高血压患者生活方式改变阶段的影响因素

Influencing factors of the lifestyle modification of the patients with hypertension

目的评价目前高血压患者生活方式现状并分析其影响因素。方法采用阶段性改变模式对174名高血压患者进行生活方式评估（高盐饮食、高脂饮食、锻炼、吸烟），并分析其影响因素。结果研究结果显示，在吸烟、缺乏锻炼、高盐、高脂饮食这四项生活方式中，缺乏锻炼的患者在前意向阶段人数最多，目前有高盐饮食不良生活习惯的人最多（93．8％）。年龄、性别与吸烟改变阶段呈正相关（r=0．605，0．159；P〈0．01或P〈0．05），教育程度、烟龄、每日吸烟支数与吸烟改变阶段呈负相关（r=-0．170，-0．845，-0．871；P〈0．05）。年龄、教育程度、职业、高血压病程与运动改变阶段呈正相关（P〈0．05），高盐、高脂饮食相关因素较少，高脂饮食只与性别呈正相关（P〈0．05）。Logistic回归分析显示，年龄、烟龄及每日吸烟支数对吸烟改变阶段有预测作用。年龄、受教育程度及高血压病程对运动改变阶段有预测作用。结论为高血压患者设计健康教育措施时，不仅要考虑患者所处改变阶段，而且对于年龄较轻，烟龄长及每日吸烟支数多的吸烟患者需要增加干预次数。对处于前意向阶段、年龄较轻、教育程度低及新发高血压患者需要加强促进规律锻炼的干预措施。在四项生活方式中，需要着重加强低盐饮食健康教育。

Objective To investigate the status of the lifestyle of the patients with hypertension using stage-based assessment and explore the influence factors. Methods Patients with hypertension at the ward of cardiovascular department in China was sampled conveniently （n = 174）： The stage based assessment was used to evaluate the four lifestyles： smoking, exercise, high salt intake and high fat intake. Results The results revealed that 163 subjects （93.8%） were at the pre-action stage for high salt intake. 47 subjects （27%） take exercise with the highest number among the four lifestyles in the stage before intention. Age and gender were positively correlated with the stages of smoking （r = 0. 605,0. 159;P 〈 0. 01 or P 〈 0. 05 ）, while education, smoking years, daily cigarette consumption were negatively correlated with the stages of smoking（ r = -0. 170, -0. 845, -0. 871; P 〈 0. 05 respectively）. Age, education, occupation and hypertension history were positively correlated with action stages （ P 〈 0. 05 ）. Only gender was positively correlated with high fat intake （ P 〈 0. 05 ）. The Logistic analysis showed that age, smoking duration years and daily cigarette consumption was predictable factors for the smoking stages of changing. Exercise stages of changing was predicted by age, education and hypertension history. Conclusions The stage based assessment not only can reveal the problematic lifestyles but also can be used to understand the patient readiness to change. This investigation was helpful to design the more desirable intervention measures for patients with hypertension to lifestyle modification.