페루 도시 저소득층 거주 지역에서의 고혈압관리 중재효과 평가 = Effectiveness of a Community-based Intervention for Hypertension Management in a Low-income Urban Area in Peru

국문 초록 (Abstract)

연구목적: 남미 페루 도시 저소득층 지역에서 수행된 지역사회 기반 고혈압관리 중재의 효과를 평가하고자 하였다.
연구방법: 비동등성 대조군 전후 비교 유사실험 설계를 사용하고, 고혈압 또는 고혈압 전단계 상태의 실험군 340명, 대조군 317명을 대상으로 했다. 중재는 12주 과정으로 개별 상담, 집단 보건교육, 자조모임, 문자메시지 전송을 통한 혈압관리 행동지침 전달 등으로 구성하였다. 참여자의 건강지식 수준, 건강행동 수행정도, 체질량지수, 허리둘레, 혈압 및 혈압 조절 여부에 대한 중재 효과성 확인을 위해 다중이중차이분석을 실시했고, 혈압 조절에 미치는 영향요인 파악을 위해 로지스틱 회귀분석을 실시했다.
연구결과: 고혈압 관련 건강지식은 중재 후 대조군보다 실험군에서 통계적으로 유의하게 더 큰 폭으로 증가하였다. 식습관, 스트레스 관리활동, 복약순응도는 중재 후 대조군보다 실험군에서 통계적으로 유의하게 더 큰 폭으로 개선되었다. 신체활동 실천, 금연, 절주 관련 건강행동 수행 정도는 중재 전보다 후에 지표가 개선되었으나 통계적으로 유의하지는 않았다. 혈압 조절 여부와 수축기혈압, 허리둘레는 중재 후 대조군보다 실험군에서 통계적으로 유의하게 더 큰 폭으로 개선되었다. 그러나 체질량지수와 이완기혈압에서는 유의미한 변화가 나타나지 않았다. 혈압 조절에 미치는 영향요인을 분석한 결과 중재 전에는 연령과 혈압약 복용 여부가 혈압 조절 여부에 통계적으로 유의한 영향을 미치는 것으로 나타났고, 중재 후에는 식습관 점수도 유의미한 영향을 미치는 것으로 나타났다.
결론: 페루 도시 저소득층 거주 지역에서 수행한 지역사회 기반 고혈압관리 중재는 참여자의 고혈압 관련 지식 수준과 식습관, 스트레스 관리, 복약순응에 관한 건강행동 수행정도, 허리둘레 감소, 수축기혈압 감소 및 혈압 조절률 향상에 효과가 있음을 확인하였고 따라서 향후 페루 내 유사 지역에 고혈압관리 중재 모형을 확대 시행하는 것과 건강증진 관련 인프라 및 정책 개선이 필요하다.

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