Vai trò tư vấn của điều dưỡng trong kiểm soát huyết áp ở bệnh nhân tăng huyết áp đang điều trị ngoại trú tại Bệnh viện huyện Lục Ngạn

Abstract

Objects: Comparison of the results of blood pressure control after 3 months between the group of hypertensive patients receiving routine treatment with the group of hypertensive patients receiving routine treatment with the consultation of nurses at Luc Ngan District Hospital, Bac Giang. Methods: A controlled intervention study with a follow-up period of 3 months at Luc Ngan district hospital, Bac Giang province. 170 hypertensive patients undergoing outpatient treatment and uncontrolled blood pressure (≥ 140/90 mmHg) were assigned to 2 groups, the nursing counseling intervention group (85 patients) and the routine care group (85 patients). Patients in the intervention group had regular followup visits and were consulted by nurses once a month, including: measuring BP, assessing lifestyle changes, estimating medication adherence and educating patients. on diseases, treatment and lifestyle changes through face-to-face interviews with KAP questionnaires (assess knowledge and lifestyle practices), 8-question Morisky scale (to assess adherence to treatment), flip picture set (for in-depth consultation for patients in the intervention group). Patients in the control group were re-examined at regular intervals without nursing consultation. The primary outcome was the difference in blood pressure between the intervention and control groups at 3-month follow-up.Results: After 3 months of intervention, the rate of reaching the target blood pressure in the intervention group was 45.9%, higher than in the control group (36.5%), but the difference was not statistically significant, p > 0.05. In the intervention group, the mean systolic and diastolic blood pressure after intervention was 142.4 ± 16.9 mmHg and 78.9 ± 11.8 mmHg, respectively, lower than the pre-intervention systolic and diastolic blood pressures. when the intervention was 156.9 ± 9.5 mmHg and 82.6 ± 11.0 mmHg, the difference was statistically significant with p<0.05. In the intervention group, the rate of adherence accordingto the Morisky scale from 70.6% before the intervention increased to 91.8% after the intervention, in the control group this rate increased slightly after the intervention (88, 8% vs 81.2%), p > 0.05.Conclusion: Counseling by nurses reduced systolic and diastolic pressure more than before the intervention, the difference was statistically significant. At the same time, the intervention increased treatment adherence of patients with uncontrolled hypertension compared with the control group, the difference was statistically significant.