Using repeated measurement of 'analysis of variance' on hypertension patients to evaluate the self-management program in the communities / 中华流行病学杂志

ABSTRACT

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.