社区轻型老年高血压患者社区护理干预研究

论文编号:HL090  论文字数:8549.页数:24

论文题目：社区老年轻度高血压患者社区护理干预研究
摘 要
研究背景
 高血压是老年人最常见的心血管病,是全球范围内的重大公共卫生问题。原发性高血压是脑卒中、冠心病和心肾功能衰竭的主要发病因素（1）。国务院2004年公布资料显示，我国成人高血压患病率已达18.8%，高血压流行呈低知晓率、低治疗率、低控制率现状，因此，尽早发现，积极防治，力争使高血压患者的血压达到理想标准,是抗高血压治疗的基本要求，国内外的经验表明，控制高血压最有效的方法是社区综合防治（2）。社区综合防治是当前我国心脑血管疾病综合防治工作中的中心环节，是一项低投入、高产出、高效益的卫生保健事业，在社区中开展高血压健康教育可大大提高社区人群对高血压知晓率和控制率,延缓病情进展,降低复发率,减少并发症,减轻疾病负担,提高生活质量（3、4、5）。。社区轻型高血压，由于其主要是患者未受到心、脑、肾和眼底器质性损害,与正常血压和确诊高血压之间存在可转化型。轻型高血压是持续性高血压的前驱,并影响其发生和发展。
研究目的
 探讨通过社区综合干预措施对轻型老年高血压患者进行干预从而控制血压，达到在社区居民中提倡和推广社区综合护理干预的目的。
研究方法
 按随机原则选择248例社区轻型老年高血压患者，排除了糖尿病、冠心病、肥厚性心肌病、心力衰竭、主动脉瓣狭窄、过速性心律失及肾功能不全等疾病的人群，通过对人群建立居民健康档案，开展健康教育宣传、进行健康行为指导，合理膳食、低盐饮食、戒烟限酒、保持良好的情绪，并进行适量的体育锻炼，连续监测血压，与干预前后进行对比分析。
研究结果
1. 在老年高血压患者进行护理干预前，患者对高血压的知晓率、低盐低脂饮食率、适量运动率都比较低，通过我们对高血压患者有计划、有组织、有系统的综合干预后，患者对高血压知识均有很大程度的掌握，知晓率为90.8%，低盐低脂饮食率达53.2%，适量运动率为76.2%。
 2. 选择的172轻度高血压老人经过干预发现1个月后血压正常者有41例(24.1%),干预2个月后血压正常者有61例(35.2%),干预3个月后血压正常者73例（42.5%）
结论
对社区老年轻度高血压患者进行社区综合护理干预，加强高血压基础、病因、临床症状知识等内容的健康教育十分必要，健康促进和健康教育可以通过影响人的知识、态度来改变人的行为, 同时进行运动锻炼、营养干预、放松训练等社区护理干预等可以有效的降低血压，降低患者服药的并发症和减少患者的经济负担。
关键词：高血压    社区护理    干预措施
论文类型：研究报告

 Thesis subject:Community old-age light degree high blood pressure sufferer the community nursing interfere a search
 
 
 
 Abstract
 Study back ground
      The high blood pressure is old people''''s most familiar cardiovascular disease, the great public hygiene question in range in the world. The hair high blood pressure was a brain at first the soldier won, coronary and core kidney function crocked up of main outbreak factor.(1) State council releases data display in 2004, our country adult''''s high blood pressure fall ill rate already 18.8%, the high blood pressure fad presents low understand a rate and low treatment of rate, low control rate present condition, therefore, as early as possible discover, actively prevention and cure, work hard for the blood pressure of making the high blood pressure sufferer to hit ideal standard, is an anti- high blood pressure the fundamental request of treatment, domestic and international experience enunciation, controling the most useful method of high blood pressure is a community synthesis to prevent and cure.(2) Community''''s synthesizing prevention and cure is current our country the core link in the centre within cerebral disease synthesis preventing and curing is a low invest, high output - input ratio, efficiently the health care business of benefit, develop high blood pressure health education in the community can consumedly raise the community crowd understands rate and control rate to the high blood pressure and defers condition progress and lowers to relapse a rate and reduces complications and lightens disease burden, exaltation life mass.(3, 4, 5).Community light high blood pressure, because it mainly is a sufferer don''''t be injured by core, brain, kidney and the eye bed machine guilder, with normal blood pressure and confirm the existence of high blood pressure can conversion type.The light high blood pressure is the forerunner of continuity high blood pressure, and effect its occurrence and shape.
 
 Study a purpose
 Inquire into passing the community synthesis interruption measure to carry on an interruption to control blood pressure thus vs the light old-age high blood pressure sufferer and hit in the community to promote and expand community to synthesize the purpose of nursing interruption in the resident.
 
 Study a method
 According to random priniple select 248 community light old-age high blood pressure sufferer, expeled diabetes, coronary, fatty thick sex myocardial disease, the mental exertion crock up, the aorta petal is narrow, the overspeed core Lyu lose and renal insufficiency of etc. paroxysm crowd, pass vs crowd create resident healthy file, develop healthy education publicity and carry on healthy behavior instruction, reasonable meal, low salt food, quit smoking to limit wine and keep good emotion, and carry on just the right amount of athletics to toughen, continuous monitor blood pressure, contrast analysis with progress in the front and back of the interruption.
 
 Study a result
Before the old-age high blood pressure sufferer carries on a nursing interruption, the sufferer understands rate and low salt and low fat food vs the high blood pressure rate and just the right amount of running rate is all lower, after passing us to having program to the sufferer of high blood pressure and have the organization, systematic synthesis the interruption, the sufferer has the keep in hand of very great degree to all the high blood pressure knowledge and understands to lead to 90.8%, the low salt and low fat food leads up to 53.2%, and just the right amount running leads to 76.2%.
Choice 172 mild hypertension old person the intervention discovered 1 month later the blood pressure normal person has 41 examples (24.1%), intervenes 2 months later the blood pressure normal person has 61 examples (35.2%), intervenes 3 months later blood pressure normal person 73 examples (42.5%)
 
 Conclusion
 Carry on community synthesis vs the old-age light degree high blood pressure sufferer of community nursing interruption, intensify contents sc, such as high blood pressure foundation, cause of disease and clinical symptom knowledge...etc. of healthy education full a necessity, healthily accelerate and healthily education can pass the knowledge of effecting the person, attitude to transform the person''''s behavior, progress running toughens at the same time, nourishment interruption, relax training etc. community nursing interruption etc. can useful step - down blood pressure, lower the economic burden of complications and decrease sufferer that the sufferer takes a medicine.
 
 Keyword:High blood pressure    Community nursing    Interfere measure
 Thesis type:Research paper

目  录
1前言 1
 1.1研究背景及意义 1
 1.2研究目的及目标 1
 1.2.1研究目的 1
 1.2.2研究目标 1
 1.3关键词及意义 2
     1.3.1高血压 2
     1.3.2社区护理 2
     1.3.3干预 2
    1.4文献回顾 2
 1.4.1高血压病的病因和主要的发病机制 2
         1.4.1.1遗传因素 2
         1.4.1.2饮食 3
 1.4.1.3精神因素 3
 1.4.1.4体重因素 3
 1.4.1.5吸烟 3
 1.4.1.6血清游离脂肪酸 3
 1.4.1.7血管紧张素Ⅱ 4
 1.4.1.8阻塞性睡眠呼吸暂停综合征 4
2研究设计与方法 5
 2.1研究设计 5
 2.2 研究对象 5
     2.2.1研究对象 5
 2.2.2纳入标准 5
     2.2.3排除标准 5
 2.3研究步骤 5
 2.4资料分析 7
3结果 9
 3.1干预前后高血压知晓率比较 9
 3.2干预前后低盐低脂生活率比较 9
    3.3干预前后适量运动率比较 9
    3.4三个月降压控制率 10
4讨论 11
5结论 13
 5.1研究结论 15
 5.2不足和建议 15
致谢 15
参考文献 17