Objective To evaluate the effects of nurse-led team management on self-management and hyperten-sion control for community-dwelling hypertensive patients. Methods A quasi-experimental study design was adopt-ed,two communities were elected as the intervention group and the control group in Wuhou District,Chengdu,and 102 hypertensive patients were recruited from each group. The intervention group received nurse-led team manage-ment for 2 years,and intervention methods included individual management,phone or home follow-up,collective inter-vention and so on. While the control group received doctor-led hypertension management. The patients' self-man-agement behaviors and hypertension control were evaluated before the intervention and 6,12,24 months after the intervention. Results After 24-month nurse-led team management,scores of self-management behaviors and hyper-tension control rate of patients in the intervention group were significantly higher than those of patients in the con-trol group(P<0.05). Conclusion Nurse-led team management could significantly improve self-management behaviors and the rate of hypertension control for hypertensive patients.%目的 评价社区护士主导的团队管理对社区高血压患者自我管理行为及血压控制的影响.方法 采用类试验研究设计,选择成都市武侯区的2所社区卫生服务中心分别作为实验组和对照组,每组各纳入102例高血压患者.实验组接受为期2年的由护士主导的团队管理,干预方法包括个体化管理、电话或居家随访、集体干预等.对照组实施以全科医师为核心的团队管理.分别评价两组在干预前、干预半年、1年、2年后的自我管理行为和血压控制达标率.结果 实验组在干预2年后的自我管理行为得分(除危险因素管理行为外)高于对照组(P<0.05),血压控制达标率高于对照组(P<0.05).结论 社区护士主导的团队管理可明显改善高血压患者的自我管理行为和血压控制达标率.
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