Farahmand Fatemeh, Khorasani Parvaneh, Shahriari Mohsen
MSc Student, Department of Community Health and Gerontological Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Assistant Professor, Nursing and Midwifery Care Research Center AND Department of Community Health and Gerontological Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2019 Mar;15(2):44-52. doi: 10.22122/arya.v15i2.1787.
The aim of the present study was to determine the effectiveness of a self-care education (SCE) discharge program with telephone follow-ups in managing hypertension (HTN) in older patients.
The study was conducted on 56 older patients with HTN who had recently been discharged from the cardiac wards of hospitals in Isfahan, Iran, in 2017. Participants were randomly allocated to the intervention and control groups. The intervention was a 60-minute SCE discharge program with 4 re-educative telephone follow-ups every 2 weeks based on 4 chapters of the designed SCE program and booklet. After coding the data and entering them into SPSS software, data were analyzed for the comparison of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as frequency of managed HTN in the intervention and control groups at baseline (before discharge), and 2 and 3 months after discharge.
Statistical tests showed no significant difference in any of the demographic and confounding variables as well as baseline BPs (P > 0.050), but at post-intervention follow-ups, after Mauchly's sphericity test, repeated measurements ANOVA showed that the effect of time (P < 0.001) and group (P = 0.043) on SBP was significant. The effect of time (P = 0.036) and group (P = 0.047) on DBP was also significant. McNemar's test showed that the frequency of managed HTN (normal BP), 3 months after discharge, was significantly higher in the intervention group compared to the control group [87.5% (n = 21) vs. 23.1% (n = 6), respectively] (P < 0.001).
SCE discharge program with telephone re-educative follow-ups was effective in reducing mean BP. The use of this program as a discharged plan for older adults with HTN and comparison of readmission rates for a longer period are recommended.
本研究的目的是确定一项包含电话随访的自我护理教育（SCE）出院计划在管理老年患者高血压（HTN）方面的有效性。
2017年，对56名近期从伊朗伊斯法罕医院心脏科病房出院的老年高血压患者进行了研究。参与者被随机分配到干预组和对照组。干预措施是一个60分钟的SCE出院计划，根据设计的SCE计划和手册的4个章节，每2周进行4次再教育电话随访。对数据进行编码并输入SPSS软件后，分析了干预组和对照组在基线（出院前）、出院后2个月和3个月时的平均收缩压（SBP）和舒张压（DBP）以及控制高血压的频率，以进行比较。
统计检验显示，在任何人口统计学和混杂变量以及基线血压方面均无显著差异（P>0.050），但在干预后随访中，经过Mauchly球形检验，重复测量方差分析显示时间（P<0.001）和组（P=0.043）对SBP的影响显著。时间（P=0.036）和组（P=0.047）对DBP的影响也显著。McNemar检验显示，出院3个月后，干预组控制高血压（血压正常）的频率显著高于对照组[分别为87.5%（n=21）和23.1%（n=6）]（P<0.001）。
包含电话再教育随访的SCE出院计划在降低平均血压方面有效。建议将该计划用作老年高血压患者的出院计划，并比较更长时期的再入院率。
