The Study On Effects And Influential Factors Of Traditional Chinese Medicine Health Management On Hypertension Patients In Community

ObjectiveThis study was to evaluate the effects of traditional Chinese medicine (TCM) health management onhypertensive patients in community from the cognitive conditions, compliance behaviors, blood pressurecontrol, Self-evaluation of health status and satisfaction about the service projects. Influential factors ofcognitive conditions, compliance behaviors and blood pressure control and the relationship betweenSelf-evaluation of health status and blood pressure control were analyzed. The aim was to actively explorethe effective way to carry out TCM health management in hypertensive patients and provide references forimproving the integrated health management service.MethodsRandom sampling and questionnaire survey were used to investigate276patients with hypertensionfrom a community in Shanghai. The survey was carried out with self-designed questionnaire.264effectivequestionnaires were obtained. The contents of the survey include six parts:(1) basic information;(2) thequestionnaire about the related knowledge of TCM health management in hypertensive patients to evaluatethe cognition degrees;(3) the questioner about the compliance behaviors to evaluate the compliance;(4)the questioner about the hypertension control to master the blood pressure of patients in the past half year;(5) the questionnaire about self-evaluation of health status to understand the health conditions of patients;(6) the satisfaction of the service projects of TCM health management in hypertensive patients.This survey took the software of Epidata3.1to establish the database and SPSS11.5was used toanalyze the data. The main methods included: descriptive analysis, chi-square test, nonparametric tests andlogistic regression analysis. The level of the significant was set to0.05(two-tail)．. Results1. On the whole, the patients had poor cognition and good compliance behaviors.The cognition levels of diagnostic criteria, proper diet, and medical food were high; the cognitiondegrees of them were87.9%,68.9%and62.9%respectively. But the cognition levels of TCM diagnosis,right acupuncture point, syndrome differentiation, and proper tea were low; the cognition degrees of themwere48.1%,29.9%,22.0%and20.1%respectively. The compliance behaviors of hypertensive patientswith no drinking, no smoking, measuring blood pressure regularly and taking the medicine according tothe instruction on time were good. The levels of them were91.7%,83.0%,76.1%and71.6%respectively.But the compliance behaviors of taking reasonable diet, exercise and massage according to the TCM healtheducation prescription were poor. The levels of them were33.0%,22.7%and26.1%respectively. Thesingle factor analysis and logistic regression analysis showed that the degrees of cognitions andcompliance behaviors among the patients with profession of teacher or medical staff, the type ofwind-yang up-boring and high frequency of clinic visiting were higher. The cognition levels of patientswith higher education degree, positively choosing the TCM clinic were better. The female and thehypertensive patients with higher income had better compliance. The difference were all statisticallysignificant (P<0.05).2. The effect of hypertension control was good, influenced by compliance behaviors largely.75.8%of264patients kept the blood pressure in the normal range in the past half year. The effect ofhypertension control was good. The results of single factor analysis and logistic regression showed that therisk factors of hypertension control were BMI, smoking and drinking, and its protective factors were takemedicine on time, measuring blood pressure regularly, carrying on reasonable diet, taking exercises andmassage. Their OR values were1.741,4.131,9.608,0.183,0.216,0.264,0.294and0.360respectively. Thehypertension control effect of patients with normal BMI, no smoking, no drinking, taking medicine on time, measuring blood pressure regularly, carrying on reasonable diet, taking exercises and massage frequentlywere better. The difference were all statistically significant (P<0.05).3. The self-evaluation of health was good, with positive relation to hypertension control.The self-evaluation of health was mainly general, a total of125cases (47.4%).94patients (35.6%)thought their health status were good. The other45(17.0%) were bad yet. The patients with effectivehypertension control had good self-evaluation of health status. There was a positive correlation betweenhypertension control and self-evaluation of health status.4. The degrees of satisfaction about various service projects of the TCM health management werehigh.The degrees of satisfaction about the service projects of TCM health management from high to lowwere: dietary guidance (70.1%), exercise guidance (67.1%), characteristic intervention (55.0%), mentalnursing (50.0%), massage (48.8%) and living guidance (44.7%).Conclusions1. As a whole, the hypertension patients had poor cognition and good compliance behaviors. Thepatients had good hypertension control and self-evaluation of healthy status. The satisfactions aboutvarious service projects were high.2. The effect of TCM health management in hypertensive patients was good, and the program waseffective and feasible. But the advantage of TCM hadn’t been brought into play.