健康信念对老年高血压患者治疗依从行为影响的研究
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摘要
目的:探讨老年高血压患者健康信念和治疗依从行为水平及其相关性。方法:采用一般情况问卷、健康信念量表、治疗依从行为量表对228例老年高血压患者进行问卷调查。结果:老年高血压患者治疗依从行为总得分为(25.37±4.94)分,处于中等水平;不同文化程度、月收入、参与社区文娱活动情况、患慢性病数目、配偶是否在世是影响患者治疗依从行为的因素(P<0.05);患者健康信念总分为(114.39±10.63)分,处于中等水平,健康信念与治疗依从行为总分呈负相关(P<0.05);配偶是否在世、健康信念的健康动力维度和障碍感知维度是治疗依从性的影响因素(F=33.396,P<0.05,决定系数R~2=0.309)。结论:老年高血压患者治疗依从行为水平中等,健康信念是影响依从性的因素之一,应增强患者健康信念水平以提高治疗依从行为水平。
Objective:To explore the health beliefs and treatment compliance behaviors and their correlation in elderly hypertensive patients.Methods: A questionnaire survey was conducted on 228 elderly hypertensive patients using the General Information Scale, Compliance Behavior Scale and Health Belief Scale. Results: The total score of compliance behavior in elderly patients with hypertension was(25.37±4.94), which was at the medium level. There were statistically significant differences in patients with different levels of education, monthly income, participation in community recreational activities, number of chronic diseases, and whether their spouses were alive(P<0.05). The total score of health belief was(114.39±10.63), which was also at the medium level. Correlation analysis showed that health belief was negatively correlated with the total score of compliance behavior(P<0.05). Because of the reverse score of compliance behavior, the better the health belief, the higher the compliance behavior. Multiple regression showed that whether the spouse was alive or not, health motivation dimension and obstacle perception dimension of health belief were selected into the equation(F=33.396,P<0.05, and the decision coefficient R~2=0.309). Conclusion: Elderly patients with hypertension have moderate level of treatment adherence. Health beliefs are one of the factors that influence compliance. Therefore, patients' health belief levels should be enhanced to improve their adherence behavior.
Objective:To explore the health beliefs and treatment compliance behaviors and their correlation in elderly hypertensive patients.Methods: A questionnaire survey was conducted on 228 elderly hypertensive patients using the General Information Scale, Compliance Behavior Scale and Health Belief Scale. Results: The total score of compliance behavior in elderly patients with hypertension was(25.37±4.94), which was at the medium level. There were statistically significant differences in patients with different levels of education, monthly income, participation in community recreational activities, number of chronic diseases, and whether their spouses were alive(P<0.05). The total score of health belief was(114.39±10.63), which was also at the medium level. Correlation analysis showed that health belief was negatively correlated with the total score of compliance behavior(P<0.05). Because of the reverse score of compliance behavior, the better the health belief, the higher the compliance behavior. Multiple regression showed that whether the spouse was alive or not, health motivation dimension and obstacle perception dimension of health belief were selected into the equation(F=33.396,P<0.05, and the decision coefficient R~2=0.309). Conclusion: Elderly patients with hypertension have moderate level of treatment adherence. Health beliefs are one of the factors that influence compliance. Therefore, patients' health belief levels should be enhanced to improve their adherence behavior.
引文
[1]国家心血管病中心.国家基层高血压防治管理指南[Z].2018-04-11.
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[11]程婧,何非,王丽姿,等.老年高血压患者达标率与知识、行为依从性及生活方式的相关性研究[J].中华护理杂志,2011,46(2):117-120.
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[13]Tung HH,Lien RY,Wei J,et al.The role of adherence in the relstionship between self-efficacy and self-management in diabeticpatients undergoing CABC in Taiwan[J].Heart Asia,2012,4(1):114-119.
[14]陈小英,赵锦英,陈小燕.原发性高血压患者服药依从性的影响因素及对策[J].湖北民族学院学报(医学版),2014,31(1):37-38.
[15]马冬花,丁萍,杜华,等.健康信念对头颈部放疗患者功能锻炼依从性影响的研究[J].中华肿瘤防治杂志,2018,25(12):836-841.
[16]叶和莲,万丽红,邹龙娇,等.脑梗死患者服药依从性与健康信念的相关性研究[J].护理与康复,2018,17(8):24-30.
[17]李春玉,姜丽萍.社区护理学[M].北京:人民卫生出版社,2017:19-24.
[18]王文.中国高血压事业发展六十年回顾[EB/OL].http://www.nccd.org.cn/News/Articles/Index/149?from=1087.
[19]王文,王増武,陈伟伟.我国高血压防治的关键在基层机[J].中华高血压杂志,2010(6):501-503.
[2]刘甜,刘杏,李胜玲,等.基于跨理论模型的社区家庭访视护理对老年高血压患者服药遵从行为的影响[J].中华护理杂志,2016,51(5):629-634.
[3]郑妍.延续护理联合中医护理健康教育对高血压患者依从行为的干预性研究[D].中国中医科学院,2017.
[4]王娇艳,周志衡,吴兰笛,等.社区高血压病人家庭功能及药物治疗依从性分析[J].护理研究,2012,26(7):1740-1742.
[5]万丽红,阮恒芳,周雯莉,等.高血压与首发高血压相关脑卒中患者的健康信念及行为[J].中华高血压杂志,2014,22(9):859-864.
[6]戴冰.基于健康信念模式的社区家庭访视护理对高龄高血压患者的影响研究[J].当代护士(上旬刊),2018,25(4):29-32.
[7]罗建平,李春明.健康信念模式对社区高血压患者服药行为的影响[J].中国老年学杂志,2013,33(6)1359-1361.
[8]Champion VL.Use of health belief model in determining frequency of self-breast exam[J].Research in Nursing and Health,1985,8(4):373-382.
[9]文朝阳.肝癌高危人群监查依从性及影响因素的调查与分析[D].广州:中山大学,2005.
[10]彭慧蛟,万丽红,黄月友,等.脑卒中患者健康信念与健康行为的调查研究[J].中华护理杂志,2012,47(1):10-13.
[11]程婧,何非,王丽姿,等.老年高血压患者达标率与知识、行为依从性及生活方式的相关性研究[J].中华护理杂志,2011,46(2):117-120.
[12]Whitworth JA,World Health Organization,International Society of Hypertension Writing Group.2003 World Health Organization(WHO)/International Society of Hypertension(ISH)statement on management of hypertension[J].Journal of hypertension,2003,21(11):1983-1992.
[13]Tung HH,Lien RY,Wei J,et al.The role of adherence in the relstionship between self-efficacy and self-management in diabeticpatients undergoing CABC in Taiwan[J].Heart Asia,2012,4(1):114-119.
[14]陈小英,赵锦英,陈小燕.原发性高血压患者服药依从性的影响因素及对策[J].湖北民族学院学报(医学版),2014,31(1):37-38.
[15]马冬花,丁萍,杜华,等.健康信念对头颈部放疗患者功能锻炼依从性影响的研究[J].中华肿瘤防治杂志,2018,25(12):836-841.
[16]叶和莲,万丽红,邹龙娇,等.脑梗死患者服药依从性与健康信念的相关性研究[J].护理与康复,2018,17(8):24-30.
[17]李春玉,姜丽萍.社区护理学[M].北京:人民卫生出版社,2017:19-24.
[18]王文.中国高血压事业发展六十年回顾[EB/OL].http://www.nccd.org.cn/News/Articles/Index/149?from=1087.
[19]王文,王増武,陈伟伟.我国高血压防治的关键在基层机[J].中华高血压杂志,2010(6):501-503.