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患者-家庭照顾者伙伴关系干预对农村社区高血压患者血压控制的有效性:一项随机对照试验

Effectiveness of a Patient-Family Carer Partnership Intervention on Blood Pressure Control for People with Hypertension in Rural Communities: A Randomised Controlled Trial.

作者信息

Zeng Dejian, Chien Wai Tong, Yang Mingyan

机构信息

Southern University of Science and Technology Hospital, No. 6019 Liuxian Street, Xili Avenue, Nanshan District, Shenzhen, China.

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 7/F, Esther Lee Building, Shatin, Hong Kong, China.

出版信息

J Nurs Manag. 2024 May 24;2024:7033013. doi: 10.1155/2024/7033013. eCollection 2024.

Abstract

OBJECTIVES

To examine the effectiveness of a patient-family (carer) partnership intervention on the BP control, self-care and self-efficacy for hypertensive people, and dyadic-relationship quality, depressive and anxiety symptoms, and health-related quality of life for the family dyads (hypertensive people and family carers) in rural communities of mainland China.

DESIGN

A randomised controlled trial.

METHODS

A total of 110 family dyads were randomly recruited from village clinics and randomly allocated to the intervention group ( = 55) or control group ( = 55). Family dyads in the control group received usual care. In addition to the usual care, family dyads in the intervention group received the individual-based, five-session patient-family (carer) partnership intervention. The primary outcomes included SBP, DBP, and the proportion of people with normal controlled BP. EuroQol five-dimensional-five-level (EQ-5D-5L) was adopted to evaluate participants' health-related quality of life. Data were collected at the baseline (T0), one-month (T1), and three-month postintervention (T2). Generalised estimating equation model was adopted to test the study hypotheses on all study outcomes.

RESULTS

Compared with the control group, hypertensive people in the intervention group had a greater reduction in SBP by 10.10 mmHg and DBP by 4.66 mmHg and a larger proportion of people with normal BP at T2, as well as statistically significant improvements at T1 and T2 in dyadic relationship, self-care, antihypertensive drug-titration rate, anxiety symptoms, and health-related quality of life. The intervention also had statistically significant positive effects on family carer's dyadic relationship and health-related quality of life at T1 and T2.

CONCLUSION

The patient-family (carer) partnership intervention has the potential to improve hypertensive people's BP control and family dyad's dyadic-relationship quality and mental health at short-to-medium term follow-ups. . This study provided evidence and direction to support healthcare providers in developing and implementing patient-family (carer) partnership intervention for hypertension care in rural areas. This trial is registered with ChiCTR1900027087.

摘要

目的

探讨患者-家庭(照顾者)伙伴关系干预对中国大陆农村社区高血压患者血压控制、自我护理及自我效能的影响,以及对家庭二元组(高血压患者和家庭照顾者)二元关系质量、抑郁和焦虑症状及健康相关生活质量的影响。

设计

一项随机对照试验。

方法

从乡村诊所随机招募110个家庭二元组,并随机分为干预组(n = 55)或对照组(n = 55)。对照组的家庭二元组接受常规护理。干预组的家庭二元组除接受常规护理外,还接受基于个体的、为期五节的患者-家庭(照顾者)伙伴关系干预。主要结局包括收缩压、舒张压以及血压控制正常者的比例。采用欧洲五维健康量表(EQ-5D-5L)评估参与者的健康相关生活质量。在基线期(T0)、干预后1个月(T1)和3个月(T2)收集数据。采用广义估计方程模型对所有研究结局的研究假设进行检验。

结果

与对照组相比,干预组的高血压患者在T2时收缩压降低幅度更大,为10.10 mmHg,舒张压降低幅度为4.66 mmHg,血压正常者比例更高,且在T1和T2时二元关系、自我护理、降压药物滴定率、焦虑症状及健康相关生活质量有统计学意义的改善。该干预在T1和T2时对家庭照顾者的二元关系和健康相关生活质量也有统计学意义的积极影响。

结论

患者-家庭(照顾者)伙伴关系干预在短期至中期随访中有可能改善高血压患者的血压控制以及家庭二元组的二元关系质量和心理健康。本研究为医疗服务提供者在农村地区开展和实施高血压护理的患者-家庭(照顾者)伙伴关系干预提供了证据和方向。本试验在中国临床试验注册中心注册,注册号为ChiCTR1900027087。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5834/11918710/51cd11dbe26e/JONM2024-7033013.001.jpg

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