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目的调查城市高血压患者对家庭血压监测(HBPM)的知晓情况及行为模式。方法采取便利取样法,自2013年5-8月在北京、杭州、广州三城市的23家医院和社区卫生中心对门诊就诊高血压患者进行横断面问卷调查。问卷包含基本的人口统计学信息、高血压史及并发症、HBPM持有情况及设备种类等信息,并对HBPM的认知及行为模式进行调查,内容涵盖收缩压与舒张压上限值、测量的时机、频度及方法等问题。结果调查共计发放问卷2040份,回收1992份(应答率97.8%),数据完整的有效问卷1895份。其中伴发心血管病危险因素的比例:吸烟为22.6%(429/1895),高盐摄入21.4%(405/1895),无规律锻炼28.3%(537/1895);33.2%(629/1895)合并心脏病,14.6%(276/1895)合并脑血管病,24.9%(471/1895)合并糖尿病。85.2%(1615/1895)配备HBPM设备,82.9%(1339/1615)为电子式,其中上臂式占78.3%(1048/1339)。能准确回答HBPM收缩压/舒张压上限值(135/85mm Hg)的仅占4.9%(92/1895),43.6%(826/1895)选择血压<140/90mm Hg为HBPM正常值。配备HBPM的患者,30.5%(493/1615)每日测量血压,6.9%(111/1615)从来不测。28.1%(454/1615)仅在有症状时测量,早晚测量者仅占19.6%(316/1615)。33.9%(547/1615)每次仅测量1遍,52.7%(851/1615)从不记录HBPM读数,37.1%(599/1615)就诊时不向医生提供测量数据。结论尽管城市高血压患者HBPM设备持有率高,但认知水平及利用率偏低,提示亟需加强教育与培训以改进对血压测量和监控的认知及行为模式。
Objective To investigate the status and behavioral patterns of family blood pressure monitoring (HBPM) in urban hypertensive patients. Methods A convenient sampling method was used to survey the outpatients with hypertension from 23 hospitals and community health centers in Beijing, Hangzhou and Guangzhou from May to August in 2013. The questionnaire contains basic demographic information, history of hypertension and complications, status of HBPM and device type, etc. The survey also investigates the cognitive and behavioral patterns of HBPM, covering the upper and lower systolic and diastolic blood pressure measurements, The timing, frequency and methods and other issues. Results A total of 2040 questionnaires were sent out to collect 1,992 questionnaires (response rate 97.8%) and 1895 valid and complete questionnaires. Among them, the risk factors associated with cardiovascular disease were 22.6% (429/1895) for smoking, 21.4% (405/1895) for high salt intake, 28.3% (537/1895) for irregular exercise, 33.2% (629/1895) ) Had heart disease, 14.6% (276/1895) had cerebrovascular disease, and 24.9% (471/1895) had diabetes mellitus. 85.2% (1615/1895) equipped with HBPM equipment, and 82.9% (1339/1615) were electronic, with the upper arm accounting for 78.3% (1048/1339). Only 4.9% (92/1895), 43.6% (826/1895), who were able to accurately answer HBPM systolic / diastolic blood pressure (135/85 mm Hg), had a blood pressure <140/90 mm Hg, which was normal to HBPM. Patients with HBPM, 30.5% (493/1615) measured daily blood pressure and 6.9% (111/1615) never tested. 28.1% (454/1615) measured only when symptomatic and 19.6% (316/1615) for morning and evening measurements. 33.9% (547/1615) measured only 1 pass at a time, 52.7% (851/1615) never recorded HBPM readings, and 37.1% (599/1615) did not provide the doctor with a measurement at the time of the visit. Conclusions Although the prevalence of HBPM devices in urban hypertensives is high, their cognitive and underuse rates suggest that there is an urgent need to strengthen education and training to improve cognitive and behavioral patterns of BP measurement and monitoring.