Application of stage change mode in nursing care of middle-aged and elderly patients with hypertension
阶段性改变模式在中老年高血压患者护理中的应用

摘要

探究阶段性改变模式在中老年高血压患者护理中的应用效果。方法 研究对象选自我院 2020年 1 月至 2021 年 1 月期间收治的中老年高血压患者 66 例，随机分组为观察组（33 例）和对照组（33 例）。观察组采用阶段性改变模式干预，在常规模式干预基础上采分前意向阶段、意向阶段、准备阶段、行动阶段及维持阶段进行护理。对照组采用常规模式干预，对患者开展健康教育，告知患者用药、饮食及运动等相关注意事项及出院后复查时间。分别于记录并分析两组患者干预后的自护能力、遵医行为及干预前、干预后 3 个月前后血压控制情况。结果 干预后 3 个月，观察组为（101.53±11.82）分，对照 组为（89.72±11.24）分；观察组收缩压由（156.25±1.67）mmHg 降至（125.25±5.82）mmHg，对照组收缩压由（156.25±1.46）mmHg 降至（133.45±5.97）mmHg，；观察组舒张压由（105.24±1.45）mmHg 降至（85.62±5.03）mmHg，对照组舒张压由（105.23±1.34）mmHg 降至（90.31±5.14）mmHg；观察组服药依从性 30 例（90.91%），对照组服药依从性 22 例（66.67%）；观察组运动锻炼 28 例（84.85%），对照组运动锻炼 20 例（60.61%）；观察组饮食控制 29 例（87.88%），对照组饮食控制 18 例（54.55%）；观察组定期复查 27 例（81.82%），对照组定期复查 21 例（63.64%）。两组差异均有统计学分析（P＜0.05）。结果显示，观察组自护能力及遵医行为各项评分均明显高于对照组，观察组血压控制情况显著优于对照组。结论 中老年高血压患者护理中应用阶段性改变模式干预有利于改善患者的自护能力及遵医行为，提高患者的血压水平的控制。

Abstract

Objective To explore the application effect of stage change mode in nursing care of middle-aged and elderly patients with hypertension.
Methods Sixty-six middle-aged and elderly patients with hypertension admitted to our hospital from January 2020 to January 2021 were randomly divided into observation group (33 cases) and control group (33 cases). The observation group adopted the phased change mode intervention, and on the basis of the conventional mode intervention, pre-intention stage, intention stage, preparation stage, action stage and maintenance stage were adopted for nursing. The control group was treated with conventional intervention mode. The patients were given health education and informed of medication, diet, exercise and other matters requiring attention as well as the time of post-discharge review. The self-care ability, compliance behavior and blood pressure control before and 3 months after intervention were recorded and analyzed respectively.
Results Three months after intervention, the score of observation group was (101.53±11.82), and that of control group was (89.72±11.24). Systolic blood pressure decreased from (156.25±1.67) mmHg to (125.25±5.82) mmHg in the observation group and from (156.25±1.46) mmHg to (133.45±5.97) mmHg in the control group. The diastolic blood pressure of the observation group decreased from (105.24±1.45) mmHg to (85.62±5.03) mmHg, and that of the control group decreased from (105.23±1.34) mmHg to (90.31±5.14) mmHg. There were 30 cases (90.91%) in the observation group and 22 cases (66.67%) in the control group. 28 cases (84.85%) in the observation group and 20 cases (60.61%) in the control group were exercised. 29 cases (87.88%) in the observation group and 18 cases (54.55%) in the control group were diet controlled. 27 cases (81.82%) in the observation group and 21 cases (63.64%) in the control group were reexamined periodically. The difference between the two groups was statistically analyzed (P < 0.05). The results showed that the scores of self-care ability and compliance behavior in the observation group were significantly higher than those in the control group, and the blood pressure control in the observation group was significantly better than that in the control group.
Conclusion   The application of stage change mode intervention in nursing care of middle-aged and elderly patients with hypertension is beneficial to improve patients' self-care ability and compliance behavior, and improve the control of patients' blood pressure level.