Health management of hypertension patients in community Measures for the Administration of Hypertension Patients in Community
With the development of China's economy, people's material life is constantly improving, and the incidence of hypertension is increasing, which seriously affects people's health and life expectancy. At present, the prevention and treatment of hypertension in China is still at a low level, with low awareness rate, low treatment rate, low control rate and low compliance rate. Patients take drugs irregularly, do not pay attention to non-drug treatment, do not follow up regularly, and do not insist on measuring blood pressure. The national basic public health service project implemented in 2009 formulated the health management service standard for patients with hypertension, which fully reflected the country's concern for hypertension. In community health service, it is of great significance for early prevention, timely treatment and health protection to carry out health education on hypertension prevention and improve the cognition of hypertension.
Health education; Community; Blood pressure; self-management
According to the requirements of the national community health service and the actual situation of the community, organize and carry out it regularly? Self-management group for hypertensive patients? Activities. Using the favorable resources in the community, we conducted comprehensive and systematic personalized health education for hypertensive patients who participated in the self-management group in the community by means of special lectures, telephone follow-up, individual explanations, organization of patients' exchange and study, blackboard newspapers, billboards, distribution of health knowledge manuals and video playback. Introduce the basic knowledge of hypertension prevention and treatment to patients in easy-to-understand language, and master the skills of self-management. And before and after health education, physical condition monitoring, personal health status evaluation, and distribution of questionnaires. Through health education, patients are fully aware of the importance of correcting bad living habits, establishing a scientific lifestyle and adhering to long-term rational drug use, so as to achieve the purpose of combining drug treatment with non-drug treatment, reasonably and effectively control blood pressure in the normal range, prevent and reduce the occurrence and development of complications, and improve the quality of life.
1 dietary guidance
1. 1 Reasonable eating habits are cultivated all the year round, and it is not easy to change eating habits. It is very important for patients to realize that a reasonable diet is the basis of prevention and treatment of hypertension, and to control the disease and prevent complications. Instruct patients to eat regularly, and appropriately increase foods with high potassium and calcium content, such as green leafy vegetables, fresh milk and bean products. Encourage patients to drink more boiled water.
1.2 Low-salt dietary sodium is closely related to the occurrence and development of hypertension. High-salt diet will not only cause water and sodium retention in human body, but also enhance vascular reactivity, make arterioles contract and spasm, and lead to high blood pressure. Who recommends that the daily salt intake of each person should not exceed 6 grams. That is, after the rubber pad is removed from the ordinary beer lid, the salt content of the flat lid is about 6g, and about 80% of the sodium in the diet comes from the cooked or pickled products with high salt content. Therefore, it is necessary to widely publicize the reduction of edible salt and seasonings with high salt content, and eat less pickles and pickled foods.
1.3 Low-fat diet can improve the structure of animal food. It is advisable to eat a light and digestible diet with low calorie, low fat and low cholesterol, eat less and more meals, eat more vegetables, fruits, beans and milk, eat less fat and animal offal such as fish eggs and pig intestines, and supplement poultry and fish with high protein and low fat. Eat more vegetable oil instead of animal oil, and teach obese people to control their weight and lose weight properly by controlling their food intake and total calories.
2 sports guidance
2. 1 Keep proper exercise Through health education, patients can realize that exercise can regulate higher nervous activity, relax blood vessels and lower blood pressure. At the same time, it can also enhance cardiovascular function, promote lipid metabolism, control obesity and enhance human disease resistance. Encourage patients to participate in moderate housework and social activities, and appropriately increase exercise in daily activities.
2.2 Guide patients to consciously develop good living habits, pay attention to moderate rest and take some step-by-step physical exercises according to their hobbies, heart function, living habits and physical condition, such as walking, Tai Ji Chuan, gymnastics, jogging and swimming. The initial exercise time is 10- 15 minutes, 3-5 times a week, and the exercise is gradual. Teach patients how to adjust and adapt to exercise, and choose the exercise mode, exercise time, intensity and frequency that suits them.
3 quit smoking and limit alcohol.
3. 1 Because nicotine and carbon monoxide inhaled in cigarette smoke can stimulate blood vessel contraction, accelerate heart rate, increase catecholamine released by adrenal gland, and cause coronary artery spasm, angina pectoris and myocardial infarction. The prevalence of hypertension among smokers also increased significantly. So encourage the whole people not to smoke and give up smoking.
3.2 Studies have proved that heavy drinking will increase stress and easily lead to cardiovascular complications. Those who advocate normal blood pressure should not drink or drink less, those who have high blood pressure should be temperate, and those who have drinking habits should limit and reduce drinking.
4 psychological guidance
4. 1 Hypertension is related to psychological, social, cultural, emotional tension, adverse environmental stimuli and other factors. Negative emotions such as anxiety, depression and excitement have a negative impact on the control of hypertension and the occurrence and development of complications. Patients are often worried about stroke, so they are particularly nervous and afraid. These symptoms not only interact with each other, but also cause new symptoms such as fatigue and depression, aggravate the condition of hypertension and form a vicious circle of symptoms. Psychological counseling is aimed at patients, pointing out that tension, anger, worry and other emotions are very common and will happen to almost everyone. If you have high blood pressure, you will be more prone to mood swings and changes than normal people.
4.2 Teach patients to master certain psychological emergency methods, learn self-psychological counseling, improve their psychological endurance and maintain a good psychological state. Teach patients to use deep breathing, guided imagination, muscle relaxation and other skills for psychological adjustment. And establish a positive concept, long-term adherence to this method will also reduce the incidence of hypertension complications and enhance the confidence to overcome the disease.
5 medication guidance
5. 1 Let patients know the benefits of rational drug use. Drug therapy is an important part of controlling hypertension. According to the characteristics of patients with poor cognitive ability and poor memory, explain and demonstrate to patients patiently and carefully, and ask patients to repeat and strengthen their memory; In order to prevent patients from forgetting to take medicine, a note can be posted in the place where they often go at home, and the time and dosage of taking medicine can be written with eye-catching labels to remind patients to take it on time and in quantity; Or put the medicine on the pillow and get up in the morning to see the medicine and take it consciously; You can also associate drugs with an alarm clock or three meals a day to avoid forgetting. Patients are also required to list the drugs they take, including the names, dosages and reasons for taking all drugs. Patients are advised to take medicine on time, check regularly and see a doctor in time. Every time they go to see a doctor, they have to take the medicine list with them and update it constantly.
5.2 Explain the efficacy and side effects, usage and precautions of commonly used antihypertensive drugs to patients, so that they can have a certain understanding of drugs. Such as medication methods: short-acting antihypertensive drugs 3 times a day, long-acting antihypertensive drugs/kloc-0 times a day, and intermediate antihypertensive drugs 2 times a day; Taking long-acting antihypertensive drugs can reduce the frequency of taking drugs and avoid blood pressure instability caused by missing drugs; Closely observe the curative effect of antihypertensive drugs, adjust the dosage of drugs or change preparations according to blood pressure. Instruct patients to take drugs for a long time, keep their blood pressure stable, and fully realize the principle that they still need to take drugs for life when their blood pressure drops to normal range. They should not stop taking drugs as soon as their blood pressure drops, but take drugs as soon as their blood pressure rises, which will make their blood pressure fluctuate repeatedly and endanger their health.
To sum up, developing community health education is an effective way to improve the self-care ability of hypertensive patients. Through the activities of the self-management group for patients with hypertension, doctors can be guided to give regular health guidance, provide more opportunities for patients with hypertension to enrich their knowledge and participate in social activities, meet their physiological and psychological needs, and guide them to develop a healthier lifestyle. With the gradual equalization of national basic public health services, effective guidance and intervention for patients with hypertension can greatly improve community residents' understanding of hypertension, guide residents to consciously participate in the prevention and treatment of hypertension, reduce and delay the occurrence and development of complications, and improve patients' ability to maintain physical and mental health, thus improving and improving their quality of life.
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