| ObjectivesTo explore the intervention effect of online We Chat health education combined with offline complication experiential health education mode on blood pressure control,health beliefs,and unhealthy behaviors of middle-aged patients with hypertension.MethodsCases of the middle-aged hypertensive patients filed by four community health service centers in XX city have been selected conveniently.With the community service center as the unit,the cluster was randomly divided into four groups(Group A,Group B,Group C,and Group D)to carry out different intervention studies: Group A is set in regular community health education;Group B is set in regular health education + offline complications experience activities;Group C is set in regular health education + online health education;Group D is set in regular health education+ online health education + offline complications experience activities.According to the inclusion and exclusion criteria,the study subjects were included in the four community health service centers on a voluntary basis.The duration of the intervention lasted 12 weeks.The four groups of patients before and after the intervention were compared in terms of blood pressure,physical activity level,treatment attitude and belief,self-management behavior,medication compliance,and compare the blood pressure changes before intervention,4 weeks intervention,8weeks intervention,12 weeks intervention.SPSS25.0 statistical software was used for statistical analysis of the data.The measurement data conforming to the normal distribution were expressed by the mean ± standard deviation,and the measurement data of the skewed distribution are statistically described by the median and interquartile range.The measurement data conforming to the normal distribution were compared between groups and in pairs by one-way analysis of variance;The paired t-test was used for the comparison before and 12 weeks after the intervention within the group.The measurement data and count data of skewed distribution were performed by nonparametric test comparison.Repeated measure analysis of variance was applied in the comparative analysis of systolic and diastolic blood pressure at each time point of the four groups before and after the intervention.The 0.05 significance level was used throughout the statistical analysis.Results1.The sample sizes included in Group A,B,C,and D are 28,56,56,and 62,respectively.Of patients in four groups,a comparison was made in such general data as age,gender,education level,marital status,average monthly income,medical insurance type,family history,smoking history,drinking,diet preferences,years of diagnosis of hypertension,years of taking antihypertensive drugs,and years of health management and the difference was not statistically significant,indicating that the baseline data of the four groups are basically the same with comparability.There were no statistically significant differences in systolic blood pressure,diastolic blood pressure,and physical activity levels between the four groups before the intervention,and differences in treatment attitudes and beliefs,self-management behaviors,and medication compliance were statistically significant.1.The comparison of physical activity,treatment attitudes and beliefs,self-management behaviors,medication compliance,systolic blood pressure,and diastolic blood pressure of each group before and after the intervention showed that only treatment attitudes and beliefs in Group A increased significantly after intervention.The difference was statistically significant;the systolic and diastolic blood pressure decreased before and after the intervention in Group B,Group C,and Group D,and the scores of physical activity,treatment attitude and belief,self-management behavior,and medication compliance increased,and these differences were all statistically significant.3.After 12 weeks of intervention,physical activities,treatment attitudes and beliefs,self-management behaviors,medication compliance,and blood pressure change range in the four groups were compared.The results showed that there was no statistically significant difference between Group A and Group C in medication compliance;there was no significant difference in treatment attitude and belief,self-management behavior,and medication compliance between Group B and C,and there was no significant difference in self-management behavior between Group C and D,the rest were statistically different.4.The repeated measurement analysis results of the systolic and diastolic blood pressure of the four groups before the intervention to 12 weeks after the intervention showed that:(1)The difference in the systolic and diastolic blood pressure of the same group of patients before and after the intervention was statistically significant;(2)There was an interaction between systolic and diastolic blood pressure groups and time;(3)At the same time point,the differences in systolic and diastolic blood pressure of patients in different groups were statistically significant.Further pairwise comparison after 4 weeks of intervention found only the systolic blood pressure of Group D lower than that of Group A;the difference was statistically significant;after8 weeks of intervention,the systolic blood pressure of Group B,C,and D were all lower than Group A and the difference was statistically significant;after 12 weeks of intervention,systolic blood pressure: Group D <Group C <Group A,Group D <Group B <Group A;the difference was statistically significant;there was no statistically significant difference between Group B and Group C;after 4 weeks of intervention,the diastolic blood pressure of Group D was lower than Group A,and the diastolic blood pressure of Group D and Group C were lower than Group B,and the differences were both statistically significant;After 8 weeks of intervention,the diastolic blood pressure of Group C and D were lower than those of Group A and B,the difference was statistically significant;after 12 weeks of intervention,there was no statistically significant difference between Group B and Group A,the diastolic blood pressure of Group D was significantly lower than the other three groups,Group C <Group B;the difference was statistically significant.ConclusionsThe effect of online We Chat health intervention combined with offline Simple experience of complications on improving patients’ treatment attitudes and beliefs,patients’ self-management behavior and reducing blood pressure was better than the other groups: Regular community health intervention can change patients’ treatment attitudes and beliefs,but the effect on blood pressure control is temporary,and blood pressure will rebound;Simple experience of complications combined with regular interventions in the community can improve patients’ treatment attitudes and beliefs,self-management behavior and reduce patients’ diastolic blood pressure.The systolic blood pressure decreases slowly in the later stage of intervention;Online We Chat intervention combined with regular community intervention can improve patients’ treatment compliance and self-management behavior and can effectively reduce patients systolic and diastolic blood pressure,but the effect of improving patient compliance with medication is not obvious;Online We Chat health intervention,offline complication experience,and conventional health intervention can improve patients’ treatment attitudes and beliefs,self-management behavior,and medication compliance and can effectively reduce patients’ systolic and diastolic blood pressure.It is a low-cost and efficient strategy for hypertension management in the community,and can be promoted in the community. |
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