心理干預(yù)對(duì)高血壓病人降壓效果的研究

論文編號(hào):HL106  論文字?jǐn)?shù):9275.頁(yè)數(shù):15
論文題目：心理干預(yù)對(duì)高血壓病人降壓效果的研究
摘 要
 目的：觀察護(hù)士執(zhí)行心理干預(yù)措施后對(duì)老年高血壓患者降壓效果的影響。
 方法：2009年1月至2010年4月在我科住院治療的老年高血壓患者106 例。納入標(biāo)準(zhǔn): ①臨床確診高血壓(1999 年世界衛(wèi)生組織/ 國(guó)際高血壓學(xué)會(huì)對(duì)高血壓新的診斷標(biāo)準(zhǔn)為:在未服用抗高血壓藥物的情況下,收縮壓> 140 mmHg 和(或) 舒張壓> 90 mmHg 即為高血壓) ,排除繼發(fā)性高血壓,嚴(yán)重肝腎功能障礙者; ②都是給予同一類(AECI 類) 降壓藥物治療; ③年齡在60 歲或以上的患者。將患者隨機(jī)分成兩組,觀察組56 例在藥物治療相同下再聯(lián)合心理干預(yù),對(duì)照組50例不采取心理干預(yù),兩組在性別、年齡、病程等方面差異無(wú)顯著性( P > 0105) ,具有可比性將患者隨機(jī)分成兩組,在藥物治療相同情況下,分別采用干預(yù)法(56 例) 和常規(guī)法(50 例) 進(jìn)行護(hù)理,4 周后觀察降壓效果。        
 結(jié)果：在執(zhí)行心理干預(yù)措施4周后,觀察兩組的降壓結(jié)果，觀察組降壓療效總有效率94.6 % , 顯效28.6 % ,分別高于對(duì)照組的76 %和16 % ,經(jīng)等級(jí)資料秩和檢驗(yàn), P = 0.015 ,兩組差異有顯著性( P < 0.05)。
 結(jié)論：1.老年人心理干預(yù)的特殊性，單一的心理護(hù)理模式并不是對(duì)所有的患者能起作用,對(duì)不同亞群的患者需要采取不同的心理護(hù)理。2.護(hù)士與家屬一起對(duì)患者進(jìn)行心理疏導(dǎo)教育可以取得事半功倍的效應(yīng)。教育的效果直接影響高血壓患者的健康模式。而正確的健康信念,有利于患者的服藥依從性。3. 通過(guò)心理干預(yù)提高降壓效果，改變患者的認(rèn)知、態(tài)度，提高患者治療的依從性，從而提高高血壓的治療率和控制率，減少并發(fā)癥，提高患者生活質(zhì)量，從而提高高血壓的臨床綜合治療效果。
 
關(guān)鍵詞: 高血壓；老年人；心理干預(yù)

 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  錄
摘 要 IV
ABSTRACT V
目  錄 VI
1 緒論 1
1.1背景及意義 1
1.2目的 2
1.3關(guān)鍵詞及定義 2
1.4文獻(xiàn)回顧 2
2 研究設(shè)計(jì) 5
2.1研究設(shè)計(jì) 5
2.2研究對(duì)象 5
2.3研究工具與方法 5
2.4研究步驟 5
2.5 統(tǒng)計(jì)分析 5
3.結(jié)果 7
4.討論 8
4.1老年人心理干預(yù)的特殊性 8
4.2護(hù)士是心理干預(yù)的主體 8
5.推論與建議 9
5.1結(jié)論 9
5.2建議 9
5.3本研究局限性及展望 9
參考文獻(xiàn) 10
致謝 11