神经内科护士对直立性低血压知识、态度和行为的调查分析

doi:10.3969/j.issn.1673-5765.2022.06.016

摘要/Abstract

摘要：

目的了解神经内科护士关于直立性低血压的知识、态度及行为现状，为临床有针对性地开展相关培训及护理管理项目提供依据。

方法于2019年4月采用便利抽样法选取首都医科大学附属北京天坛医院149名神经内科护士为研究对象，使用自行设计的直立性低血压知信行量表进行调查。知信行量表包括知识（6个条目）、态度（6个条目）、行为（10个条目）3个维度的22个条目。比较不同学历、年龄、工作年限、职务、职称的护士直立性低血压知信行总分，以及不同病区护士的知识、态度、行为各维度得分。调查护士对直立性低血压知识的工作需求。

结果神经内科护士直立性低血压知信行量表总分为85.80±12.80分，知识得分23.30±3.30分，态度得分25.10±3.30分，行为得分37.30±8.50分。不同学历、年龄、工作年限、职务、职称的神经内科护士直立性低血压知信行总分比较，差异均无统计学意义。不同病区的护士直立性低血压知识（P <0.01）、态度（P =0.03）、行为（P =0.02）得分差异具有统计学意义。目前神经内科护士最希望学习的直立性低血压知识为其预防措施和危险因素，分别占59.73%（89/149）和19.46%（29/149）。

结论神经内科护士预防直立性低血压的知识、态度、行为仍有待提高。在今后的工作中管理者应加强直立性低血压的培训，将其预防措施纳入管理系统，提高护理质量。

文章导读： 本研究基于“知信行理论模型”与专家函询设计的直立性低血压知信行问卷调查结果显示，神经内科护士直立性低血压知信行水平有待提高，提高其知识水平，有助于改善其态度和行为。

关键词: 直立性低血压; 神经内科; 护士; 护理质量

Abstract:

Objective To explore the knowledge, attitude and practice status of orthostatic hypotension in neurology nurses.

Methods In April 2019, 149 neurology nurses in Beijing Tiantan Hospital, Capital Medical University were selected using the convenience sampling method. They were investigated using the self-designed orthostatic hypotension questionnaire scale, which included three dimensions 22 items: knowledge (6 items), attitude (6 items), and clinical practice (10 items). The total scores were compared among the nurses of different education level, ages, working years, post, professional titles, and the items scores were compared among the nurses of different wards, to analyze these nurses' work needs in orthostatic hypotension.

Results The mean total score of orthostatic hypotension in neurology nurses was 85.80±12.80 points, the score of knowledge was 23.30±3.30 points, the score of attitude was 25.10±3.30 points, and the score of clinical practice was 37.30±8.50 points. There was no statistical differences in the total score among the nurses. There were statistical differences in knowledge (P<0.01), attitude (P=0.03) and clinical practice (P=0.02) of orthostatic hypotension among the nurses in different wards. At present, what neurology nurses would like to learn about orthostatic hypotension were preventive measures and risk factors, accounting for 59.73% (89/149) and 19.46% (29/149), respectively.

Conclusions The neurology nurses' knowledge of orthostatic hypotension needs to be improved. In the future, managers should strengthen the training of orthostatic hypotension among the neurology nurses, and incorporate preventive measures for orthostatic hypotension into the management system to improve the quality of nursing.

Key words: Orthostatic hypotension; Neurology; Nurse; Nursing quality

王垚, 李京连, 邓永梅, 柳欣. 神经内科护士对直立性低血压知识、态度和行为的调查分析[J]. 中国卒中杂志, 2022, 17(06): 643-647.

WANG Yao, LI Jinglian, DENG Yongmei, LIU Xin. Analysis on Knowledge, Attitude and Practice Status of Orthostatic Hypotension among Neurology Nurses[J]. Chinese Journal of Stroke, 2022, 17(06): 643-647.

参考文献

[1] 曾秀梅. 社区老年高血压病人直立性低血压现状及药物影响[D]. 广州：广州医科大学，2015.

[2] HANADA M，TAWARA Y，MIYAZAKI T，et al. Incidence of orthostatic hypotension and cardiovascular response to postoperative early mobilization in patients undergoing cardiothoracic and abdominal surgery[J/OL]. BMC Surg，2017，17（1）：111[2021-12-02]. https://doi.org/10.1186/s12893-017-0314-y.

[3] VELSEBOER D C，DE HAAN R J，WIELING W，et al. Prevalence of orthostatic hypotension in Parkinson's disease：a systematic review and meta-analysis[J]. Parkinsonism Relat Disord，2011，17（10）：724-729.

[4] TANG X B，WU B，LIU L，et al. Correlation of orthostatic hypotension with extracranial carotid and intracranial cerebral arteries atherosclerosis in patients with acute ischemic stroke under cerebral angiography[J]. Blood Press Monit，2021，26（5）：328-332.

[5] RAWLINGS A M，JURASCHEK S P，HEISS G，et al. Association of orthostatic hypotension with incident dementia，stroke，and cognitive decline[J/OL]. Neurology，2018，91（8）：e759-e768[2021-12-02]. https://doi.org/10.1212/WNL.0000000000006027.

[6] ONG H L，ABDIN E，SEOW E，et al. Prevalence and associative factors of orthostatic hypotension in older adults：results from the well-being of the singapore elderly（WiSE）study[J/OL]. Arch Gerontol Geriatr，2017，72：146-152[2021-12-02]. https://doi.org/10.1016/j.archger.2017.06.004.

[7] HAMILTON N E，BELZER E G，THIEBAUX H J. An experimental evaluation of the KAP model for HE[J]. Int J Health Educ，1980，23（3）：156-161.

[8] METZLER M，DUERR S，GRANATA R，et al. Neurogenic orthostatic hypotension：pathophysiology，evaluation，and management[J]. J Neurol，2013，260（9）：2212-2219.

[9] SUTTON R. Clinical classification of syncope[J]. Prog Cardiovasc Dis，2013，55（4）：339-344.

[10] HARTOG L C，SCHRIJNDERS D，LANDMAN G，et al. Is orthostatic hypotension related to falling? A meta-analysis of individual patient data of prospective observational studies[J]. Age Ageing，2017，46（4）：568-575.

[11] FREEMAN R，ABUZINADAH A R，GIBBONS C，et al. Orthostatic hypotension：JACC state-of-the-art review[J]. J Am Coll Cardiol，2018，72（11）：1294-1309.

[12] ALAGIAKRISHNAN K，PATEL K，DESAI R V，et al. Orthostatic hypotension and incident heart failure in community-dwelling older adults[J]. J Gerontol A Biol Sci Med Sci，2014，69（2）：223-230.

[13] PETERS R，ANSTEY K J，BOOTH A，et al. Orthostatic hypotension and symptomatic subclinical orthostatic hypotension increase risk of cognitive impairment：an integrated evidence review and analysis of a large older adult hypertensive cohort[J]. Eur Heart J，2018，39（33）：3135-3143.

[14] 中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中华心血管病杂志，2011，39（7）：579-616.

[15] MANCIA G，FAGARD R，NARKIEWICZ K，et al. 2013 ESH/ESC guidelines for the management of arterial hypertension：the task force for the management of arterial hypertension of the European Society of Hypertension（ESH）and of the European Society of Cardiology（ESC）[J]. J Hypertens，2013，31（7）：1281-1357.

[16] 张梅梅.兰州市某综合性三甲医院护理人力资源配置现状及工作满意度调查研究[D]. 兰州：兰州大学，2016.