Application Of Health Coaching In The Health Management Of Hypertensive Patients In Communities

Objective1.To understand the current status of health education implementation of hypertension patients in the community,and to analyze the relevant factors of health education.2.To explore the application effect of the health coaching in the management of hypertension patients,and to provide theoretical and practical basis for promoting the precisely management of chronic diseases in the community.Methods1.Making a questionnaire to investigate the implementation and related influencing factors of health education of hypertension patients in the community.2.A total of 128 hypertensive patients who met the inclusion criteria in one of Guangzhou communities from March to April 2018,were randomly divided into the experimental group and the control group,in each of 64 cases.The experimental group was given the health coaching intervention,while the control group was given the routine community chronic disease management measures,all of them were intervened for 6months.The intervention effects were compared before and after the intervention.Results1.The mainly method of health education was face to face,and the mainly health education time was about 5-10 minutes.2.Follow-up implementation:50% of staffs reviewed previous records every time before the follow-up;54% of staffs according to plan to follow up on time;60% of staffs recorded all health problems of patients after the follow-up.3.Health assessment: 28% of staffs and 43% of patients indicated that they would be informed about health issues;34% of staffs and 32%of patients indicated that all behaviors can be accurately assessed.4.Health education contents were health behavior direction,medicin direction,blood pressure messure.5.Health education effect: 9% of staffs and 11.5% of patients indicated that guidance could be completely referenced and changed behavior.6.Influencing factors of health education effect: Staffs believed that large follow-up workload(75%),patients not cooperated(62%),staffs have limited knowledge(56%),etc.were the factors;Patients believed that the short follow-up time(80%),staffs have limited knowledge(56%),and the patient information was inaccurate(8.5%)were the factors.7.Views on health education: 94% of staffs and 86.5% of patients indicated that they were satisfied of the health education effect;17% of staffs and 41.5% of patients indicated that health education was meaningful and achieved successfully.8.Rpeated measurement of variance analysis showed that: The total scores of behavior change(the experimental group 28.23 ± 0.95,the control group 26.00±2.39),self-efficacy(the experimental group 39.11±2.07,the control group37.16±3.12)and quality of life(the experimental group 73.58±3.50,the control group 70.58±4.04)in the two groups were affected by time factors,and the scores of the experimental group were better than the control group(P<0.05).The total scores of them in the two groups were affected by different intervention methods,and the scores of the experimental group were better than the control group(P<0.05).9.Rpeated measurement of variance analysis showed that: SBP(the experimental group 123.45±7.52,the control group 135.19±13.60)and DBP(the experimental group 76.74 ± 6.33,the control group 82.89 ±9.39)in the two groups were affected by time factors,the blood pressure in the experimental group was lower than the control group(P<0.05);SBP and DBP in the two groups were affected by different intervention methods,and the blood pressure in the experimental group was lower than the control group(P<0.05).Conclusion1.The single type and the short-time of health education,the lack of follow-up,the inaccurate health assessment,and the lack of personalization of guidance are important factors leading to low compliance of patients' behavior and poor health education.2.The Large workload and short time of the follow-up,limited staff knowledge,poorly targeted health guidance content,inaccurate patient information,and incomplete health guidance content,etc.were the influencing factors of the follow-up.3.Health coaching could provide precisely behavioral change evaluation indicators,promote healthy behavior changes of hypertensive patients in community and effectively improved their self-efficacy.4.Health coaching applied to community chronic disease management could effectively reduce blood pressure levels and improve the quality of life of patients with hypertension.