JAMA. 1979 Jun 8;241(23):2534-7. doi: 10.1001/jama.1979.03290490040024.
Behaviors critical to hypertensive patients' achieving therapeutic control and assuming active responsibility for their own care were defined by an interdisciplinary group brought together by the National High Blood Pressure Education Program. The report focused on the achievement and maintenance of long-term control through drug therapy and concentrated on the patient-physician interaction as a critical factor. The basic hypothesis that active participation by the patient favors successful management of hypertension identifies the physician, the prime diagnostician and initiator of the subsequent interaction, as a promotor of that important collaboration. The working group views the patient as the decision-maker and problemsolver, with the professional functioning as advisor and guide. This synthesis of available theory and practice in therapy adherence includes knowledge, attitudes, and skills defined under four major behaviors: making the decision for control, taking medication, monitoring progress, and problem solving.
由国家高血压教育计划召集的一个跨学科小组明确了高血压患者实现治疗控制并积极参与自身护理的关键行为。该报告重点关注通过药物治疗实现和维持长期控制,并将医患互动视为关键因素。患者积极参与有助于成功管理高血压这一基本假设,将医生(后续互动的主要诊断者和发起者)确定为这一重要合作的推动者。工作组将患者视为决策者和问题解决者,专业人员则充当顾问和指导者。这种治疗依从性方面现有理论与实践的综合包括在四种主要行为下定义的知识、态度和技能:决定控制、服药、监测进展和解决问题。