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预防医学  2023, Vol. 35 Issue (4): 350-354,358    DOI: 10.19485/j.cnki.issn2096-5087.2023.04.019
  健康教育 本期目录 | 过刊浏览 | 高级检索 |
社区高血压患者Triangle分层分级管理效果评价
张红1, 胡志明2, 潘晓锋3, 朱梦胜1, 戴伟丽4, 谢伊丽2, 诸建方1
1.杭州市第九人民医院健康事业发展部,浙江 杭州 311225;
2.杭州市第九人民医院,浙江 杭州 311225;
3.杭州市钱塘区前进街道社区卫生服务中心,浙江 杭州 311228;
4.杭州市钱塘区河庄街道社区卫生服务中心,浙江 杭州 311222
Effect of Triangle hierarchical management among community patients with hypertension
ZHANG Hong1, HU Zhiming2, PAN Xiaofeng3, ZHU Mengsheng1, DAI Weili4, XIE Yili2, ZHU Jianfang1
1. Department of Health Development, Hangzhou Ninth People's Hospital, Hangzhou, Zhejiang 311225, China;
2. Hangzhou Ninth People's Hospital, Hangzhou, Zhejiang 311225, China;
3. Qianjin Community Health Service Center, Qiantang District, Hangzhou, Zhejiang 311228, China;
4. Hezhuang Community Health Service Center, Qiantang District, Hangzhou, Zhejiang 311222, China
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摘要 目的 评价社区高血压患者实施Triangle分层分级管理的效果,为加强高血压规范化管理提供依据。方法 选择杭州市钱塘区2家社区卫生服务中心2020年底新确诊的高血压患者,随机分配至常规组和Triangle组。常规组患者按照基本公共卫生服务规范要求实施健康管理服务,Triangle组患者实施Triangle分层分级管理,为期1年。采用自我管理行为量表、治疗依从性量表和自行设计的问卷调查两组患者干预前后血压,自我管理行为,治疗依从性,以及吸烟、饮酒、锻炼等管理指标,采用协方差分析和广义估计方程比较两组干预前后差异。结果 常规组和Triangle组各纳入100例。干预前两组患者性别、年龄、文化程度和职业等基本人口学资料比较,差异均无统计学意义(P>0.05)。干预后,Triangle组患者血压下降幅度,自我管理行为总分及其治疗管理、饮食管理、运动管理和生活习惯管理维度评分的上升幅度,治疗依从性总分及其遵医服药行为、日常生活管理行为和烟酒嗜好管理维度评分的上升幅度,戒烟、戒酒、锻炼和血压达标患者数增加幅度均大于常规组,且差异均有统计学意义(P<0.05)。结论 Triangle分层分级管理可提高高血压患者治疗依从性,改善患者自我管理行为,有利于患者血压控制,可在社区高血压患者健康管理中推广应用。
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张红
胡志明
潘晓锋
朱梦胜
戴伟丽
谢伊丽
诸建方
关键词 高血压Triangle 分层分级管理自我管理行为治疗依从性    
AbstractObjective To evaluate the effect of Triangle hierarchical management among community patients with hypertension, so as to provide insights into the improvements of standardized hypertension management. Methods Patients with newly diagnosed hypertension from 2 community health service centers in Qiantang District of Hangzhou City by the end of 2020 were randomly assigned to the conventional group and the Triangle group. Patients in the conventional group were given health management services according to the requirements of basic public health service standard for one year, while patients in the Triangle group were given Triangle hierarchical management. The blood pressure, self-management behaviors, treatment compliance, smoking, alcohol consumption and exercise were collected using the self-management behavior scale, treatment compliance scale and self-designed questionnaires, and were compared before and after intervention with analysis of covariance and generalized estimation equations. Results Totally 200 patients with hypertension were recruited, including 100 patients in the conventional group and 100 patients in the Triangle group. There were no significant differences between the two groups before implementation of interventions in terms of gender, age, educational level or occupation (P>0.05). The reduction in blood pressure, increase in the score of treatment, diet, exercise and living habitat management and the total score of self-management behaviors, increase in the score of adherence to medication regimens, daily living management behaviors, smoking and alcohol consumption preference and the total score of treatment compliance, and increase in the number of patients with normal standard of quitting smoking, quitting alcohol consumption, exercise and blood pressure were significantly higher in the Triangle group than in the conventional group after intervention (P<0.05). Conclusions Triangle hierarchical management may increase the treatment compliance, improve the self-management behavior and facilitate hypertension control among hypertensive patients, which may be popularized for health management among community patients with hypertension.
Key wordshypertension    Triangle hierarchical management    self-management behavior    treatment compliance
收稿日期: 2022-11-09      修回日期: 2023-02-23      出版日期: 2023-04-10
中图分类号:  R544.1  
基金资助:杭州市医药卫生科技项目(B20200007)
作者简介: 张红,本科,副主任护师,主要从事公共卫生管理、医联体管理工作
引用本文:   
张红, 胡志明, 潘晓锋, 朱梦胜, 戴伟丽, 谢伊丽, 诸建方. 社区高血压患者Triangle分层分级管理效果评价[J]. 预防医学, 2023, 35(4): 350-354,358.
ZHANG Hong, HU Zhiming, PAN Xiaofeng, ZHU Mengsheng, DAI Weili, XIE Yili, ZHU Jianfang. Effect of Triangle hierarchical management among community patients with hypertension. Preventive Medicine, 2023, 35(4): 350-354,358.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2023.04.019      或      http://www.zjyfyxzz.com/CN/Y2023/V35/I4/350
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