本文選題：原發(fā)性高血壓 + 自我管理��； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:調(diào)研原發(fā)性高血壓患者健康素養(yǎng)和自我管理行為的現(xiàn)狀;分析影響原發(fā)性高血壓患者健康素養(yǎng)和自我管理行為的人口變量學(xué)因素;探究健康素養(yǎng)與自我管理行為的關(guān)系,為臨床高血壓患者自我管理干預(yù)提供理論依據(jù),更好地進(jìn)行原發(fā)性高血壓疾病的管理,達(dá)到有效控制患者血壓的目的。方法:采用方便抽樣,調(diào)查于大連市某三級甲等綜合性醫(yī)院高血壓門診就診的419名原發(fā)性高血壓患者。調(diào)查內(nèi)容包括:自制一般資料問卷、慢性病病人健康素養(yǎng)量表、高血壓病人自我管理量表。采用SPSS 20.0統(tǒng)計軟件進(jìn)行數(shù)據(jù)錄入分析。結(jié)果:1.原發(fā)性高血壓患者的健康素養(yǎng)總分為104.00(96.00,110.00),其中24.1%的患者不具備健康素養(yǎng),各維度得分從高到低依次為信息獲取能力、經(jīng)濟(jì)支持意愿、改善健康意愿和交流互動能力,其中交流互動能力得分不足;不同性別、年齡、學(xué)歷、家庭人均月收入、醫(yī)療費(fèi)用、患病年限、血壓分級、合并癥的患者在健康素養(yǎng)總分上存在統(tǒng)計差異(P0.05),不同吸煙狀況的患者在改善健康意愿維度得分上存在統(tǒng)計差異(P0.05);而不同工作狀態(tài)、婚姻狀況和住院情況的患者于健康素養(yǎng)總分或各維度得分均未發(fā)現(xiàn)顯著差異(P0.05)。2.原發(fā)性高血壓患者的自我管理行為總分為(74.16±9.669),各維度得分從高到低依次為危險因素管理、飲食運(yùn)動管理、治療管理和生活習(xí)慣管理,其中治療管理和生活習(xí)慣管理得分相對較低;不同學(xué)歷、家庭人均月收入、醫(yī)療費(fèi)用、血壓分級、吸煙狀況的患者在自我管理總分上存在統(tǒng)計差異(P0.05),不同學(xué)歷的患者在治療管理水平上存在統(tǒng)計差異(P0.05),不同年齡、學(xué)歷、醫(yī)療費(fèi)用的患者在飲食運(yùn)動管理水平上存在統(tǒng)計差異(P0.05),不同性別、年齡、學(xué)歷、家庭人均月收入、患病年限、血壓分級、合并癥的患者在生活習(xí)慣管理水平上存在統(tǒng)計差異(P0.05),不同學(xué)歷、家庭人均月收入、患病年限、合并癥、吸煙狀況的患者在危險因素管理水平上存在統(tǒng)計差異(P0.05);而不同工作狀態(tài)、婚姻狀況和住院情況的患者在自我管理行為總分各個維度均未發(fā)現(xiàn)顯著差異(P0.05)。3.健康素養(yǎng)總分和四個維度分別與自我管理行為總分呈正相關(guān)(P0.01),危險因素管理維度僅與健康素養(yǎng)的改善健康意愿維度呈正相關(guān)(P0.01)、與健康素養(yǎng)其他維度為弱負(fù)相關(guān)或不相關(guān)。結(jié)論:1.原發(fā)性高血壓患者的健康素養(yǎng)水平良好,其中24.1%的患者不具備健康素養(yǎng),四個維度中交流互動健康素養(yǎng)得分不足。女性、中老年、初中及以下學(xué)歷、家庭人均月收入小于3000元、新農(nóng)合、患病時間長、3級高血壓、有合并癥、吸煙患者的健康素養(yǎng)水平較低,需要特別注重對這一群體的指導(dǎo)幫助。2.原發(fā)性高血壓患者的自我管理行為處于中等水平。初中及以下學(xué)歷、家庭人均月收入小于3000元、新農(nóng)合、3級高血壓和吸煙患者的高血壓自我管理總分較低,需要進(jìn)一步提升。3.原發(fā)性高血壓患者的健康素養(yǎng)與自我管理存在密切相關(guān)關(guān)系,應(yīng)采取針對性措施提高患者的健康素養(yǎng)水平,以促進(jìn)患者自我管理行為的形成。此外,需重點(diǎn)識別低學(xué)歷、低收入、新農(nóng)合及血壓分級高患者的健康素養(yǎng)和自我管理水平,以健康宣教為基礎(chǔ),通過授權(quán)、動機(jī)教育和信息溝通反饋,有效促進(jìn)的自我管理行為形成;強(qiáng)化家屬及外界人員的支持,幫助中老年等健康素養(yǎng)低的患者提高認(rèn)知和疾病管理能力;對于吸煙患者重點(diǎn)采取動機(jī)性訪談等方式,注重激勵患者的改善健康意愿,提高患者參與疾病管理的積極性和意志力;給予男性、學(xué)歷高、收入高的高血壓患者更多的心理減壓干預(yù),緩解心理壓力和不良情緒對病情的影響。
[Abstract]:Objective: To investigate the status of health literacy and self management behavior in patients with essential hypertension, to analyze the demographic factors affecting the health literacy and self management behavior of patients with essential hypertension, to explore the relationship between health literacy and self-management behavior, and to provide a theoretical basis for the self-management intervention of patients with hypertension and to better carry out it. Management of essential hypertension to achieve the purpose of effective control of the blood pressure of the patients. Methods: a convenient sampling was used to investigate 419 primary hypertension patients in a three grade first class hospital in Dalian. The contents included the self-made general data questionnaire, the health literacy scale of chronic patients, and the hypertension patients. I manage the scale with SPSS 20 statistical software. Results: 1. the total score of health literacy of patients with essential hypertension was 104 (96.00110.00), of which 24.1% of the patients did not have health literacy, and the scores of each dimension from high to low were the ability to obtain information, the willingness to support the economy, the improvement of the health will and the interaction and interaction. There was a statistical difference (P0.05) in the total score of health literacy (P0.05) in the patients with different smoking status (P0.05), and the differences in the health willingness dimension of the patients with different smoking status (P0.05). There was no significant difference between the total score of health literacy and the scores of all dimensions (P0.05). The total score of self-management behavior in.2. primary hypertension patients was (74.16 + 9.669). The order of each dimension from high to low was the management of risk factors, diet management, treatment management and living habits management, The score of treatment management and living habits management was relatively low; there were statistical differences in the total score of self management in patients with different educational background, family per capita income, medical expenses, blood pressure classification and smoking status (P0.05). Patients with different educational backgrounds had statistical differences (P0.05), patients of different ages, educational backgrounds and medical expenses. There were statistical differences (P0.05) in the diet management level. There were statistical differences between the different sex, age, education, family per capita income, age, blood pressure grade, and the standard of living habits Management (P0.05). Different educational background, family average monthly income, illness years, complication, smoking status were the risk factors There were statistical differences (P0.05) on the level of management, but there was no significant difference in the dimensions of the total score of self management behavior (P0.05). The total score of.3. health literacy and four dimensions were positively correlated with the total score of self management behavior (P0.01), and the management dimension of risk factors was only with the health factor. There was a positive correlation between the improvement of health willingness dimension (P0.01) and weak negative correlation with other dimensions of health literacy. Conclusion: 1. patients with primary hypertension have good health literacy level, 24.1% of them do not have health literacy, and the scores of communication and interaction health literacy in the four dimensions are insufficient. Women, middle and old age, junior high school and below, The per capita monthly income of the family is less than 3000 yuan, the new rural cooperation, the long time of the disease, the 3 grade hypertension, the complication and the low level of health literacy of the smokers, it is necessary to pay special attention to the guidance of this group to help the.2. patients with primary hypertension self-management at the middle level. Junior and below education, the per capita monthly income of the family is less than 3000 yuan. The total score of the self-management of hypertension and smoking of the 3 level hypertension and smoking patients is low. There is a close relationship between the health literacy and self management of the patients with.3. essential hypertension. The specific measures should be taken to improve the health literacy level of the patients so as to promote the formation of the self management behavior of the patients. The health literacy and self management level of patients with low education, low income, NCMS and high blood pressure are based on health education, through authorization, motivation education and information communication feedback, effective self-management behavior, strengthening support of family and outside people, and helping patients with low health literacy, such as middle and old age, improve cognition and The ability to manage the disease; to focus on motivational interviews with smoking patients, pay attention to encouraging patients to improve their health will, improve the patient's enthusiasm and willpower to participate in the disease management, and give more psychological pressure to the male, high education and high income hypertensive patients to relieve the effect of psychological pressure and bad mood on the condition.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.5

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