社区老年中重度高血压患者衰弱发展轨迹及影响因素研究

doi:10.3761/j.issn.1672-9234.2023.03.018

摘要/Abstract

摘要：

目的探索社区老年中重度高血压患者的衰弱发展轨迹，并分析其影响因素。方法 2021年1月—12月对南宁市4所社区卫生服务中心的老年中重度高血压患者进行随访调查，使用一般资料调查表、Tilburg衰弱评估量表、Barthel指数、老年人抑郁量表、社会支持评定量表进行调查，了解其1年内衰弱变化及影响因素。结果社区老年中重度高血压患者存在C1低-稳定型（253名）、C2低-快速增长型（65名）、C3中-快速增长型（118名）、C4高-缓慢增长型（65名）4种不同的衰弱发展轨迹。以C1为参照，多分类Logistic回归分析显示，年龄、高血压病程（>10年）、患其他慢性病是C2、C3、C4的危险因素，Barthel指数是C2、C3、C4的保护因素，民族（以汉族为参照）是C4的危险因素，高血压级别和抑郁是C3、C4的危险因素，高血压病程（5~10年）是C2、C3的危险因素，均具有统计学意义（P<0.05）。结论社区老年中重度高血压患者存在不同的衰弱发展轨迹，护理人员应根据患者的情况制订相应的护理措施。

关键词: 老年人, 高血压, 衰弱, 纵向研究

Abstract:

Objective This study aims to explore the frailty trajectories of elderly patients with moderate and severe hypertension and analyze the influencing factors. Methods Elderly patients with moderate or severe hypertension in four communities of Nanning were selected to conduct questionnaires survey with a general questionnaire，Tilburg Frailty Indicator，Barthel Index，5-item Geriatric Depression Scale and Social Support Rating Scale. Results The elderly patients with moderate and severe hypertension in the community had four different debilitating development tracks：C1 low-stable type（n=253），C2 low-rapid growth type（n=65），C3 medium-rapid growth type（n=118） and C4 high-slow growth type（n=65）. With C1 as a reference，multi-classified logistic regression analysis showed that age，hypertension duration（>10 years） and other chronic diseases were risk factors for C2，C3 and C4，Barthel index was the protective factor for C2，C3 and C4，nationality（take the Han nationality as a reference） was the risk factor for C4，hypertension grade and depression were the risk factors for C3 and C4，and hypertension duration（5~10 years） was the risk factor for C2 and C3，which all have statistical significance （P<0.05）. Conclusion The elderly patients with moderate and severe hypertension in the community have different debilitating development tracks，and nursing staff should formulate corresponding nursing measures according to the situation of the patients.

Key words: Aged, Hypertension, Frailty, Longitudinal Study

王水玲, 杨连招, 陈玲, 杨永. 社区老年中重度高血压患者衰弱发展轨迹及影响因素研究[J]. 中华护理教育, 2023, 20(3): 343-348.

WANG Shuiling, YANG Lianzhao, CHEN Ling, YANG Yong. The frailty trajectory and influencing factors in community elderly patients with moderate to severe hypertension[J]. Chinese Journal of Nursing Education, 2023, 20(3): 343-348.

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