Hermansson-Borrebaeck Rasmus, Fors Andreas, Bengtsson Ulrika, Kjellgren Karin, Calling Susanna, Midlöv Patrik
Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
University Clinic Primary Care Skåne, Region Skåne, Sweden.
J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14981. doi: 10.1111/jch.14981.
Self-efficacy is tightly intertwined with person-centered care and correlates with engaging in self-care behaviors, an important part of hypertension treatment. Evidence indicates that e-Health-based self-management interventions could increase self-efficacy. The objectives of this study were to investigate whether an intervention with a person-centered approach supported by e-Health technology can impact self-efficacy. Furthermore, to examine the impact of self-efficacy on hypertension management, and assess if self-efficacy can indicate which patients might see the greatest improvement on blood pressure from an e-Health-based self-management intervention for hypertension. This multicenter randomized controlled trial included 949 primary healthcare patients with hypertension. After exclusions, data was analyzed for 862 patients. The intervention group used an e-Health-based self-management system for 8 weeks. Self-efficacy was measured with the general self-efficacy (GSE) scale at inclusion, 8-week follow-up and 1-year follow-up. A significant increase in the mean GSE score in the intervention group was identified (p 0.042). No significant association between self-efficacy and blood pressure control was found. GSE scores did not significantly differ between the patients that had the best effect on blood pressure and those that had none. This study showed a significant increase in self-efficacy after the intervention. Self-management-based e-Health interventions might have a role in clinical practice to increase self-efficacy and improve general health. We found no association between self-efficacy and achieving a blood pressure below 140/90. Furthermore, no support was found to claim that self-efficacy would be an indicator of which patients might have the greatest effect from a self-management-based e-Health intervention for hypertension.
自我效能感与以患者为中心的护理紧密相连，并与自我护理行为相关，而自我护理行为是高血压治疗的重要组成部分。有证据表明，基于电子健康的自我管理干预措施可以提高自我效能感。本研究的目的是调查由电子健康技术支持的以患者为中心的干预措施是否会影响自我效能感。此外，研究自我效能感对高血压管理的影响，并评估自我效能感是否能够表明哪些患者可能会从基于电子健康的高血压自我管理干预措施中在血压方面获得最大程度的改善。这项多中心随机对照试验纳入了949名患有高血压的初级医疗保健患者。排除部分患者后，对862名患者的数据进行了分析。干预组使用基于电子健康的自我管理系统8周。在纳入研究时、8周随访和1年随访时，使用一般自我效能感（GSE）量表来测量自我效能感。研究发现干预组的平均GSE得分有显著提高（p = 0.042）。未发现自我效能感与血压控制之间存在显著关联。在血压改善效果最佳的患者和无改善效果的患者之间，GSE得分没有显著差异。本研究表明干预后自我效能感有显著提高。基于自我管理的电子健康干预措施可能在临床实践中发挥作用，以提高自我效能感并改善总体健康状况。我们发现自我效能感与血压降至140/90以下之间没有关联。此外，没有证据支持自我效能感可以作为哪些患者可能会从基于自我管理的高血压电子健康干预措施中获得最大效果的指标这一说法。
