衛生教育對於榮民之家高血壓老人自我照顧行為與血壓控制之影響

The Effect of Health Education on self-care Behaviors and Hypertension Control in Elderly Hypertensive Patients at a Veterans Home

杜明勳(Ming-Shium Tu)

《中華公共衛生雜誌》 18卷1期 (1999/02) Pp. 54-65

https://doi.org/10.6288/CJPH1999-18-01-07

摘要

明白施予衛生教育六個月後，高血壓個案之疾病認知、態度、自我照顧行為及血壓變化情形如何，又影響其變化之因素為何。以83年某榮家全體住家榮民健康調查時，篩檢出懷疑高血壓個案為對象。於其每月門診追蹤時，施予衛教前測驗，後予衛教。衛教以隨機分組分為每月衛教及隔月衛教兩組。85年7月至86年元月共收集有效問卷222份。個案以71-80歲老人居多，教育年數大多不及六年，視力及聽力不佳，智能狀況不理想，對高血壓之認知、態度及行為得分好壞各半。464%個案之朋友亦患高血壓或中風，716%個案除高血壓外尚志有其他疾病。衛教後，其高血壓之認知、「在意血壓」態度、及「依指示用藥」、「定期看診」和「自刻血壓」行為各分數均有顯著改進。衛教方面，每月組之認知改善比隔月組明顯，但態度或行為之差異則不顯著。血壓方面，不論縮壓或舒壓於衛教後均比衛教前稍高，而舒壓之增高於隔月組比每月組明顯。衛教後促成各因素改變之探討，鈴認知、態度、或各項行為方面，各別均或與個案之「年齡、智能、亦患他病、衛教分組、朋友數、及衛教前個別健康信念得分」有關。另舒張壓方面，除上述因子可能相關外，個案之「教育、讀寫能力、聽力、認知、及用藥行為」均亦有關。就本榮家高血壓老人而言，除定期追蹤給予藥物治療對個案血壓控制有幫忙外，每月一次重複衛教，給予清楚簡單的訊息，對其疾病照顧也很重要。另外，增進人際關係及彼此關懷應該也有助益。

關鍵字

高血壓 ； 老人 ； 自我照顧行為 ； 衛生教育

並列摘要

This study examined the effect of health education (HE) on individual's hypertension (HT) cognition, attitude, self-care behaviors and blood pressure (BP) control after 6 months HE for those suspected HT subjects at a veterans home. All suspected hypertensive individuals screened in 1994 were included as subjects. Pre-test and HE were applied at clinic before participant's regular monthly followup. Subjects were randomly allocated to monthly education group (MEG) and everyother-month group (EOMG). A total of 222 complete interviews were collected from July 1996 to January 1997. Most subjects were 71 to 80 years old with less than 6 years of education, had poor vision and audition, and had low mental scores. Only half of the subjects had good HT cognition, attitude and self-care behaviors. Of these individuals, 46.4% had friends with HT or a stroke history. In addition to HT, 71.6% were co-morbid with other diseases. After HE, the HT cognition, the attitude toward BP, and self-care behaviors, such as medical compliance, on-schedule clinic visits and self-check of BP, improved. MEG was better than EOMG in disease cognition, but not in attitude or behaviors. The BP measurements, both systolic and diastolic, were slightly higher after HE than before. From analysis of factors that influence the changes after HE, the promotion of HT cognition, attitude, and behaviors were related to individual's age, mentality, co-morbidity, HE group, the number of friends and pre-educational HT health believes. In addition to above factors, the diastolic BP reduction was also related to individual's educational level, writing or reading ability, audition, disease cognition and medical compliance. For those HT residents, in addition to physician's regular follow up and medication, repeated monthly education, giving simple and clear messages, was helpful for their disease care.

並列關鍵字

hypertension ； elderly ； self-care ； health education