| Objectives Through the introduction of CGA(Comprehensive Geriatric Assessment CGA)in elderly hypertensive patients with anxiety state on the basis of clinical diagnosis and treatment,the patients were comprehensively evaluated and reasonablely intervented from disease,physical function,psychological and social environment and other aspects,to discus its effect on the patients’ anxiety symptoms,the improvement of medication adherence,the control of blood pressure,the autonomic nerve function and quality of life,so as to provide clinical reference how to promote the patients to recovery better.Methods Selected 326 cases of hospitalized elderly hypertensive patients with anxiety state in Affiliated Hospital of North China University of science and technology from October 2015 to April 2016 in geriatrics department.There are 152 patients which conforms to the diagnostic criteria and inclusion criteria.Diagnostic criteria: 1)the diagnostic guidelines for “prevention and treatment of hypertension Chinese(2010Edition)” the provisions of the hypertension standard.2)State anxiety diagnosis: SAS self rating Anxiety Scale score more than 40 points,and the symptoms consistent with Clinical manifestations of generalized anxiety disorder conforms to “Chinese classification and diagnostic criteria for mental disorders”.Inclusion criteria: 1)age≥60 years old;2)the clear consciousness;3)the length of time in hospital more than 72 hours;4)the subjects volunteered to participate in this study,and informed consent before signing.All patients were randomly divided into intervention group and control group in 75 cases and 77 cases.The general data,record the blood pressure,ambulatory blood pressure and heart rate variability index of the two groups were collected before the study.All inclusive patients were completed CGA including anxiety symptoms assessment,medication adherence and quality of life assessment within 3 days of admission.In the course of the study,the two groups were both given standard treatment of disease,combined with psychological consultation for psychological treatment and drug treatment,intervention group and comprehensive geriatric assessment,the problems found during the assessment process were given targeted intervention.The intervention time was 2 months and 14 days.At the end of this study,a total of second evaluations were performed and blood pressure,ambulatory blood pressure and heart rate variability were reviewed.All the data were analyzed by SPSS20.0.The enumeration data were expressed by number and percentage,and use χ2 test to compare between groups.Measurement data with normal distribution were expressed by x ±s,and use two independent samples t test to analyze between groups,use paired t test to analyze before and after the group comparison.P<0.05 for the difference was statistically significant.Results 1 Compared the results of two groups patients in gender,age,culture degree,number and duration of disease years,oral medication,body mass index,smoking and drinking history and basic data of CGA information,no significant difference P>0.05).2Before the research,compared two groups of patients’ SAS scores,no significant difference(P>0.05).After the research,the SAS scores of two groups were lower than before,and intervention group anxiety symptoms improved more obviously(P<0.01).3Before the research,compared two groups of patients’ medication adherence,no significant difference(P>0.05).After the research,the medication adherence of intervention group was significantly higher than that of control group(P<0.01).4 Before the research,compared two groups of patients’ blood pressure lever,no significant difference(P>0.05).After the study,the systolic and diastolic blood pressure of intervention group was significantly lower than that of control group(P<0.05).5 Before the research,compared two groups of patients’ ambulatory blood pressure levels,no significant difference(P>0.05).After the research,in addition to night average diastolic blood pressure,the intervention group’ the remaining 6 indicators were lower(P<0.05).7Before the research,compared two groups of the number of patients with dipper blood pressure,no significant difference(P>0.05).After the study,the intervention’ patients with dipper blood pressure is more(P<0.05).7 Before the research,compared two groups of patients’ index of heart rate variability,no significant difference(P>0.05).After the research,the index of heart rate variability in patients in the two groups were improved after the research(P<0.01);and the intervention group’ heart rate variability index was improved significantly more(P<0.05).8 Before the research,compared two groups of patients’ quality of life score,no significant difference(P>0.05).After the study,the quality of life score in patients in the two groups were improved after the study(P<0.05);and in addition to the physiological function,the remaining 7 of the intervention group were significantly higher(P<0.05).Conclusions The introduction of CGA in the treatment of elderly patients with hypertension complicated with anxiety,and give a scientific intervention for screening out the problem,can have the following effects: 1)to effectively alleviate the anxiety symptoms of patients.2)to improve patients’ medication adherence and promote the stable blood pressure,improve autonomic nerve function.3)to make the life quality of the patients improved significantly. |
