探討得舒飲食（Dietary Approaches to Stop Hypertension） 對於血壓之影響

Effect of DASH Intervention on Hypertensive and Pre-hypertensive Individuals

蔡璧君(Pi-Chun Tsai)

指導教授 ： 陳俊榮

共同指導教授 ： 韓柏檉

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/碩士(2014年)

https://doi.org/10.6831/TMU.2014.00034

摘要

背景 行政院衛生署公佈 2005 至 2008國民營養健康狀況變遷調查結果顯示65歲以上男女高血壓盛行率分別為55.9%與52.3%。2008至2012年，高血壓每十萬人口死亡率，有逐年上升之勢，顯示我國在高血壓防治工作上，仍須積極努力。
目的 針對內湖科學園區附近的高血壓前期和第一期的上班族進行得舒飲食教育介入，並評估教育介入對其營養知識、飲食行為、自我效能和血壓的影響。
研究方法與設計 本研究於2013年，招募內湖科學園區及其周邊港都里與港華里的60位高血壓前期和第一期的上班族，運用健康信念模式 （Health Belief Model, HBM） 強調 「自我效能」（self-efficacy），進行一對一個別得舒飲食教育，希望藉由得舒飲食 （Dietary Approaches to Stop Hypertension, DASH） 以及生活方式的修正，幫助受試者達到維持正常血壓的效果。60位受試者在8週介入期間，每隔週接受血壓、體位測量、飲食諮商以及填寫24小時飲食回憶；並在前測（第零週）、後測（第8週）、追蹤（第16週）填寫營養知識、飲食行為、自我效能問卷。
結果 前測時60位受試者平均收縮壓為133.8±15.0 mmHg，舒張壓為86.4±6.5mmHg，實施得舒飲食8週後，平均收縮壓降為122.5±14.9 mmHg（與前測相較P<0.001）舒張壓為77.7±9.8 mmHg（與前測相較P<0.001）；第16週追蹤時，平均收縮壓降為）119.6±13.2 mmHg （與追蹤相較P<0.024），舒張壓為75.3±8.4 mmHg（與追蹤相較P<0.006）。
結論 運用健康信念模式強調「自我效能」的得舒飲食教育介入對於內湖科學園區附近高血壓前期，以及第一期的上班族，可以有效的增加營養知識、改善飲食行為、加強自我效能、調降血壓且可維持至第16週。

關鍵字

高血壓 ； 健康信念模式 ； 自我效能 ； 得舒飲食

並列摘要

Background According to the Ministry of Health and Welfare, during 2005 and 2008, the prevalence rates of hypertension for men and women aged 65 years or older were 55.9% and 52.3% respectively. However, the mortality rate of hypertension per hundred thousand population during 2008 and 2012 had risen up gradually. In view of the continuing epidemic of BP-related diseases and the increasing prevalence of hypertension, efforts to reduce BP in both nonhypertensvie and hypertensive individuals are warranted.
Purpose The aim of the research was to give prehypertensive or hypertensive individuals working in or around Neihu Technology Park the tailored one on one intervention of Dietary Approaches to Stop Hypertension（DASH）and then assessed if the intervention did help them improve their nutrition knowledge, dietary practice, self-efficacy, and eventually lowered their blood pressures.
Methods In 2013, 60 participants working in Neihu Technology Park and its surrounding Gangdu Borough and Ganghua Borough were recruited for the research. In 8 weeks, Health Belief Model with an emphasis on self-efficacy was incorporated to the DASH intervention on one on one basis. The participants’ blood pressures, waist circumferences, body fat, height, and weight were measured, and their 24-hour dietary recalls were collected every other week. Each participant also filled out questionnaires regarding nutrition knowledge, dietary practice, and self-efficacy in pretest（week 0）, posttest（week 8）, and follow- up（week 16）.
Results At baseline（week 0） , the mean systolic blood pressure was 133.8±15.0 mmHg, and the mean diastolic blood pressure was 86.4±6.5mmHg. After 8 weeks of intervention, the mean systolic blood pressure and diastolic blood pressure dropped to122.5± 14.9mmHg, and 77.7±9.8 mmHg（compared to baseline systolic, and diastolic blood pressures, both P<0.001）. In week 16, the mean systolic blood pressure and diastolic blood pressure further dropped to 119.6±13.2mmHg（compared to week 8, P<0.024）, and 75.3±8.4mmHg（compared to week 8 , P<0.006）.
Conclusion Incorporating Health Belief Model with an emphasis on self-efficacy in DASH intervention tailored to prehypertensive and hypertensive working individuals in the research proved to be feasible signigicantly.

並列關鍵字

blood pressures ； Health Belief Model ； self-efficacy

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