2015年上海市黄浦区高血压患者用药依从性与社会支持的相关研究

Correlation between medication adherence and social support of patients with hypertension in Huangpu District,Shanghai,2015

目的探索社区高血压患者用药依从性与社会支持之间的关系,分析高血压患者用药依从性的影响因素,为社区高血压疾病干预提供依据。方法 2015年10月采用整群抽样的方法,在黄浦区抽取1 296名高血压患者进行问卷调查,问卷内容包括人口学特征、用药依从性评价和社会支持评定量表。采用SPSS软件分析不同人口特征的高血压患者的用药依从性、社会支持得分及二者的关系,探讨影响社会支持得分的因素。结果 1 121名有效调查对象中用药依从性好450人(40.1%),部分依从566人(50.5%),不依从105人(9.4%);调查对象社会支持总分为(36.33±7.54),客观支持得分(8.23±2.70),主观支持得分(20.80±4.70),对支持的利用度得分(7.30±2.06),不同年龄、婚姻状况、工作状态、家庭平均月收入、居住状况患者的用药依从性差异有统计学意义(P<0.05),男性客观支持得分高于女性(P<0.05),但对支持的利用度低于女性(P<0.05),随年龄增加,调查对象社会支持总分及3个维度呈现递减趋势(P<0.001)。调查对象社会支持总分(r=-0.174)、客观支持(r=-0.205)、主观支持(r=-0.102)、对支持的利用度(r=-0.136)均与高血压用药依从性呈显著负相关(P<0.001);年龄和婚姻状况是调查对象社会支持总分(β=-2.156,P<0.001;β=-2.165,P<0.001)、客观支持(β=-0.557,P<0.001;β=-0.757,P<0.001)、主观支持(β=-1.292,P<0.001;β=-1.216,P<0.001)、对支持的利用度(β=-0.307,P<0.001;β=-0.193,P<0.05)的影响因素。年龄和婚姻状况是调查对象社会支持总分、客观支持、主观支持、对支持的利用度的影响因素。结论 2015年上海市黄浦区社区高血压患者用药依从性较低,用药依从性与社会支持存在负相关关系,年龄和婚姻状况是调查对象社会支持总分、客观支持、主观支持、对支持的利用度的影响因素。

Objective To explore the correlation between medication compliance and social support of community patients with hypertension and to analyze the inβuencing factors of their medication adherence, so as to provide a basis for hypertension intervention in communities. Methods A cluster sampling method was used to select 1,296 patients with hypertension in Huangpu District in October, 2015. Demographic characteristic questionnaire, self-reported medication adherence assessment questionnaire and Social Support Rating Scale were used to conduct questionnaire surveys. SPSS software was employed for analyzing the scores of medication adherence and social support in hypertension patients with different demographic characteristics and the relationship be- tween the scores of the two items, and for exploring the factors inβuencing the score of social support. Results Among the l, 121 valid surveyed patients, 450 （40. 1%） had good adherence to medication, 566 （50.5% ） had poor adherence and 105 （ 9.4% ） did not comply. The total score of social support and the scores of objective support, subjective support and availability of social support were （36.33＋-7.54） , （ 8.23＋2.70） , （20.80~4.70） and （7.30~2.06） respectively. There were statistically signifi- cant differences in the medication adherence among patients with different ages, marital status, work status, average monthly household income and living conditions （P〈0.05）. The score of objective support was higher in males than in females I P〈0.05）, while the score of availability of social support was lower in males than in females （ P〈0.05 ）. The total score of social support and and the scores of the three dimensions showed a decreasing trend with the increasing age （ P〈0.001 ）. The total score of social sup- port （r=-0.174） and the scores of objective support （ r=-0.205） , subjective support （r=-0.102） and availability of social sup- port （r=-0.136） were significantly negatively correlated with medication adherence （ P〈0.001 ）. Age and marital status were the inβuencing factors for the total score of social support （β = - 2. 156, P 〈 0. 00 ） ; β = - 2. 165, P 〈 0.001 ）, objective support （β = -0. 557, P〈0.001 ;β= -0.757, P〈0.001 ）, subjective support （β= -1.292, P〈0.001 ;β= -1.216, P〈0.001 ） and the availability of social support （β=-0.307,P〈0.001 ;β=-0.193 ,P〈0.05）. Conclusions Medication adherence of patients with hyperten- sion in Huangpu District, Shanghai in 2015 is poor, and there is a negative correlation between medication adherence and social support. Age and marital status are the factors inβuencing the total score of social support, objective support, subjective support and the availability of social support.