摘要
目的 了解上海市社区老年高血压患者服药依从性,分析老年居民健康自我管理能力与服药依从性之间的关系,为提高患者健康自我管理能力、改善服药依从性提供依据。方法 采用整群抽样的方法,对2021年11—12月在抽样社区卫生服务中心/站点就诊的603例老年高血压患者进行面对面问卷调查,包括基本人口学特征、服药依从性和成年人健康自我管理的相关信息,采用卡方检验、Pearson相关分析、二元Logistic回归等方法分析服药依从性的影响因素。结果 调查老年患者平均年龄(71.86±5.98)岁,服药依从性得分为(6.69±1.48)分,20.6%依从性评分低于6分。健康自我管理能力得分为(146.01±23.55)分,行为维度、环境维度和认知维度的得分分别为(50.14±11.27)分、(38.93±7.87)分、(56.95±8.15)分。自我管理能力(r=0.24,P<0.01)、行为维度(r=0.23,P<0.01)和环境维度(r=0.22,P<0.01)与老年患者的服药依从性相关。随着年龄的增加,服药依从性有所降低。在校正其他混杂因素后,自我管理能力与服药依从性呈正相关,城区、郊区老人自我管理能力每增加1分,服药依从性分别增加3.5%(OR=1.035,95%CI:1.019~1.051)和1.4%(OR=1.014,95%CI:1.000~1.029)。结论 上海市社区老年高血压患者服药依从性、自我管理能力均处于中等偏上水平,健康自我管理能力高有利于老年高血压患者提高服药依从性,可针对不同自我管理能力水平的患者,采取不同的健康教育模式,从而提高患者服药依从性,改善健康状况。
Objective To analyze the relationship between health self-management ability and medication adherence among elderly patients with hypertensive in the Shanghai community,and to provide a basis for improving self-management ability and medication adherence of patients.Methods By using a cluster sampling method,a face-to-face questionnaire survey including information on basic demographic characteristics,medication adherence,and adult health self-management ability was conducted among 603 elderly patients with hypertensive,who attended the sampled community health centers/sites from November to December 2021.Chi-square test,Pearson correlation analysis,and binary logistic regression were used to analyze the influencing factors of medication adherence.Results The mean age of the investigated elderly patients was(71.86±5.98)years old,the medication adherence score was(6.69±1.48)points,and 20.6%of adherence scores were lower than 6 points.The score of health self-management ability was(146.01±23.55),and the scores of behavioral,environmental,and cognitive dimensions were(50.14±11.27),(38.93±7.87)and(56.95±8.15),respectively.Health self-management ability(r=0.24,P<0.01),behavioral dimension(r=0.23,P<0.01),and environmental dimension(r=0.22,P<0.01)were associated with medication adherence in elderly patients.Medication adherence decreased with increasing of age.After adjusted for confounders,health self-management ability was positively correlated with medication adherence,with 3.5%(OR=1.035,95%CI:1.019-1.051)and 1.4%(OR=1.014,95%CI:1.000-1.029)increase in medication adherence for 1-point increase in self-management ability among urban and suburban elderly,respectively.Conclusion The medication adherence and health self-management ability of elderly patients with hypertensive in communityin Shanghai were all at an intermediate to a high level,and high health self-management ability is beneficial to elderly hypertensive patients to improve their medication adherence.Dfferent health education models would be adopted
作者
杜荣
高晶蓉
江佳艳
戴丹华
李静
李扬
张斌
赵琦
DU Rong;GAO Jing-rong;JIANG Jia-yan;DAI Dan-hua;LI Jing;LI Yang;ZHANG Bin;ZHAO Qi(School of Public Health,Fudan University,NHC Key Laboratory of Health Technology Assessment(Fudan University),Shanghai 200030,China)
出处
《中国健康教育》
北大核心
2023年第4期310-314,共5页
Chinese Journal of Health Education
基金
上海市浦江人才计划资助(2020PJC005)。
关键词
老年高血压患者
服药依从性
健康自我管理能力
Elderly hypertensive patients
Medication adherence
Health self-management ability
