心理干预对高血压病人降压效果的研究

论文编号:HL106  论文字数:9275.页数:15
论文题目：心理干预对高血压病人降压效果的研究
摘 要
 目的：观察护士执行心理干预措施后对老年高血压患者降压效果的影响。
 方法：2009年1月至2010年4月在我科住院治疗的老年高血压患者106 例。纳入标准: ①临床确诊高血压(1999 年世界卫生组织/ 国际高血压学会对高血压新的诊断标准为:在未服用抗高血压药物的情况下,收缩压> 140 mmHg 和(或) 舒张压> 90 mmHg 即为高血压) ,排除继发性高血压,严重肝肾功能障碍者; ②都是给予同一类(AECI 类) 降压药物治疗; ③年龄在60 岁或以上的患者。将患者随机分成两组,观察组56 例在药物治疗相同下再联合心理干预,对照组50例不采取心理干预,两组在性别、年龄、病程等方面差异无显著性( P > 0105) ,具有可比性将患者随机分成两组,在药物治疗相同情况下,分别采用干预法(56 例) 和常规法(50 例) 进行护理,4 周后观察降压效果。        
 结果：在执行心理干预措施4周后,观察两组的降压结果，观察组降压疗效总有效率94.6 % , 显效28.6 % ,分别高于对照组的76 %和16 % ,经等级资料秩和检验, P = 0.015 ,两组差异有显著性( P < 0.05)。
 结论：1.老年人心理干预的特殊性，单一的心理护理模式并不是对所有的患者能起作用,对不同亚群的患者需要采取不同的心理护理。2.护士与家属一起对患者进行心理疏导教育可以取得事半功倍的效应。教育的效果直接影响高血压患者的健康模式。而正确的健康信念,有利于患者的服药依从性。3. 通过心理干预提高降压效果，改变患者的认知、态度，提高患者治疗的依从性，从而提高高血压的治疗率和控制率，减少并发症，提高患者生活质量，从而提高高血压的临床综合治疗效果。
 
关键词: 高血压；老年人；心理干预

 Title: Elderly patients with hypertension clinical study of psychological intervention
ABSTRACT
 Objective：Observation of nurses after the implementation of psychological interventions in elderly patients with hypertension antihypertensive effect of．
 Methods：From January 2007 to April 2009 in my inpatient treatment of 106 cases of elderly patients with hypertension. Inclusion criteria: ① the clinical diagnosis hypertension (1999 WHO / International Society of Hypertension of new diagnostic criteria for hypertension are: Before taking the case of anti-hypertensive drugs, systolic blood pressure&gt; 140 mmHg and (or) diastolic blood pressure &gt; 90 mmHg namely, high blood pressure), to exclude secondary hypertension, severe hepatic and renal dysfunction; ② are given the same category (AECI class) antihypertensive drug treatment; ③ aged 60 or over patients. Patients were randomly divided into two groups to observe the group of 56 cases of the same drug treatment and then under the joint psychological intervention in the control group of 50 patients do not take psychological intervention, the two groups in gender, age, duration, etc. There was no significant difference (P&gt; 0105), comparable to the patients were randomly divided into two groups, under similar circumstances in the drug treatment, respectively intervention method (56 cases) and conventional method (50 cases) for care, the antihypertensive effect observed after 4 weeks．
 Results：From January 2007 to April 2009 in my inpatient treatment of 106 cases of elderly patients with hypertension. Inclusion criteria: ① the clinical diagnosis in the implementation of psychological interventions after 4 weeks were observed in blood pressure, observation of group total effective antihypertensive efficacy of 94.6%, effective in 28.6%, respectively, higher than 76% and 16%, The class rank and test data, P = 0.015, difference between the two groups was significant (P <0.05)．
 Conclusion：1. Particularities of psychological intervention in the elderly, a single model of psychological care for all patients is not able to work on different subsets of patients need to take a different psychological care. 2. Nurses, patients and their families with the right education, psychological counseling can get more with less effect. The effect of a direct impact on education, health patterns in patients with hypertension. And correct health beliefs are conducive to patient medication compliance. 3. By raising blood pressure effects of psychological interventions to change the patient''''s knowledge, attitudes, improve patient compliance, thereby improving hypertension treatment and control rates, reduce complications and improve patient quality of life, thereby enhancing blood pressure the clinical effect of combined treatment．
 
Keywords：Hypertension; elderly; psychological intervention

目  录
摘 要 IV
ABSTRACT V
目  录 VI
1 绪论 1
1.1背景及意义 1
1.2目的 2
1.3关键词及定义 2
1.4文献回顾 2
2 研究设计 5
2.1研究设计 5
2.2研究对象 5
2.3研究工具与方法 5
2.4研究步骤 5
2.5 统计分析 5
3.结果 7
4.讨论 8
4.1老年人心理干预的特殊性 8
4.2护士是心理干预的主体 8
5.推论与建议 9
5.1结论 9
5.2建议 9
5.3本研究局限性及展望 9
参考文献 10
致谢 11