文章摘要
高俊岭,杨春,朱美英,傅华.应用重复测量统计分析方法评价高血压自我管理的效果[J].中华流行病学杂志,2008,29(9):869-872
应用重复测量统计分析方法评价高血压自我管理的效果
Using repeated measurement of 'analysis of variance' on hypertension patients to evaluate the self-management program in the communities
收稿日期:2008-03-11  出版日期:2014-09-15
DOI:
中文关键词: 高血压|重复测量|自我管理|社区
英文关键词: Hypertension|Repeated measurement|Self-management|Community
基金项目:上海市医学重点社区课题资助项目(051027)
作者单位E-mail
高俊岭 200032 上海, 复旦大学公共卫生学院预防医学教研室  
杨春 上海市松江区岳阳街道社区卫生服务中心  
朱美英 松江区疾病预防控制中心  
傅华 200032 上海, 复旦大学公共卫生学院预防医学教研室 hfu@shmu.edu.cn 
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中文摘要:
      目的 探讨重复测量统计分析方法在评价社区高血压自我管理效果中的应用。方法 采用以社区为基础的平行对照试验设计。干预组共有169例患者接受自我管理课程,对照组共有204例患者接受三级管理。然后用重复测量方差分析比较项目实施前、实施后6个月、12个月各指标的变化情况。结果 单变量重复测量方差分析结果显示,干预组中健康自评、健康担忧、情绪低落、症状管理自我效能、共性管理自我效能、收缩压、舒张压7个方面3个时间点的变化有统计学意义,且呈线性变化趋势;其中症状管理的自我效能得分从基线时的(6.84±2.53)升高到干预结束12个月后的(8.20±1.44),共性管理的自我效能得分从(7.28±2.45)升高到(8.89±1.05),收缩压从(137.66±7.30)mm Hg(1 mm Hg=0.133 kPa)降低到(130.41±7.71)mm Hg,舒张压从(84.13±6.70)mm Hg降低到(81.04±5.98)mm Hg;而对照组只有情绪低落和收缩压两个方面在3个时间点的变化有统计学意义,亦呈线性变化趋势,其中情绪低落得分从基线时(6.37±4.58)升高到干预结束12个月后的(7.12±4.33),收缩压从(137.55±12.37)mm Hg降低到(134.01±11.35)mm Hg。多变量重复测量方差分析结果显示,两组间健康自评、健康担忧、情绪低落、疾病影响、症状管理自我效能、共性管理自我效能、收缩压7个方面差异有统计学意义;而且分组因素和时间因素的交互作用对健康自评、情绪低落、症状管理自我效能、共性管理自我效能、收缩压5个方面的影响差异有统计学意义。结论 重复测量数据的方差分析不但可以分析分组效应,而且可以分析时间效应及其与分组效应的交互作用,结果更可靠;高血压自我管理在社区是切实可行的。
英文摘要:
      Objective To explore the application of repeated measurement‘analysis of variance'(ANOVA)in evaluating the effectiveness of 'community-based hypertension self-management program'.Methods A community-based parallel controlled trial was conducted among 3 communities.169 patients in intervention group took part in the course on hypertension self-management program once a week and 204 patients in control group received routine hypertension management services.Data collected through questionnaire at baseline and 6 months,12 months after intervention and were compared through repeated ANOVA measurement.Results Subjects in the intervention group showed statistical significance and linear trends in health self-evaluation,distress,in lOW spirit,self-efficacy in managing symptoms(SEMS),self-efficacy to managing diseases in general(SEMDG),systolic blood pressure(SBP)and diastolic blood pressure(DBP)over time by univariate test of repeated measurement ANOVA.The score of SEMS increased from 6.84±2.53 at baseline to 8.20±1.44 at 12 months after intervention while SEMDG from 7.28±2.45 to 8.89±1.05,and SBP decreased from 137.66±7.30 inln Hg(1 mm Hg=0.133 kPa)to 130.41±7.71 mm Hg.DBP decreased from 84.13±6.70 mm Hg to 81.04±5.98 mm Hg respectively.Only tow spirit and SBP changed over time were seen in the control group.Self-evaluation,distress,in low spirit,caused by diseases,SEMS,SEMDG and SBP were statistically different between control and intervention groups,and the effect of interaction between groups and time span were statmtically significanton indicators as self-evaluation,low spirit,self-efficacy in managing symptoms,seLf-efficacy tO manage diseases and sBP etc,by multivariate test of repeated measurement ANOVA. Conclusion Repeated measurement ANOVA not only could be used to analyze group-effect,but could also explain the effect and the interaction among groups and time,to make the results more reliable.The self-management approach could improve the health status and self-efficacy of the patients,so as to reduce the blood pressure.Our result showed that it was effective for hypertensive patients to be on the chronic diseases selfmanagement program.
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