中国全科医学2017，Vol.20Issue(27)：3343-3348,6.DOI:10.3969/j.issn.1007-9572.2017.00.028
社区护士主导的新型社区慢性病团队管理模式对高血压患者服药自我效能及依从性的影响研究
Impact of Community Nurse-led New Team Model of Community-based Chronic Disease Management on the Medication Adherence Self-efficacy and Medication Adherence in Hypertensive Patients
摘要
Abstract
Objective To explore the impact of community nurse-led team model of community-based chronic disease management on the medication adherence self-efficacy and medication adherence in hypertensive patients,in order to offer support for community-based management of chronic disease in the future.Methods We carried out this study between December 2014 and December 2015.The study sample comprised 180 participants who were divided equally into two groups:90 from the Wangyuehu Community Health Service Center(intervention group) and other 90 from the Hexinyuan Community Health Service Center(control group).All of them were selected from those hypertensive patients whose medical records were established and maintained in the above centers by systematic random sampling.Patients in the intervention group received nurse-led team model of community-based chronic disease management services,and those in the control group received the conventional community-based health services.The medication adherence self-efficacy was assessed by Medication Adherence Self-efficacy Scale(MASES),and medication adherence was assessed by Eight-Item Morisky Medication Adherence Scale(MMAS-8) before intervention,at the end of 6-month intervention,and at the end of 1-year intervention,respectively.And the results of the three assessments of medication adherence self-efficacy and medication adherence were compared between the two groups.Results Total 175 cases(88 in the intervention group,and 87 in the control group) completed the intervention,the other 5 cases were lost to follow up.The method and duration of intervention exerted interaction effects on the scores of MASES and MMAS-8(P<0.05).Moreover,they produced significant main effects on the scores of MASES and MMAS-8(P<0.05).Before intervention,both groups had similar scores of MASES and MMAS-8(P>0.05).However,the scores of MASES and MMAS-8 were much higher in the intervention group at the end of 6-month intervention and 1-year intervention(P<0.05).The score of MASES in the intervention group before intervention was lower than that the end of 6-month intervention,and the end of 1-year intervention(P<0.05);and the score of MASES in the 1 years after the intervention was higher than that in the end of 6-month intervention(P<0.05).With view to the scores of MMAS-8 for the intervention group,the latter two assessment results were both higher than the first assessment result(P<0.05),but the third assessment result was lower than the second assessment result(P<0.05).Conclusion The nurse-led team model of community-based chronic disease management can significantly improve the medication adherence self-efficacy and medication adherence in patients with essential hypertension.However,the intervention effect on the medication adherence of these patients could decrease over time.关键词
高血压/社区医学/护士/团队管理/自我效能/服药依从性Key words
Hypertension/Community medicine/Nurses/Group management/Self-efficacy/Medication adherence分类
医药卫生引用本文复制引用
王莎,杨洪华,王秀华,刘丹..社区护士主导的新型社区慢性病团队管理模式对高血压患者服药自我效能及依从性的影响研究[J].中国全科医学,2017,20(27):3343-3348,6.基金项目
中华医学基金会(CMB)四校联合基金项目(11-085) （CMB）
