綜合性護理干預對高血壓患者睡眠質量、不良情緒及生活方式依從性的影響

余建琴　朱利月

[摘要] 目的 探討綜合性護理干預對高血壓患者睡眠質量、不良情緒及生活方式依從性的影響。方法 選取我院2010年1月～2013年1月住院治療的原發(fā)性高血壓患者80例，分為干預組和對照組各40例，兩組均予以降壓及對癥支持治療，對照組實施常規(guī)隨機對癥護理，干預組實施綜合性的護理干預，尤其是心理護理干預，比較兩組患者睡眠質量的優(yōu)良率及兩組患者治療前后SAS、SDS評分和生活方式依從性，如攝鹽量、飲食、運動、戒煙限酒方面。結果 干預組患者治療期間睡眠質量優(yōu)良率達70%，明顯高于對照組，差異有統(tǒng)計學意義（P<0.05）。治療前干預組患者的SAS及SDS評分與對照組比較，差異無統(tǒng)計學意義（P>0.05）。治療后干預組和對照組患者的SAS及SDS評分均較治療前明顯降低，且干預組較對照組降低更顯著，差異有統(tǒng)計學意義（P<0.05）。干預組患者的生活方式如攝鹽量、飲食、運動、戒煙限酒方面的依從性均明顯高于對照組，差異有統(tǒng)計學意義（P<0.05）。 結論 綜合性護理干預能明顯改善高血壓患者睡眠質量，減少其焦慮、抑郁等不良情緒，提高患者生活方式如攝鹽量、飲食、運動、戒煙限酒的依從性，促進疾病恢復，提高患者的生活質量。

[關鍵詞] 高血壓；睡眠質量；不良情緒；生活方式；依從性

[中圖分類號] R473.5 [文獻標識碼] B [文章編號] 1673-9701（2014）12-0108-04

[Abstract] Objective To investigate the effects of comprehensive nursing intervention on quality of sleep， bad mood and lifestyle adherence in patients with hypertension. Methods From January 2010 to January 2013 in our hospital， 80 cases patients were randomly divided into intervention group and control group， each of 40 cases， two groups were given antihypertensive therapy and symptomatic and supportive treatment， the control group received conventional random symptomatic care， the intervention group received comprehensive nursing intervention， especially psychological care intervention， the sleep quality excellent rate of two groups were compared， two groups of patients before and after treatment， and SAS， SDS scores and patients salt intake， diet， exercise， quit alcohol limit compliance aspects of lifestyle were compared. Results The intervention group patients sleep quality excellent rate was 70%， significantly higher than that of the control group， there were significant differences（P<0.05）. The differences of SAS scores and SDS scores in the intervention group and the control group compared before and after treatment were not significant（P> 0.05）. After treatment， the SAS and SDS scores of the intervention group and control group patients were lowered significantly than before treatment， and the intervention group lowered more significantly than the control group， there were significant differences between the two groups （P<0.05）. Lifestyle of intervention group patients compliance as salt intake， diet， exercise， quit alcohol limit aspects of compliance were significantly higher， there were significant differences between two groups（P<0.05）. Conclusion Comprehensive nursing intervention can significantly improve the quality of sleep in patients with high blood pressure， reduce anxiety， depression and other negative emotions， such as high blood pressure and increasing salt intake in patients with lifestyle， diet， exercise， quit alcohol limit compliance， thereby promoting recovery of the disease to improve the treatment of patients with life.endprint

[Key words] High blood pressure； Sleep quality； Bad mood； Lifestyle； Compliance

高血壓是目前最常見的心血管疾病之一，隨著人們生活水平的逐漸提高其發(fā)病率逐年增加。高血壓患者常伴睡眠紊亂，進一步增加跌倒等意外或腦出血等并發(fā)癥的發(fā)生，也可導致認知損害，嚴重影響患者的生活質量，因此，高血壓患者的睡眠質量在臨床護理工作中成為越來越值得重視的問題[1]。另一方面，高血壓也是一種心身疾病，在疾病發(fā)展過程中，由于病程長、并發(fā)癥多，患者易產(chǎn)生焦慮、抑郁等不良情緒，而這些不良情緒又成為影響高血壓發(fā)生、發(fā)展的重要因素，如此惡性循環(huán)不利于疾病的治療及康復[2]。單一的藥物治療亦不能滿足現(xiàn)代醫(yī)學模式（生物-社會-心理模式）的需求，調查顯示：在原發(fā)性高血壓的死因分析中，生活方式和心理行為因素已超過傳統(tǒng)的生物學因素[3]。……