Health Development Research Center, Pudong Institute for Health Development, Shanghai, China.
General Office, Pudong New Area Center for Patriotic Sanitation Campaign and Health Promotion Counsel, Shanghai, China.
Int J Health Plann Manage. 2019 Jul;34(3):960-974. doi: 10.1002/hpm.2867. Epub 2019 Jul 31.
Preventive interventions of hypertension and health care activities are often performed in the community and at home. Studies have shown that self-management plays an indispensable role in the management of chronic diseases. This study aimed to explore an innovative community-based hypertension self-management model and to evaluate its effects.
The study involved qualitative and quantitative research methods. A community-based hypertension self-management model was developed using consultation with experts and qualitative interviews. The intervention was executed in the communities of Pudong New Area in Shanghai, China. We enrolled 1080 patients with hypertension in the intervention group and 588 similar patients in the control group. A questionnaire was administered before and after the intervention to collect information on patients' health status, self-management skills, and disease management abilities. Analyses were conducted to evaluate changes in the health-related outcomes.
There was a significant difference in general health and health literacy after the intervention for the intervention patients group (P < .05). Furthermore, the proportion of health literacy was higher in the intervention group than in the control group (71.6% vs 59.6%). The significant differences were demonstrated in the comparison of the disease management ability data between the intervention and control group, especially in drug compliance, physical activity, regulate diet, and smoking. In addition, there is other evidence of the successful applicability and effectiveness of the community-based hypertension self-management program in 2007-2013, such as self-management teams formation and blood pressure control rate.
The community-based self-management hypertension model, which involved the participation of general practitioners, is suitable for the management of hypertension disease in Pudong of Shanghai and could provide a reference for its large-scale promotion and application.
高血压的预防干预和保健活动通常在社区和家庭中进行。研究表明，自我管理在慢性病管理中起着不可或缺的作用。本研究旨在探索一种创新的基于社区的高血压自我管理模式，并评估其效果。
本研究采用定性和定量研究方法。通过专家咨询和定性访谈，制定了基于社区的高血压自我管理模式。干预在上海市浦东新区的社区进行。我们招募了 1080 名高血压患者进入干预组，588 名类似患者进入对照组。在干预前后通过问卷调查收集患者健康状况、自我管理技能和疾病管理能力的信息。分析用于评估健康相关结果的变化。
干预后，干预组患者的一般健康状况和健康素养有显著差异（P <.05）。此外，干预组的健康素养比例高于对照组（71.6%比 59.6%）。干预组和对照组之间的疾病管理能力数据比较存在显著差异，特别是在药物依从性、体育活动、调节饮食和吸烟方面。此外，2007-2013 年基于社区的高血压自我管理计划在自我管理团队的组建和血压控制率方面取得了成功应用和有效性的其他证据。
该社区参与的自我管理高血压模式适合上海市浦东新区的高血压管理，可以为其大规模推广和应用提供参考。
