Effects of health education based on empowerment cognition theory on self-management ability and blood pressure variability in outpatients with hypertension
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摘要:
目的 健康教育在高血压治疗管理中起到重要作用，本研究旨在探讨基于授权认知理论的健康教育在门诊高血压患者中的应用效果。 方法 选取2022年6月—2024年6月于邯郸市第一医院就诊的高血压患者204例，采用随机数字表法分为常规干预组(行常规健康教育)和授权健康教育组(行基于授权认知理论的健康教育)，每组各102例。比较2组干预前后自我管理行为、自我效能，测量血压并统计血压变异性，干预后2组满意度及不良事件。 结果 干预后授权健康教育组自我管理行为中饮食等得分均高于常规干预组[(40.54±4.03)分vs. (36.28±3.91)分，F=4.879，P < 0.05]。干预后授权健康教育组自我效能中日常生活等得分均高于常规干预组[(16.56±1.92)分vs. (14.87±1.26)分，F=4.832，P < 0.05)]。干预后授权健康教育收缩压、舒张压、24 h收缩压标准差、24 h舒张压标准差均更低于常规干预组(P < 0.05)。授权健康教育组满意度高于常规干预组[101例(99.02%) vs. 86例(84.31%)，P < 0.05]，不良事件发生率低于常规干预组[5例(4.90%) vs. 14例(13.73%)，P < 0.05]。 结论 基于授权认知理论的健康教育可提高患者自我管理能力、较好地控制患者血压、提高患者满意度、减少不良事件发生。 Abstract:Objective Health education plays a vital role in hypertension management. This study aims to explore the application effects of empowerment theory-based health education in outpatient hypertensive patients. Methods A total of 204 hypertensive patients treated at the First Hospital of Handan from June 2022 to June 2024 were randomly divided into either an empowered health education group (n=102, routine health education) and a routine intervention group (n=102, health education based on empowerment cognition theory). The scores of self-management behavior and self-efficacy were compared before and after intervention. Blood pressure was measured, and post-intervention blood pressure variability, satisfaction, and incidence of adverse events were recorded. Results After the intervention, the scores of self-management behaviors (e.g., dietary habits) in the empowered health education group was higher [(40.54±4.03) points vs. (36.28±3.91) points, F=4.879, P < 0.05]. Similarly, the scores of self-management ability (e.g., dietary habits) in the empowered health education group was higher [(16.56±1.92) points vs. (14.87±1.26) points, F=4.832, P < 0.05]. Whereas, systolic blood pressure, 24 h diastolic blood pressure, systolic blood pressure standard deviation, and 24 h diastolic blood pressure standard deviation were dramatically decreased in the empowered health education group (P < 0.05). The satisfaction in the empowered health education group was higher than that in the routine intervention group [101 cases (99.02%) vs. 86 cases (84.31%), P < 0.05], while the incidence of adverse events was lower [5 cases (4.90%) vs. 14 cases (13.73%), P < 0.05]. Conclusion Health education based on empowerment cognition theory can improve self-management ability, enhance blood pressure control, improve the satisfaction, and reduce the occurrence of adverse events in hypertensive outpatients. -
表 1 2组高血压患者自我管理行为得分比较(x ±s，分)
Table 1. Comparison of self-management behavior scores between the two groups of patients with hypertension (x ±s, points)
组别 例数 饮食 t值 P值 用药 t值 P值 干预前 干预后 干预前 干预后 授权健康教育组 102 31.27±3.16 40.54±4.03 26.042 < 0.001 11.93±1.83 16.36±2.18 22.315 < 0.001 常规干预组 102 32.04±3.78 36.28±3.91 13.764 < 0.001 11.65±1.74 14.88±1.95 17.681 < 0.001 统计量 1.578a 4.879b 1.120a 5.261b P值 0.116 0.024 0.264 0.012 组别 例数 情绪 t值 P值 运动 t值 P值 干预前 干预后 干预前 干预后 授权健康教育组 102 24.19±2.27 31.87±3.26 28.052 < 0.001 8.64±1.28 12.36±1.54 26.646 < 0.001 常规干预组 102 23.83±2.52 28.19±2.79 16.585 < 0.001 8.49±1.04 10.64±1.92 14.672 < 0.001 统计量 1.072a 5.388b 0.919a 5.134b P值 0.285 0.009 0.359 0.014 组别 例数 工作与休息 t值 P值 病情监测 t值 P值 干预前 干预后 干预前 干预后 授权健康教育组 102 15.29±2.03 21.43±2.97 24.804 < 0.001 12.11±1.63 17.23±2.02 28.334 < 0.001 常规干预组 102 14.96±1.98 18.42±2.74 14.807 < 0.001 11.87±1.54 15.16±1.42 22.451 < 0.001 统计量 1.175a 5.821b 1.081a 4.963b P值 0.241 0.007 0.281 0.021 注：a为t值，b为F值。 
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表 2 2组高血压患者自我效能得分比较(x ±s，分)
Table 2. Comparison of self-efficacy scores between the two groups of patients with hypertension (x ±s, points)
组别 例数 日常生活 t值 P值 自我管理 t值 P值 干预前 干预后 干预前 干预后 授权健康教育组 102 12.37±1.83 16.56±1.92 22.569 < 0.001 5.34±0.93 8.29±1.02 30.557 < 0.001 常规干预组 102 11.94±1.69 14.87±1.26 20.062 < 0.001 5.12±0.87 6.95±0.98 19.981 < 0.001 统计量 1.743a 4.832b 1.745a 5.274b P值 0.083 0.023 0.083 0.011 组别 例数 健康行为 t值 P值 药物治疗 t值 P值 干预前 干预后 干预前 干预后 授权健康教育组 102 19.36±2.03 26.18±2.58 29.882 < 0.001 7.47±1.53 11.87±1.64 28.036 < 0.001 常规干预组 102 19.04±2.16 23.96±2.74 20.281 < 0.001 7.26±1.08 10.24±1.66 21.968 < 0.001 统计量 1.090a 3.896b 1.132a 5.366b P值 0.277 0.032 0.259 0.010 注：a为t值，b为F值。
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表 3 2组高血压患者血压变异性比较(x ±s，mmHg)
Table 3. Comparison of blood pressure variability between the two groups of patients with hypertension (x ±s, mmHg)
组别 例数 收缩压 t值 P值 舒张压 t值 P值 干预前 干预后 干预前 干预后 授权健康教育组 102 174.26±15.97 134.27±9.45 31.776 < 0.001 106.37±10.25 85.46±8.28 22.793 < 0.001 常规干预组 102 172.83±13.86 142.96±10.04 25.245 < 0.001 104.89±11.32 94.36±8.87 10.535 < 0.001 统计量 0.683a 4.017b 0.979a 3.938b P值 0.495 0.030 0.329 0.032 组别 例数 24 h收缩压标准差 t值 P值 24 h舒张压标准差 t值 P值 干预前 干预后 干预前 干预后 授权健康教育组 102 11.37±2.47 9.23±1.26 11.589 < 0.001 10.86±2.03 8.41±1.18 15.417 < 0.001 常规干预组 102 11.29±2.36 10.01±1.14 7.387 < 0.001 10.74±2.38 9.23±1.06 16.410 < 0.001 统计量 0.237a 3.679b 0.387a 3.548b P值 0.813 0.034 0.699 0.036 注：a为t值，b为F值。
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表 4 2组高血压患者满意度比较
Table 4. Comparison of satisfaction between the two groups of patients with hypertension
组别 例数 满意(例) 比较满意(例) 不满意(例) 满意度[例(%)] 授权健康教育组 102 63 38 1 101(99.02) 常规干预组 102 40 46 16 86(84.31) 注：2组患者满意度比较，χ2=14.439，P < 0.001。
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表 5 2组高血压患者不良事件发生率比较
Table 5. Comparison of the incidence of adverse events between the two groups of patients with hypertension
组别 例数 高血压肾病(例) 脑出血(例) 青光眼(例) 不良事件发生率[例(%)] 授权健康教育组 102 3 0 2 5(4.90) 常规干预组 102 7 3 4 14(13.73) 注：2组不良事件发生率比较，χ2=4.701，P=0.030。
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