Abstract: Background　Hypertensive patients' self-management is an important method to delay disease progression and reduce the risk factors of complications.However，in China，such patients have unsatisfactory self-management level and lack of continuous efforts on changing unhealthy behaviors.To improve their self-management level，health coaching，a type of technique focusing on providing self-management support，may contribute greatly.Objective　To evaluate the impact of health coaching on the self-management of patients with hypertension.Methods　106 hypertensive inpatients were recruited from a grade A tertiary hospital in Xinxiang City from January to April 2018，and were equally randomized into the experimental group and control group，receiving health coaching-based interventions，routine hypertension-related health education，respectively.The primary endpoints were systolic blood pressure（SBP），diastolic blood pressure（DBP），blood pressure control rate，and self-management score〔assessed by LIU Ning's Self-management Scale （SMS）〕，and secondary endpoints were body weight，BMI，and self-efficacy score 〔assessed by Lorig's Self-efficacy for Managing Chronic Disease 6-item Scale（SMCDS）〕 at 3 months after interventions.Results　A total of 104 cases completed the results evaluation，including 53 in the experimental group and 51 in the control group.Mean SBP，DBP，blood pressure control rate，self-management level，SMCDS score，body weight and BMI were similar in both groups at baseline（P>0.05）.After intervention，mean SBP，DBP，blood pressure control rate，and SMCDS score improved significantly in both groups（P<0.05）.Moreover，mean scale and subscales scores of SMS improved significantly in the experimental group（P<0.05），and also in the control group（P<0.05） except the mean subscale score of life habits.The experimental group showed lower mean post-intervention SBP，DBP and body weight and higher mean blood pressure control rate，scale and subscales scores of SMS，and SMCDS score compared with the control group（P<0.05）.Conclusion　Health coaching may improve the self-management level，effectively reduce SBP and DBP，and improve blood pressure control rate.

Key words: Hypertension, Health coaching, Health promotion, Health self-management

摘要： 背景　高血压患者的自我管理是延缓疾病进展、降低并发症危险因素的重要方法，而我国目前的高血压患者自我管理水平较低，健康行为的转变仍缺乏持续性。健康教练技术专注于提供自我管理支持，对高血压患者自我管理水平的提升有关键作用。目的　评估健康教练技术对高血压患者自我管理的影响。方法　选取2018年1—4月在新乡市某三级甲等医院住院的高血压患者106例为研究对象。将研究对象按随机数字表法分组，试验组、对照组各53例，试验组采用以健康教练技术为基础的干预措施，对照组采用常规高血压健康教育。干预3个月后，评估两组结果指标的变化情况并进行分析。主要结果包括收缩压、舒张压、血压控制率及自我管理行为评分，次要结果包括体质量、体质指数及自我效能评分。结果　经过3个月的干预，共有104例完成结果评估，其中试验组53例、对照组51例。干预前，两组患者收缩压、舒张压、血压控制率、自我管理行为水平、自我效能得分、体质量及体质指数比较，差异无统计学意义（P>0.05）。干预后两组患者的收缩压、舒张压、血压控制率、自我效能得分均较干预前改善，差异有统计学意义（P<0.05）。干预后，试验组患者自我管理行为总分及各维度得分较干预前明显增加，差异有统计学意义（P<0.05）；对照组患者自我管理行为总分较干预前增加，除生活习惯外，各维度得分较干预前改善，差异有统计学意义（P<0.05）。干预后试验组患者收缩压、舒张压、体质量低于对照组，血压控制率、自我管理行为总分及各维度得分、自我效能得分高于对照组，差异有统计学意义（P<0.05）。结论　健康教练技术能够改善高血压患者自我管理水平，可有效降低收缩压、舒张压，提高血压控制率。

关键词: 高血压, 健康教练技术, 健康促进, 自我健康管理