and medication adherence. The intervention group also had statistically, significantly decreased systolic blood pressure and increased blood pressure control rate. Smoking and alcohol use behaviors were not affected.
At 3 months, use of the Comprehensive Reminder System based on the Health Belief Model, yielded improvement in most health behaviors and blood pressure control in hypertensive ischemic stroke patients. Continued implementation of this intervention protocol is warranted to determine the long-term effect. Smoking and alcohol use behaviors need to be targeted with a different intervention.
中国高血压脑卒中患者的健康行为并不理想。本研究旨在测试健康信念模型综合提醒系统对高血压缺血性脑卒中患者发病后和出院后的健康行为和血压控制的影响。
采用随机、平行组、评估者盲法实验设计,纳入 174 名住院高血压缺血性脑卒中患者。干预措施包括面对面和电话健康信念教育、患者日历手册和每周自动短信服务。数据在基线和出院后 3 个月收集。
出院后 3 个月,干预组在身体活动、营养、低盐饮食和药物依从性方面的健康行为有统计学意义上的显著改善。干预组的收缩压也有统计学意义上的降低,血压控制率增加。吸烟和饮酒行为不受影响。
在 3 个月时,使用基于健康信念模型的综合提醒系统,可改善高血压缺血性脑卒中患者的大多数健康行为和血压控制。需要继续实施该干预方案,以确定其长期效果。需要采用不同的干预措施来针对吸烟和饮酒行为。