Analysis of the effect of targeted nursing on improving blood pressure control and sleep quality in elderly patients with hypertension
针对性护理改善老年高血压患者血压控制及睡眠质量的作用分析

摘要

目的 随着我国老龄化进程的加速，老年高血压已成为重要的公共卫生问题，其血压控制不佳与睡眠质量低下相互影响，形成恶性循环。本研究旨在深入分析针对性护理对老年高血压患者血压控制及睡眠质量的改善作用。方法 采用前瞻性随机对照研究设计，选取 2024 年 5 月 - 2025 年 5 月于我院老年保健科就诊的 90 例 50-90 岁老年高血压患者作为研究对象。运用随机数字表法将患者分为对照组（45 例）和实验组（45 例）。对照组实施常规护理，包括基础生命体征监测、用药指导等；实验组则在此基础上实施系统化针对性护理方案，具体涵盖精细化血压监测管理、个性化睡眠环境优化、专业心理干预及科学睡眠行为指导等多维护理措施。通过动态监测与量化评估，比较两组患者干预前后的血压水平 [收缩压（SBP）、舒张压（DBP）]、睡眠质量（采用国际通用的匹兹堡睡眠质量指数量表 PSQI 进行评分）及睡眠相关核心指标（入睡时间、有效睡眠时间、睡眠障碍发生率）。结果 数据经 SPSS 26.0 软件进行统计学分析显示，干预后实验组收缩压降至（132.5±6.8）mmHg、舒张压降至（80.2±5.1）mmHg，显著低于对照组的（145.3±7.2）mmHg、（87.6±5.8）mmHg（P<0.05）；实验组 PSQI 评分（4.2±1.3）分较对照组（7.8±1.9）分显著降低（P<0.05）；同时，实验组入睡时间缩短至（22.5±5.7）min，显著短于对照组的（35.8±8.2）min，睡眠时间延长至（6.8±1.2）h，显著长于对照组的（5.3±1.1）h，睡眠障碍发生率仅为 8.9%，远低于对照组的 28.9%（P<0.05）。结论 针对性护理方案通过多维度干预措施，可有效改善老年高血压患者血压控制效果，显著提升睡眠质量，对促进老年高血压患者的健康管理、提高生活质量具有重要的临床实践意义和推广价值。

Abstract

Objective With the acceleration of China's aging process, elderly hypertension has become an important public health problem, and poor blood pressure control and poor sleep quality interact with each other, forming a vicious cycle. This study aims to analyze in depth the effect of targeted nursing on blood pressure control and sleep quality improvement in elderly patients with hypertension.
Methods A prospective randomized controlled study design was adopted, selecting 90 elderly hypertensive patients aged 50-90 who visited the Department of Geriatric Health Care at our hospital from May 2024 to May 2025 as the research subjects. Patients were divided into a control group (45 cases) and an experimental group (45 cases) using a random number table method. The control group received routine nursing care, including monitoring of basic vital signs and medication guidance; On this basis, the experimental group implemented a systematic and targeted nursing plan, which specifically covered multidimensional nursing measures such as refined blood pressure monitoring and management, personalized sleep environment optimization, professional psychological intervention, and scientific sleep behavior guidance. Through dynamic monitoring and quantitative evaluation, the blood pressure levels [systolic blood pressure (SBP), diastolic blood pressure (DBP)], sleep quality (scored using the internationally recognized Pittsburgh Sleep Quality Index (PSQI)), and sleep related core indicators (falling asleep time, effective sleep time, and incidence of sleep disorders) were compared between two groups of patients before and after intervention. The results of statistical analysis using SPSS 26.0 software showed that after intervention, the systolic blood pressure in the experimental group decreased to (132.5 ± 6.8) mmHg and the diastolic blood pressure decreased to (80.2 ± 5.1) mmHg, significantly lower than the control group's (145.3 ± 7.2) mmHg and (87.6 ± 5.8) mmHg (P<0.05); The PSQI score of the experimental group (4.2 ± 1.3) was significantly lower than that of the control group (7.8 ± 1.9) (P<0.05); At the same time, the sleep time of the experimental group was shortened to (22.5 ± 5.7) minutes, significantly shorter than the control group's (35.8 ± 8.2) minutes, and the sleep time was prolonged to (6.8 ± 1.2) hours, significantly longer than the control group's (5.3 ± 1.1) hours. The incidence of sleep disorders was only 8.9%, much lower than the control group's 28.9% (P<0.05).
Conclusion   Targeted nursing programs, through multidimensional intervention measures, can effectively improve the blood pressure control effect of elderly hypertensive patients, significantly enhance sleep quality, and have important clinical practice significance and promotion value for promoting health management and improving the quality of life of elderly hypertensive patients.