Analysis of a questionnaire on hypertension. Analysis and evaluation of the results of a study of patients with hypertension. Stages of hypertension

State budgetary educational institution of secondary vocational education of the Moscow region

"Sergievo-Posad Medical School (Technical School)"

Educational and research work on the topic:

Completed by: 4th year student

Zubareva A.I.

Scientific adviser:

teacher

Konstantinova N.V.

Sergiev Posad

Introduction………………………………………………………………………………..3

Chapter 1. Features of preventive work among patients suffering from arterial hypertension

1.1 Classification of arterial hypertension…………………………………..5

1.2 Preventive aspects of the work of medical staff at a school of arterial hypertension.................................................... ........................................................ .................8

1.3 Structured program for patient education at the arterial hypertension school…………………………………………………………………………………...11

Chapter 2. Study of the dynamics of the results of the school of arterial hypertension…………………………………………………………………………………13

Conclusion…………………………………………………………………………………16

References…………………………………………………………………………………17

Appendix No. 1

Appendix No. 2

Introduction

Arterial hypertension (hypertension) - a persistent increase in blood pressure from 140/90 mm Hg. Art. and higher. This is a disease whose main manifestation is high blood pressure. The problem of arterial hypertension is quite serious.

Firstly, this disease is characterized by high prevalence. Arterial hypertension affects 20–30% of the adult population. Before the age of 50, the disease is more often observed in men, after 50 years – in women. According to experts from various countries, every third inhabitant of the globe suffers from arterial hypertension, in the Russian Federation - more than 40% of the population, of which 50% of patients do not know that they have this disease.

Secondly, arterial hypertension is often asymptomatic, especially in the early stages. It is no coincidence that she is called the “silent killer.” Experience shows that even with very high blood pressure, the patient’s health can remain good. Such a subjectively calm course of arterial hypertension leads to the fact that a person simply does not know that he has a serious pathology.

Since arterial hypertension is a major risk factor for the development of coronary heart disease, cerebrovascular disease, chronic renal failure and chronic heart failure, it is very important to encourage patients to take better care of their own health. In this regard, it is clear how important early detection of all persons with arterial hypertension is.

The problem of combating arterial hypertension is given due attention by ministries and health departments of all countries. In many countries of the world, including Russia, appropriate programs have been developed that provide for early detection, treatment and prevention of the disease.

In this case, schools of arterial hypertension play an important role.

The purpose of the educational and research work is to study the preventive aspects of the activities of the medical staff of the school of arterial hypertension.

1) study special medical literature on arterial hypertension and methods of preventing its complications;

2) get acquainted with the peculiarities of the activities of the medical staff of the school of arterial hypertension;

3) conduct a survey among patients attending school;

4) analyze the dynamics and effectiveness of the implementation of the program of conducting classes at the school of arterial hypertension.

To solve these problems and obtain statistical materials for the purpose of their subsequent analysis, we conducted a study on the basis of the cardiology office of the clinic of the Sergiev Posad Regional Hospital.

Chapter 1. Features of preventive work among patients suffering from arterial hypertension

1.1 Classification of arterial hypertension

Arterial hypertension (AH) is a chronic disease accompanied by a persistent increase in blood pressure above acceptable limits (systolic pressure above 139 mm Hg and/or diastolic pressure above 89 mm Hg).

There is no uniform systematization, but most often doctors use the classification that was recommended by WHO and the International Society of Hypertension (ISHA) in 1999. According to the WHO definition, hypertension is classified, first of all, by the degree of increase in blood pressure, among which:

First degree – mild (borderline hypertension) – characterized by pressure from 140/90 to 159/99 mm Hg. pillar

In the second degree hypertension – moderate – hypertension ranges from 160/100 to 179/109 mm Hg. pillar

In the third degree – severe – pressure is 180/110 mm Hg. pillar and above.

You can find classifiers that distinguish 4 degrees of hypertension. In this case, the third form is characterized by pressure from 180/110 to 209/119 mm Hg. column, and the fourth is very heavy - from 210/110 mm Hg. pillar and above. The degree (mild, moderate, severe) indicates solely the level of pressure, but not the severity of the course and condition of the patient.

In addition, doctors distinguish three stages of hypertension, which characterize the degree of organ damage. Classification by stages:

Stage I. The increase in pressure is insignificant and inconsistent, the functioning of the cardiovascular system is not impaired. Patients usually have no complaints.

Stage II. Blood pressure is high. There is an enlargement of the left ventricle. Usually there are no other changes, but local or generalized narrowing of the retinal vessels may be noted.

Stage III. There are signs of organ damage:

• 
  heart failure, myocardial infarction, angina pectoris;
• 
  chronic renal failure;
• 
  stroke, hypertensive encephalopathy, transient cerebral circulatory disorders;
• 
  from the fundus of the eye: hemorrhages, exudates, swelling of the optic nerve;
• 
  lesions of peripheral arteries, aortic aneurysm.

• 
  systolic – only the upper pressure is increased, the lower – less than 90 mm Hg. pillar;

• 
  diastolic – increased lower pressure, upper – from 140 mm Hg. pillar and below;
• 
  systolic-diastolic;
• 
  labile – blood pressure rises for a short time and normalizes on its own, without medications.

Hypertensive crises

This is the most severe manifestation of arterial hypertension, in which the pressure rises to critical levels. As a result, cerebral circulation is disrupted, intracranial pressure rises, and brain hyperemia occurs. The patient experiences severe headaches and dizziness, accompanied by nausea or vomiting.

Hypertensive crises, in turn, are divided according to the mechanism of pressure increase. In the hyperkinetic form, the systolic pressure rises, in the hypokinetic form, the diastolic pressure rises; in the eukinetic crisis, both the upper and lower levels increase.

Refractory hypertension

In this case, we are talking about arterial hypertension, which cannot be treated with medications, that is, the pressure does not decrease even when using three or more drugs. This form of hypertension is easily confused with those cases where treatment is ineffective due to an incorrect diagnosis and incorrect choice of medications, as well as due to the patient’s non-compliance with doctor’s prescriptions.

White coat hypertension

The main teaching method includes a lecture course, practical classes on teaching self-control skills, followed by keeping a diary. The formation of study groups, scheduling of study sessions, maintaining a patient file and notifying patients by telephone, as well as monitoring patient attendance at classes is carried out by a nurse at the school of arterial hypertension. When conducting practical exercises, a doctor and a nurse can use the visual materials at their disposal. Patients are given manuals “Recommendations for patients with hypertension” and instructions for patients. Particular attention is paid to the patient’s ability to analyze the data obtained and predict pre-crisis conditions for timely provision of independent assistance.

In practical classes, patients, as well as people with risk factors for arterial hypertension, become familiar with the rules of behavior for lifestyle changes, learn about the possibility of influencing manageable risk factors, learn to control their blood pressure, and take into account its response to therapy.

The lesson on non-drug methods of treating hypertension is of great interest to school students. Recommendations for organizing work and rest schedules, diet, physical therapy and other interventions are selected individually for each school participant. The school's medical staff draws special attention to patients to the need to quit smoking and drinking alcohol, increase physical activity in patients, and combat excess body weight in obese individuals.

The principles of combination drug therapy are substantiated. More often, antihypertensive treatment consists of a comprehensive selection of drugs with different mechanisms for lowering blood pressure.

Organization of preventive blood pressure measurement in persons with risk factors, blood pressure monitoring in the presence of hypertension influence the degree of patient adherence to treatment. After school, there is an increase in the number of patients with arterial hypertension who regularly take antihypertensive drugs. The degree of patient adherence to treatment is influenced by the following factors: gender, age, level of education, and personal characteristics of the patient. The effectiveness of treatment (achieving the target blood pressure level), the complexity of the treatment regimen (number of tablets per day, frequency of administration, fixed time of administration), side effects, and cost of drugs are of certain importance. In addition, the nature of the disease, the “medical” factor (competence and “conscientiousness” of the doctor and nurse in the prevention room), the patient’s awareness, and the patient’s quality of life also play an important role.

Patients who have completed such schools gain real chances to significantly expand the area of ​​their existing life interests and realize their abilities in the field of socially useful work.

Undoubtedly, the widespread introduction of developed programs and visual aids into medical practice will be useful for both patients and doctors in their daily work.

1.3 Structured patient education program at the hypertension school

During the year, approximately 150-180 people are trained at the school of arterial hypertension, of which 70% are pensioners and 30% are the working population. When forming groups for classes, the nurse unites patients according to the following criteria: age, working population, pregnant women, people with no effect from the antihypertensive therapy used. The nurse involves patients with risk factors and their relatives, as well as pregnant women with arterial hypertension, in school classes. The group consists of 10-15 people, which allows for an individual approach to each patient. The duration of the lesson is about an hour, the frequency is once a week, there are five lessons in total.

First lesson:

Analyzing most of the points of the questionnaire offered to the patients of the study group at the end of the training, we can conclude that during the classes, the attitude of the group patients to their health changed significantly for the better, since the patients received comprehensive information from the school medical staff regarding the disease itself, its complications, and the rules of self-control and self-help, methods of preventing possible complications.

For example, 13 out of 15 people began to follow the diet prescribed by the doctor and regularly monitor their weight; 12 people became interested in popular scientific literature on their disease; 5 smokers reported that they would try to quit smoking; out of 9 people who drink alcohol even occasionally, seven gave up drinking alcohol altogether; all 15 people began to regularly monitor their blood cholesterol levels and blood pressure. And finally, 14 out of 15 people said at the end of the training that during the classes they received adequate psychological support from the medical staff of the arterial hypertension school.

Conclusion

As practice shows, not all patients can successfully control the course of hypertension. The most common reason is a simple lack of information about the disease, its symptoms, methods of treatment and prevention of complications, as well as methods for correct and effective self-control of one’s disease.

Currently, the World Health Organization has officially recognized education as a full-fledged method of treating chronic diseases, as important as taking medications or performing surgery.

Training people suffering from arterial hypertension in methods of self-control and “management” of their disease is the most important and real element of improving the quality of care for patients in order to prevent complications and further disability. Doctors and nurses do everything they can to teach patients how to “manage” their illness.

Bibliography

1. 
   Baksheev V.I., Kolomoets N.M. "Hypertonic disease. How to live and survive. Educational and methodological manual for classes at school for a patient with hypertension M.: IKF “Catalogue 2012. 4th edition, supplemented and corrected.

1. 
   Baksheev V.I., Kolomoets N.M., Tursunova G.F. Clinical effectiveness of the work of the school for patients with hypertension at the outpatient stage. Therapeutic archive, 2009, T. 77. No. 11.- P. 49-55

1. 
   Ginzburg M.M., Kryukov N.N. Obesity. Influence on the development of metabolic syndrome, prevention and treatment. M. "Medpraktika-M" 2010. 172 p.

1. 
   Gogin E.E. Hypertonic disease. New in diagnosis and treatment. Moscow 2007. – 400 p.

1. 
   Kryukov N.N., Larina T.A., Osipov Yu.A. Educational schools for the diagnosis and treatment of arterial hypertension. Samara, “Commonwealth Plus” 2014. 194 p.

1. 
   Polyakov V.P., Movshovich B.L., Savelyeva G.G. Cardiological practice: A guide for doctors in 2 volumes. Samara 2004

QUESTIONNAIRE No. 1

Dear respondent!

Preventive aspects of the activities of medical staff at the school of arterial hypertension »

1. Your age is _________

2. Gender ________________

3. How long have you been suffering from hypertension? _________

4. What stage of hypertension have you been diagnosed with? _______________

5. Do you regularly visit a cardiologist?

7. Do you read any literature about arterial hypertension?

9. Are you obese?

11. Do you smoke?

12. Do you drink alcohol?

13. Do you regularly monitor your blood cholesterol levels?

15. Do you know about possible complications with this disease?

17. Do you know how to behave in a stressful situation (taking into account your illness)?

18. Do you know how to help yourself if your health worsens?

19. Do you need psychological support?

QUESTIONNAIRE No. 2

Dear respondent!

We, medical school students, are conducting research on the topic “ Preventive aspects of the activities of medical staff at the school of arterial hypertension »

1. Your age_________

2. Gender___________

3. Do you regularly visit a cardiologist?

5. Do you know what stage of hypertension you suffer from?

7. Are you obese?

9. Do you drink alcohol?

10. Do you regularly monitor your blood cholesterol levels?

12. Do you know how to behave in a stressful situation (taking into account your illness)?

14. Do you need psychological support?

No

Catalog: conference
konferenciya -> Burnout syndrome of medical workers
konferenciya -> Research work the role of the nurse in identifying risk factors and preventing respiratory diseases
konferenciya -> 1. 1 The concept of diabetes mellitus
konferenciya -> Dependent orientations of modern youth
konferenciya -> Pregnant woman's health
konferenciya -> Study of introduced fruit and berry and ornamental crops in the arid conditions of the Astrakhan region
konferenciya -> Student research work

Data were obtained using a self-developed questionnaire.

From Figure 2.1 it can be seen that in the therapeutic department of the State Autonomous Institution "City Clinic No. 18" with arterial hypertension, men predominate (62.5%). This is explained by the lack of female hormones in men, which protect women from this disease.

Figure 2.1. Gender of patients in the therapeutic department of the State Autonomous Institution "GP No. 18" with arterial hypertension.

Rice. 2.2. Age of patients in the therapeutic department of "GP No. 18" with arterial hypertension.

Rice. 2.3 Patients’ answers to the question of whether they are often bothered by heart problems. The vast majority rarely experience heart problems.

Fig.2.4. Patients' responses to the question of how often they measure their blood pressure.
Most people don't measure their blood pressure regularly.

Rice. 2.5. Patients' answers to questions about excess weight. This chart indicates that most people suffering from high blood pressure are overweight.

Rice. 2.6 Patients’ answers about the amount of salt consumed. The majority of respondents found it difficult to answer. This suggests that people are not watching their diet.

Rice. 2.7 Patients' answers to the question about smoking. Most of the subjects were non-smokers.

Rice. 2.8 Patients’ answers to the question about awareness of such a disease as atherosclerosis. The vast majority of patients are unaware of this disease.

Rice. 2.9. When asked about alcohol consumption, the majority of respondents answered “Yes.”

Rice. 2.10. Most patients found it difficult to answer the question about hereditary predisposition to hypertension.

Rice. 2.11 Patients' responses to the question about exposure to stress. Most people are stressed.

Rice. 2.12. Patients' responses to questions about activity during the day.
The vast majority lead an inactive lifestyle and move little.

Rice. 2.13. Patients' answers about the availability of a blood pressure measuring device at home. Most patients do not.

Rice. 2.14. Patients' responses to the question of whether they know how to use a blood pressure measuring device. The vast majority do not know how to use it.

Studying the role of the nurse in the medical examination of patients with hypertension.

1. The nurse gives the patient a consent and information sheet. The patient must read it carefully and sign it. (Appendix No.)

3. Measurement of basic physical indicators of a person. Includes weighing, measuring body length, chest and abdominal circumference.

If hypertension is suspected, a cholesterol test is performed. If the indicators are high, they are sent to the 2nd stage of medical examination (lipid profile). Next, consultation with a cardiologist.

Patient Ivanova Evgenia Vladimirovna, 63 years old, was admitted with complaints of pressing, weakly intense pain in the chest, radiating to the area of ​​the left shoulder blade, lasting about 10 minutes, occurring when walking 50 m, relieving on its own at rest or 1-2 minutes after administration nitroglycerin; intense headaches in the occipital region, tinnitus against the background of increased blood pressure.

From the anamnesis. At the age of 57, the patient began to notice the appearance of pain in the occipital region of the head, due to stress. I went to the doctor, and for the first time an increase in blood pressure to 150/90 mm was registered. rt. Art. She was not examined for high blood pressure; she took Adelfan for antihypertensive purposes for several months, then discontinued treatment on her own. Currently not receiving treatment. Risk factors: does not smoke, does not drink alcohol. Heredity is burdened with cardiovascular diseases: my father suffered from hypertension and died at the age of 60 from acute cerebral circulation.

ECG: correct rhythm, heart rate 82 beats/min. Signs of left ventricular hypertrophy. Increased cholesterol. She was sent for a lipid profile.

The patient was diagnosed with coronary artery disease, angina pectoris class II, post-infarction cardiosclerosis. Stage III hypertension, 2nd degree.

Studying the role of the nurse in the work of the School of Health. Arterial hypertension."

BIBLIOGRAPHY

1. A. John Camm, Thomas F. Luscher, Patrick W. Serruis, trans. from English edited by E. V. Shlyakhto; VNOK, Feder. Center for Heart, Blood and Endocrinology named after. V. A. Almazova. - M.: GEOTAR-Media, 2011. - 1446 p.

2. Aleksandrov Yu.I. Psychophysiology. Textbook for universities. - St. Petersburg: Peter, 2013. – 496 p.

4. Arterial hypertension in outpatient practice. Osadchuk M. A., Kireeva N. V., Korzhenkov N. P. Textbook. UMO approved. 2012, Moscow.

5. Beavers G. Arterial hypertension / G. Beavers, G. Lip, E. O'Brainen; lane from English A.N. Anvaera; edited by V.I. Metelitsa. - M.: BINOM. Lab. knowledge, 2005. - 175 p.: ill. — Bibliography at the end of the chapters.

Questionnaire for patients

1. Please indicate your gender:

2. Please indicate your age

3. Do you often worry about heart problems?

4. Do you measure your blood pressure regularly?

No
— Sometimes I measure

5. Are you overweight?
- Yes

6. Do you consume a lot of salt?

No
- Can not answer

— I smoked, but I quit

8. Do you know what Atherosclerosis is?
- Yes

No
— I find it difficult to answer

9. Do you drink alcohol?

10. Did your relatives suffer from hypertension?

11. Do you experience stress, if so, how often?

12. Do you have Atherosclerosis?
- Yes

No
— I find it difficult to answer

13. How much do you move a day?

— I always walk

- Constantly driving

— I lead a sedentary lifestyle

14. Do you have a device for measuring pressure?

15. Do you know how to use it?

— My blood pressure is measured by my relatives/relatives

Source http://lektsia.com/6x5ee.html

Diagram No. 1: comparative data by gender.

Based on the results of the study and questionnaire, we see that the majority of patients with hypertension were women.

Diagram No. 2 is a comparison diagram by age.

Most HD sufferers are over 55 years old 60%

Comparative analysis of anamnestic data of healthy and hypertensive patients

Previous and concomitant diseases

Blood pressure control

A comparison of the anamnestic data of the subjects in the main and control groups established a higher degree of stress load.

With statistical significance of the differences in the group of hypertensive patients, it was 80%, i.e. significantly higher than in healthy people (46.6%). In 53.3% of the main group, i.e. less than in healthy 60%, the fact of bad habits was established. A study of hereditary predisposition showed its significant predominance in the group of patients with hypertension (40%) compared with the corresponding indicators in healthy people (hereditary predisposition 26.6%).

Clinical assessment of disease severity.

Disease severity

Stage 1 hypertension

Hypertension stage 2

Hypertension stage 3, risk 4

As can be seen from the diagram, stage 3 hypertension, risk 4 53%, ranks 1st, stage 1 hypertension is in second place with 27%, and stage 2 hypertension is in 3rd place with 20%.

Associated psychovegetative symptoms

Psycho - emotional stress

The main accompanying psychovegetative symptoms are: headaches 32%, psycho-emotional stress 21%, low mood 26%, depression 13%, and the least common is asthenia 20.8%.

Analysis of data from questionnaire No. 2.

Thus, before the course of interviews, patients revealed a high level of awareness about the presence of arterial hypertension (AH), risk factors in 45%, adherence to treatment in 71%, high quality of life in 13%, frequent hypertensive crises in 32%, side effects. 30% of patients noted the effects of drug therapy. Only 29% of patients control their blood pressure independently

In my opinion, the results obtained are significant. They demonstrate that the adherence of HD patients to treatment is potentially predictable, and the factors influencing this prognosis can be identified, measured and corrected. To substantiate the predictive value of these provisions, a model experiment was performed as part of the study.

Integral indicators of adherence to treatment

Source http://vuzlit.ru/831581/analiz_otsenka_rezultatov_issledovaniya_bolnyh_gipertonicheskoy_boleznyu

The survey is carried out in order to identify the knowledge of the population obtained during the events within the framework of World Health Day, held in April 2015, as well as to identify preventive skills to preserve the health of themselves and those around them.

1. Correct answer - 1 point, total correct answers - 19.

19 points – the information is presented in a high-quality manner.

10 points – information was not provided in full.

0-5 points - the information was provided of poor quality.

2. Answer to the fifth question:

6 points – 100 percent knowledge of hypertension prevention measures.

4 points – 80 percent knowledge of hypertension prevention measures.

0-2 points – lack of knowledge of hypertension prevention.

3. Answer to the sixth question:

3 points – 100 percent knowledge of the symptoms of hypertension.

0-1 point – lack of knowledge of the symptoms of hypertension.

The results of the survey are provided to the department of hygienic education to prepare a summary assessment for the region.

Source http://fbuz41.ru/lmk/inf_dlya_nasel/129343/

Patient Survey Questionnaire

The Moscow City Compulsory Medical Insurance Fund, studying the population’s attitude to reforms in the medical care system, urges you to express your opinion by answering the questions in our questionnaire.

It's easy to fill out the form. Possible answer options are given for many questions on the survey. Choose from the suggested answers the one that matches your opinion and mark it. If none of the proposed answer options suits you, write the answer yourself.

The anonymity of your answers is guaranteed!

Thank you in advance for your cooperation!

We ask you to answer questions regarding your health

1. How do you assess your health?

1. Good => go to question 3

2. How do you explain your health? (you can provide multiple answers)

2. Unsatisfactory environmental and sanitary conditions of the area of ​​residence (work)

3. Work overload

4. Lack of opportunity for regular rest

5. Poor nutrition

6. Long-term conflict situation at home

7. Long-term conflict situation at work

8. Inattention to your health, bad habits

9. Inaccessibility of quality medical care

10. Hereditary predisposition

11. Consequences of the war

12. Other (write)

3. What diseases have you visited the clinic for in the last year? (you can provide multiple answers)

1. Diseases of the heart and blood vessels (coronary artery disease, hypertension, angina pectoris, myocardial infarction, atherosclerosis, arrhythmia, tachycardia, rheumatism, heart disease, strokes, varicose veins, thrombophlebitis, etc.)

2. Diseases of the digestive system (diseases of the teeth and oral cavity, esophagus, gastritis, duodenitis, enteritis, colitis, cholecystitis, cholelithiasis, pancreatitis, hepatitis, cirrhosis of the liver, peptic ulcer, hernia, etc.)

3. Diseases of the musculoskeletal system (diseases of the joints, curvature of the spine, radiculitis, osteoporosis, osteomyelitis, osteochondrosis, spinal hernia and

4. Respiratory diseases (bronchial asthma, bronchitis, pneumonia, emphysema, pneumosclerosis, allergic and vasomotor rhinitis, nasopharyngitis, sinusitis, influenza, ARVI, etc.)

5. Endocrine diseases (diabetes, thyroid diseases, hormonal disorders, etc.)

6. Diseases of the genitourinary system (gynecological diseases, prostate adenoma, prostatitis, urolithiasis, pyelonephritis, glomerulonephritis, hematuria, cystitis, etc.)

7. Diseases of the nervous system (parkinsonism, tremor, epilepsy, multiple sclerosis, migraine, etc.)

8. Ear diseases (otitis media, auditory nerve diseases, etc.)

9. Eye diseases (cataracts, glaucoma, retinal diseases, etc.)

10. Oncological diseases

11. Skin diseases (dermatitis, psoriasis, lichen, urticaria, nail diseases, etc.)

12. Mental and behavioral disorders

13. Blood diseases and immunodeficiencies

14. Injuries, burns, frostbite, poisoning and their consequences

4. Do you suffer from chronic diseases?

2. No => go to question 10

5. Are you registered with a dispensary?

6. Do you undergo an annual medical examination?

1. Don't have => go to question 10

2. Applying now => go to question 10

3. I have group III

4. I have group II (with the right to work)

5. I have group II (without the right to work)

6. I have group I

7. Disabled childhood

8. As a result of the reform on monetization of benefits, you chose to receive:

1. Preferential medications

2. Cash compensation => go to question 10

9. Have you had any difficulties in obtaining subsidized medications?

When writing a prescription at a clinic

When receiving medicine from a pharmacy

10. Do you use the services of traditional healers, homeopaths, psychics, etc.? (you can provide multiple answers)

1. Never had to before => go to question 12

2. Contacted a homeopath

5. To different healers

6. Other services (write)

11. Did this alternative treatment help you?

4. I find it difficult to answer

12. In case of illness, do you turn to the Temple for help?

1. Yes, and this is my main support.

2. Yes, but I have other forms of support.

3. No, I don’t contact you

13. How do you eat?

4. Rather good => go to question 15

5. Ok => go to question 15

6. Difficult to answer => go to question 15

14. What do you attribute poor nutrition to? (you can provide multiple answers)

1. With financial difficulties

2. With working mode

2. No => go to question 19

16. Does your employer provide any support in obtaining medical care?

2. No => go to question 19

3. Undecided => go to question 19

17. How does your employer support you? (you can provide multiple answers)

1. Organizes medical stations

2. The enterprise has a medical facility for employees (for example, a clinic, a medical unit)

3. Provides spa treatment

4. Provides additional medical insurance (in the form of voluntary medical insurance)

5. Makes payment (full or partial) for medical care

6. Other (write)

18. What type of medical services were provided to you at the expense of your employer over the past year? (you can provide multiple answers)

1. Treatment in a clinic

2. Treatment in hospital

3. Treatment in a medical facility of the enterprise

6. Dental care

8. Other (write)

9. I did not use any medical services from my employer

Please answer questions related to your contacts with the healthcare system (excluding dental care)

19. Where do you usually get treatment? (you can provide multiple answers)

1. At the district clinic at the place of registration

2. In the clinic at the place of actual residence

3. In a departmental clinic

4. In paid institutions

(1 - very poor quality, 2 - poor, 3 - satisfactory, 4 - good, 5 - very good, 6 - difficult to answer).

Identification of risk factors for arterial hypertension in patients was carried out using a self-developed questionnaire (Appendix No. 1). A total of 100 patients were interviewed, including 50 men and 50 women, and then all of them had their blood pressure measured. The study was conducted in one of the health care facilities of the city of Ulyanovsk - the State Healthcare Institution "Central Clinical Medical and Sanitary Unit named after the Honored Doctor of Russia Valery Aleksandrovich Egorov (patients of the hospital and clinic No. 2).

Rice. 6 Frequency of high blood pressure in men and women from the total number of those examined

The frequency of elevated blood pressure in men and women from the total number of patients examined (100 patients) showed that arterial hypertension among men was 18%, and among women – 31% (Fig. 6).

Rice. 7 Risk factors among respondents

Risk factors among patients are presented in Figure 7. The prevalence of such risk factors as smoking was 83%, alcohol consumption - 88%, stress - 92%, atherosclerosis - 83%, excess salt consumption - 90%, physical inactivity - 71%, obesity - 66 %, heredity – 54%, menopause in women – 21%, environmental factors – 23%, diabetes – 44%.

Various risk factors were simultaneously identified in patients, for example, smoking and alcohol consumption, stress and atherosclerosis, excess salt intake, physical inactivity and obesity, heredity and diabetes, menopause in women and environmental factors.

2.3 Studying the level of knowledge of nurses about risk factors and prevention of arterial hypertension, identifying the time they devote to prevention in the department

The study of the level of knowledge of nurses about risk factors and prevention of arterial hypertension was carried out using a questionnaire. The survey was conducted using a specially developed questionnaire (Appendix No. 2). A total of 20 nurses with work experience ranging from 3 to 25 years took part in the study.

Rice. 9 Knowledge of risk factors for arterial hypertension by nurses

It was found that nurses are aware of the risk factors for arterial hypertension, such as heredity and excess salt intake - 100%, smoking - 95%, stress - 80%, alcohol abuse - 75%, obesity - 60%, physical inactivity - 55%, heredity – 53%, menopause in women – 31%, environmental factors – 30%, atherosclerosis – 78%, diabetes – 70% (Fig. 9).

Thus, from Figure 9, it is clear that nurses’ knowledge about risk factors is insufficient (alcohol abuse, obesity, physical inactivity, menopause, atherosclerosis, diabetes mellitus).

Rice. 10 Level of knowledge of nurses about the prevention of arterial hypertension

The level of knowledge of the nurse about the prevention of arterial hypertension was assessed using a questionnaire (Appendix No. 3) (Fig. 10).

Areas of prevention:

· control of medication intake - carried out by 100% nurses

· 90% of nurses are trained in diet rules

· publication of health bulletins takes place only in cardiology departments

· only 60% of nurses conduct conversations about risk factors

· consultation with a psychologist – 50%.

It was revealed that nurses generally know the directions of prevention, but do not always carry out activities, such as monitoring the implementation of doctor’s recommendations, conversations about risk factors and consultation with a psychologist.

Rice. 11 Timing of a nurse’s working hours

In order to assess the quality of the activities carried out by nurses to prevent arterial hypertension, we used the observation method to time the work shifts of nurses and found out that on average 30% of the working time is spent on paperwork, 40% is spent on carrying out medical prescriptions (distributing pills, preparing for tests , administering injections, providing assistance in emergency situations, etc.), 20% - for compliance with the sanitary and epidemiological regime, 2% takes up the personal time of nurses.

8% of the time is allocated for conversations with patients, including an explanation of preparation for research, rules for taking medications, and methods for correcting risk factors. Thus, there is a lack of time to carry out preventive measures.

conclusions

1. Awareness of arterial hypertension was 74.3% among men, 79.9% among women; treatment of arterial hypertension is carried out among men - 59.4, among women - 74.1; are effectively treated - 9.4% of men and 13.7% of women.

In recent years, there has been an increase in risk factors among the population

2. Arterial hypertension among respondents was 49% out of 100% - 18% in men and 31% in women, respectively.

3. Not all nurses know all the risk factors for arterial hypertension.

4. The timing of the working hours of nurses showed insufficient time for carrying out preventive measures.

Offers

1. Increase the role of the nurse in the prevention of arterial hypertension. Attract their attention to carrying out health education work among the population and training the population.

Conclusion

The solution to many problems in the prevention of arterial hypertension lies within the framework of the health care system. However, despite the fact that the health service is the most important link in prevention, it is impossible to improve public health indicators in the country through medical measures alone. Control of most causes of hypertension can and should be carried out by non-medical institutions. Medical workers should act as initiators and “catalysts” of preventive programs, evaluate their effectiveness and inform the structure and population about the results.

The development and implementation of the prevention of hypertension is impossible without an effective partnership between the medical (therapeutic and preventive) and non-medical sectors, public and private organizations, as well as the active participation of the population itself.

In the healthcare system, great attention should be paid to the development and implementation of programs to control risk factors for hypertension, identifying people at high risk of developing arterial hypertension and those who need active treatment.

Having considered the role of the nurse in organizing patient education on measures to prevent hypertension, we concluded: to increase the effectiveness of preventive work with patients suffering from hypertension, it is necessary to constantly improve the pedagogical professional competence of nurses in the field of sanitary and hygienic education of the population.

A detailed disclosure of material on the topic of the thesis “Studying the role of the nurse in the prevention of arterial hypertension” made it possible to increase the knowledge of the nurse and the awareness of patients about measures to prevent arterial hypertension.

List of abbreviations

AG – arterial hypertension

BP - blood pressure

AGP – antihypertensive drugs

AK – calcium antagonists

ACS – associated clinical conditions

RRA – plasma renin activity

LVH – left ventricular hypertrophy

DBP – diastolic blood pressure

IHD – coronary heart disease

CT – computed tomography

LV – left ventricle of the heart

PAH - malignant arterial hypertension

MAU – microalbuminuria

MI - cerebral stroke

MRI – magnetic resonance imaging

MS – metabolic syndrome

IGT – impaired glucose tolerance

OJ - way of life

ACS – acute coronary syndrome

OM – target organs

OT – waist circumference

THC - total cholesterol

POM - target organ damage

RAAS – renin-angiotensin-aldosterone system

SBP - systolic blood pressure

DM – diabetes mellitus

HF – heart failure

ABPM – 24-hour blood pressure monitoring5

CVD – cardiovascular diseases

CVC – cardiovascular complications

Ultrasound – ultrasound examination

HDL cholesterol – high density lipoprotein cholesterol

LDL cholesterol – low density lipoprotein cholesterol

CHF – chronic heart failure

ECG – electrocardiogram

EchoCG – echocardiography