| Summary: | 碩士 === 臺北醫學大學 === 護理學系 === 91 === With the increasing changes in health care environment and health policies, hospitals need to found effective strategies such as case management care model to control costs and to improve patient care. Therefore, the purposes of this study were to explore and compare the differences among self-care knowledge, daily health behaviors, and blood pressure control between case management group and control group for hypertensive patients at an outpatient department.
The design was quasi-experimental using a purposive sampling. The time of weekly outpatient visit was used to assign subjects to case management group or control group. The data collection period was from January to June of 2003. Subjects were outpatient hypertensive patients who met criteria for inclusion in this study and from a district teaching hospital in Taipei areas. The case management care model was only implemented in a case management group. But the usual care model was used in a control group. The demographics of the subjects and pre-test data including the level of self-care knowledge, daily health behaviors, and blood pressure were collected before implementation of care management care model. Post-test data were collected after 3-month of implementation. Regular outpatient visits and blood pressure were collected from patient charts. Data were managed using SPSS 10.0 version for Windows and SAS 8.0 version for Windows and analyzed using Chi-square test and independent t-test for demographics data, and Generalized Estimating Equations (GEEs) to compare the differences between these two groups before and after implementing the case management care model.
Thirty subjects were in case management group and 25 subjects were in control group. The results indicated that there was no significant difference among the level of self-care knowledge (p=.687), daily health behaviors (diet; p=.802, exercise; p>.05, and medication compliance; p= .160), and regular outpatient visits (p=.493) between these two groups. However, the ratio of blood pressure control to normal (<140/90 mmHg) was higher in case management group than in control group and showed a significant difference (p= .011).
The findings of this study can not only serve as a reference for health care providers to provide case management care for hypertensive patients, but also to develop a case management care model for other chronic diseases at outpatient departments.
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