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高血压患者自我血压监测的观点和体验:定性研究的系统评价。

Perspectives and Experiences of Self-monitoring of Blood Pressure Among Patients With Hypertension: A Systematic Review of Qualitative Studies.

机构信息

Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.

Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, Bari, Italy.

出版信息

Am J Hypertens. 2023 Jun 15;36(7):372-384. doi: 10.1093/ajh/hpad021.

Abstract

BACKGROUND

Self-monitoring of blood pressure is a key strategy in managing hypertension but may be challenging and burdensome for patients. The aim of the study was to describe the perspectives and experiences of self-monitoring of blood pressure in patients with hypertension.

METHODS

MEDLINE, Embase, PsycINFO, and CINAHL were searched from database inception to March 2022. We used thematic synthesis to analyze the data.

RESULTS

Thirty-five studies involving 872 patients aged 18-95 years were included. Four themes were identified: enabling autonomy and empowerment of own health (allowing access to comprehensive and accurate data, bolstering motivation for lifestyle changes, encouraging diligence in medication taking, gaining interest in self-management, and increasing awareness of health status); providing reassurance and convenience (instilling a sense of security, readiness for troubleshooting, and reducing the frequency of clinical appointments); triggering confusion and stress (anxiety and panic over "bad" numbers, constant reminder of illness identity, disregarded by clinicians, lack of confidence in interpreting and responding to results, redundancy of continuous monitoring, and uncertainties around targets and frequency of measures, concerns of unreliability); financial and operational burden of device (vulnerability preventing use, or unsustainable cost).

CONCLUSIONS

Inadequate knowledge about the benefits of lowering blood pressure, home blood pressure monitoring, blood pressure goals, and interpretation of blood pressure values, limited access to home blood pressure monitoring devices, and psychological burden with home blood pressure monitoring limit home blood pressure monitoring.

摘要

背景

自我血压监测是管理高血压的关键策略,但可能对患者具有挑战性和负担。本研究旨在描述高血压患者自我血压监测的观点和体验。

方法

从数据库建立到 2022 年 3 月,我们在 MEDLINE、Embase、PsycINFO 和 CINAHL 上进行了搜索。我们使用主题合成分析数据。

结果

纳入了 35 项研究,涉及 872 名年龄在 18-95 岁的患者。确定了四个主题:使患者对自身健康具有自主权和赋权感(允许获取全面、准确的数据,增强改变生活方式的动力,鼓励患者坚持服药,增加自我管理的兴趣,并提高对健康状况的认识);提供保证和便利(增强安全感,随时准备解决问题,减少临床就诊的频率);引发困惑和压力(对“坏”数值感到焦虑和恐慌,持续提醒疾病身份,被临床医生忽视,对解释和应对结果缺乏信心,连续监测的冗余,以及目标和测量频率的不确定性,对不可靠性的担忧);设备的经济和运营负担(设备易损坏,或成本不可持续)。

结论

对降低血压、家庭血压监测、血压目标以及血压值解释的益处了解不足,家庭血压监测设备的获取有限,以及家庭血压监测的心理负担,限制了家庭血压监测的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee6c/10267641/aefb5f428b7a/hpad021_fig3.jpg

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