儿童高血压认知现状及管理策略提升的质性研究

周佳丽; 张晨昊; 孙炜迪; 侯乐莹; 罗泽宇; 朱冰; 章荣华; 宋培歌

doi:10.16835/j.cnki.1000-9817.2025120

儿童高血压认知现状及管理策略提升的质性研究

doi: 10.16835/j.cnki.1000-9817.2025120

1.
浙江大学公共卫生学院，杭州 310058
2.
浙江省疾病预防控制中心营养与食品安全所

基金项目:

国家自然科学基金项目 72104211

详细信息

作者简介:
周佳丽(1999-)，女，浙江绍兴人，在读硕士，主要研究方向为儿童健康

通讯作者:
宋培歌，E-mail: peigesong@zju.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R544.1 G479
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- 文章访问数: 7
- HTML全文浏览量: 3
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2025-02-14
- 修回日期: 2025-03-07
- 网络出版日期: 2025-05-08
- 刊出日期: 2025-04-25

A qualitative study on the awareness and management strategy improvement of childhood hypertension

1.
^*School of Public Health, Zhejiang University, Hangzhou (310058), Zhejiang Province, China

摘要

摘要: 目的归纳儿童高血压管理策略的提升路径，为中国儿童高血压管理的相关实践与政策制定提供科学参考。方法 2024年3—4月，采用分层抽样与方便抽样相结合的方法选取杭州市5个区的儿童健康利益相关者为研究对象，运用扎根理论对访谈资料进行分析。深入访谈阶段共纳入6名政策制定者；焦点小组访谈阶段分别对学校管理人员、医疗保健提供者和家长开展访谈，累计纳入62名对象。结果通过三级编码提炼出116个初始范畴(如“低龄化趋势” “行为改变困难”)、35个主范畴(如“发生率较以前更高”“由综合影响因素引起”)和12个核心范畴(如“流行状况”“影响因素”)，最终构建儿童高血压认知现状、问题分析与管理策略提升路径。结论儿童高血压的防控需政府、学校、家庭与社会多方携手，共同构建覆盖全面的综合管理体系，并通过动态监测与评估优化政策实施效果。
- 高血压 /
- 认知 /
- 卫生保健提供 /
- 儿童
Abstract: Objective To summarize strategies for improving childhood hypertension, so as to provide evidence-based recommendations for poliy-making and practice childhood hypertension management in China. Methods From March to April 2024, child health stakeholders from five districts in Hangzhou were selected using a combination of stratified and convenience sampling methods. Data were analyzed using a grounded-theory approach. During the in-depth interview phase, six policymakers were interviewed. Focus group discussions were conducted with school administrators, healthcare providers, and parents, comprising a total of 62 participants. Results Through three-level coding, 116 initial categories were identified(e.g., "trend of younger age" "difficulty in behavior change"), 35 main categories (e.g., "higher incidence compared to the past" "caused by comprehensive influencing factors"), and 12 core categories (e.g., "epidemic status" "influencing factors"). Finally, the cognitive status, problem analysis, and management strategies of children hypertension were constructed. Conclusion Effective prevention and control of childhood hypertension requires coordinated efforts among governments, schools, families, and society to establish a comprehensive management system, with dynamic monitoring and evaluation to optimize policy implementation.
- Hypertension /
- Cognition /
- Delivery of health care /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 儿童高血压认知现状及政策建议访谈文本编码频次

Table 1. Cognitive status of children's hypertension and coding frequency of interview test of policy suggestions

选择编码	主轴编码	政策制定者	学校管理者	医疗卫生服务提供者	家长
流行状况		6	3	12
	发生率较以前更高	4		4
	不属于常见病	2	2	3
	是一种常见疾病			5
	儿童不会出现高血压		1
影响因素
	由综合影响因素引起	28	128	299	57
健康影响		7	3	23	2
	应受重视	6		11
	存在危害	1	3	9	2
	管理很重要			3
管理现状		48	18	60	4
	已有针对性措施	35	17	50	4
	尚未出台专项政策	12	1	10
	防控措施有力，现状改善	1
面临挑战		29	3	26
	未受重视	8	3	11
	未充分落实	14
	判定复杂			11
	对危害与现状了解不足	4
	缺乏有说服力的科学证据	2		1
	较难控制			3
	现有措施效果不好	1
提供依据		7
	了解病因	4
	提供科学可靠的依据	3
增强意识		8	29	30	1
	增大宣传教育力度	6	29	20	1
	加强防控意识	2		10
监测识别		6		16
	定期监测血压	3		12
	需普及体检			4
	及时反馈体检结果	3
政府支持		3		8
	加大政府支持力度	2		8
	政府出台相关文件	1
部门合作
	多部门合作管理	3
具体措施		11	5	14	1
	减少儿童的学业压力	1	5	7	1
	针对性管理高危儿童	5		3
	调整儿童的行为生活方式	3		4
	对儿童提供心理支持	1
	设立专项主题项目	1
后效评价		2		1
	建立管理效果评价	1		1
	监测执行效果反馈	1

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参考文献(27)

[1]	SONG P, ZHANG Y, YU J, et al. Global prevalence of hypertension in children: a systematic review and Meta-analysis[J]. JAMA Pediatr, 2019, 173(12): 1154-1163. doi: 10.1001/jamapediatrics.2019.3310
[2]	YE X, YI Q, SHAO J, et al. Trends in prevalence of hypertension and hypertension phenotypes among Chinese children and adolescents over two decades (1991-2015)[J]. Front Cardiovasc Med, 2021, 8: 627741. doi: 10.3389/fcvm.2021.627741
[3]	QIAO J, WANG Y, LI X, et al. A lancet commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China[J]. Lancet, 2021, 397(10293): 2497-2536. doi: 10.1016/S0140-6736(20)32708-2
[4]	孟玲慧. 儿童青少年高血压及其危险因素对早期靶器官损害的影响[D]. 北京: 北京协和医学院, 2012. MENG L H. Impacts of hypertension and related risk factors on early target organ damage in childhood[D]. Beijing: Peking Union Medical College, 2012. (in Chinese)
[5]	GARTLEHNER G, VANDER SCHAAF E B, ORR C, et al. Screening for hypertension in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force[J]. JAMA, 2020, 324(18): 1884-1895. doi: 10.1001/jama.2020.11119
[6]	LURBE E, AGABITI-ROSEI E, CRUICKSHANK J K, et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents[J]. J Hypertens, 2016, 34(10): 1887-920. doi: 10.1097/HJH.0000000000001039
[7]	RENJITH V, YESODHARAN R, NORONHA J A, et al. Qualitative Methods in Health Care Research[J]. Int J Prev Med, 2021, 12: 20. doi: 10.4103/ijpvm.IJPVM_321_19
[8]	浙江省卫生健康委员会. 《浙江省儿童医疗服务发展行动计划(2021-2025年)》政策解读[EB/OL]. (2021-12-28)[2025-01-14]. https://wsjkw.zj.gov.cn/art/2022/1/6/art_1229123416_2388347.html.
[9]	浙江省人民政府办公厅关于推进浙江省卫生健康现代化建设的实施意见[EB/OL]. (2023-03-31)[2025-01-14]. https://www.zj.gov.cn/art/2023/4/18/art_1229733219_2478654.html.
[10]	钱倩严慧, 严璟. 基于共同生产理论对我国健康管理实践的探讨[J]. 医学与哲学, 2020, 41(17): 12-16. QIAN Q Y H, YAN J. Discussion on health management practice in China from the perspective of coproduction[J]. Med Philos, 2020, 41(17): 12-16. (in Chinese).
[11]	谢爱磊, 陈嘉怡. 质性研究的样本量判断: 饱和的概念、操作与争议[J]. 华东师范大学学报(教育科学版), 2021, 39(12): 15-27. XIE A L, CHEN J Y. Sample size judgments in qualitative research: concepts, operations, and controversies of saturation[J]. J East China Norm Univ(Educ Sci), 2021, 39(12): 15-27. (in Chinese)
[12]	ZHOU J, WU J, JIANG D, et al. National, regional and provincial prevalence of childhood hypertension in China in 2020: a systematic review and modelling study[J]. Lancet Child Adolesc Health, 2024, 8(12): 872-881. doi: 10.1016/S2352-4642(24)00260-8
[13]	LIANG X, XIAO L, LUO Y, et al. Prevalence and risk factors of childhood hypertension from birth through childhood: a retrospective cohort study[J]. J Hum Hypertens, 2020, 34(2): 151-164. doi: 10.1038/s41371-019-0282-z
[14]	MANIOS Y, KARATZI K, MOSCHONIS G, et al. Lifestyle, anthropometric, socio-demographic and perinatal correlates of early adolescence hypertension: the healthy growth study[J]. Nutr Metab Cardiovasc Dis, 2019, 29(2): 159-169. doi: 10.1016/j.numecd.2018.10.007
[15]	中华人民共和国国务院关于印发中国妇女发展纲要和中国儿童发展纲要的通知[EB/OL]. (2021-09-27)[2025-01-14]. https://www.gov.cn/zhengce/content/2021-09/27/content_5639412.htm.
[16]	CLARK H, COLL-SECK A M, BANERJEE A, et al. A future for the world's children? A WHO-UNICEF-Lancet Commission[J]. Lancet, 2020, 395(10224): 605-658. doi: 10.1016/S0140-6736(19)32540-1
[17]	张敏. 长春市某城区小学生和家长对儿童高血压认知现状调查分析[D]. 长春: 吉林大学, 2021. ZHANG M. Investigation and analysis of the cognitive status of primary school students and their parents about children's hypertension in a certain urban area of Changchun[D]. Changchun: Jilin University, 2021. (in Chinese)
[18]	TSUCHIHASHI T. Dietary salt intake in Japan: past, present, and future[J]. Hypertens Res, 2022, 45(5): 748-757. doi: 10.1038/s41440-022-00888-2
[19]	李红梅, 田朝霞, 刘爱梅, 等. 汾阳市小学生家长儿童高血压知识与培训意愿调查分析[J]. 现代预防医学, 2017, 44(15): 2784-2787, 2801. LI H M, TIAN Z X, LIU A M, et al. Parents' hypertension knowledge and training intention of elementary school students: a survey[J]. Mod Prev Med, 2017, 44(15): 2784-2787, 2801. (in Chinese)
[20]	BOVAIRD T. Beyond engagement and participation: user and community coproduction of public services[J]. Public Administr Rev, 2007, 67(5): 846-860. doi: 10.1111/j.1540-6210.2007.00773.x
[21]	席波, 宋逸, 马军. 预防成年人心血管疾病应重视儿童期危险因素防控[J]. 中华流行病学杂志, 2020, 41(9): 1428-1432. XI B, SONG Y, MA J. Prevention of cardiovascular disease in adulthood should attach importance to related risk factors in childhood[J]. Chin J Epidemiol, 2020, 41(9): 1428-1432. (in Chinese)
[22]	陈奕彤, 马明静, 姬阆, 等. 学龄前儿童社区血压管理模式研究[J]. 中国全科医学, 2021, 24(4): 496-503. CHEN Y T, MA M J, JI L, et al. Effect of community-based monitoring on blood pressure control in preschool children: a pilot study[J]. Chin Gen Pract, 2021, 24(4): 496-503. (in Chinese)
[23]	黄先玫. 儿童和青少年高血压诊断与健康管理[J]. 浙江医学, 2019, 41(18): 1915-1920, 1927. HUANG X M. Diagnosis and health management of hypertension in children and adolescents[J]. Zhejiang Med J, 2019, 41(18): 1915-1920, 1927. (in Chinese)
[24]	WEBB V L, WADDEN T A. Intensive lifestyle intervention for obesity: principles, practices, and results[J]. Gastroenterology, 2017, 152(7): 1752-1764.
[25]	HALLE M, PAPADAKIS M. A new dawn of managing cardiovascular risk in obesity: the importance of combining lifestyle intervention and medication[J]. Eur Heart J, 2024, 45(13): 1143-1145. http://www.nstl.gov.cn/paper_detail.html?id=22e6bf85d49a859568bd42d13774c901
[26]	BRAZIL J F, GIBSON I, DUNNE D, et al. Improved quality of life, fitness, mental health and cardiovascular risk factors with a publicly funded bariatric lifestyle intervention for adults with severe obesity: a prospective cohort study[J]. Nutrients, 2021, 13(11): 4172.
[27]	MOHSENI M, KUCKUCK S, MEEUSEN R E H, et al. Improved physical and mental health after a combined lifestyle intervention with cognitive behavioural therapy for obesity[J]. Int J Endocrinol Metab, 2023, 21(1): e129906.