原发性高血压患者治疗依从性行为特征及影响因素分析

Behavioral characteristics of therapeutic adherence in patients with essential hypertension and factors influencing the adherence

目的探讨重庆市社区原发性高血压患者治疗依从性行为特征及血压控制情况,并分析人口社会学因素对依从性的影响。方法采用目的抽样方法,使用自行编制的原发性高血压患者治疗依从性量表,对重庆市3家社区卫生服务中心及3所三级甲等医院门诊和入院24 h内的317例高血压患者进行调查。采用多元逐步回归分析患者人口社会学因素对依从性的影响。结果患者血压控制率为34.4%,血压控制达标者的依从性得分比未达标者高(P<0.01)。逐步回归分析显示,性别、家庭人均月收入、医疗费用支付方式是影响高血压患者依从性的主要因素(P<0.01,P<0.05)。结论重庆市社区高血压患者血压控制率较低,对治疗的依从性较差。应将男性、家庭收入低、无医疗保险、在职、居住农村的高血压患者作为干预的重点对象。

Objective To explore the behavioral characteristics of therapeutic adherence and the hypertension control rate in the patients with essential hypertension in Chongqing,China,to analyze the socio-demographic factors that influence the therapeutic adherence.Methods A survey was conducted using a self-designed therapeutic adherence scale for the patients with essential hypertension.This survey involved 317 patients with essential hypertension,who were the outpatients and inpatients（within 24 h after admission） in 3 community health service centers and 3 grade-A general teaching hospitals in Chongqing.Multi-variable stepwise regression was used to analyze the socio-demographic factors influencing the therapeutic adherence of the patients.Results The hypertension control rate of the patients was 34.4%.The patients with controlled hypertension had a significantly higher therapeutic adherence than those without controlled hypertension（P0.01）.The multi-variable stepwise regression showed that sex,household monthly per capita income,and mode of medical payment were the main factors that influenced the therapeutic adherence of the patients（P0.01,P0.05）.Conclusion The hypertension control rate of the patients with essential hypertension is low in Chongqing,and the therapeutic adherence of the patients is poor.Intervention emphasis should be put on the male patients,patients with low family income,patients without medical insurance,patients with full-time jobs,and patients living in rural areas.