南京市兰园社区高血压患者自觉健康控制现状及其影响因素分析

Status and Influence Factors of Health Locus of Control in Patients with Hypertension in Lanyuan Community of Nanjing

目的探讨兰园社区高血压患者自觉健康控制现状及其影响因素,为社区制定相应的高血压管理方案提供依据。方法采取便利抽样的方法,选取南京市兰园社区已建立健康档案且定期随访的高血压患者409例,采用一般资料调查表、高血压疾病资料及相关知识调查表及自觉健康控制量表B表进行问卷调查。采用多元逐步回归分析自觉健康控制的影响因素。结果兰园社区高血压患者自觉健康控制各维度得分为,外部权威人士控制(26.89±6.10)分、内部控制(24.86±6.14)分、命运控制(19.83±7.45)分;多元逐步回归分析结果显示:年龄越大,医疗费用越高,文化程度越低,病程越短,越倾向于外部权威人士控制;年龄越小,文化程度越高,工作状态越好,越倾向于内部控制;年龄越大,疾病相关知识得分越低,医疗费用越高,文化程度越低,越倾向于命运控制。结论兰园社区高血压患者倾向于外部权威人士控制,年龄、文化程度、医疗费用、工作状况、病程和疾病知识掌握程度是社区高血压患者自觉健康控制的主要影响因素,因此,社区医务人员应当针对不同特征的患者提供有针对性地健康指导,帮助增强其健康信念,提高自我管理水平。

Objective To explore the level of health locus of control in patients with hypertension and its influencing factors, so as to provide evidences for the development of appropriate hypertension management program in community. Methods A convenience sample of 409 hypertension patients with health records and regular follow-up in Lanyuan community of Nanjing was selected. The investigation was completed using the socio-demographic information questionnaire and Multidimensional Health Locus of Control Scale（MHLC, Form B）. Results The score of powerful others externality was 26.89±6.10; that of the internality 24.86±6.14 and that of the chance externality 19.83 ±7.45. The older, the higher medical expenses, lower education level, the shorter the duration, the higher the level of powerful others externality; the younger, the higher level of education, better working status, the higher the level of the internality; the older, disease related knowledge score lower, the higher the degree of medical expenses, the lower level of education, the higher the level of the chance externality. Conclusion The hypertension patients in Lanyuan community tend to be controlled by powerful others externality, age, education level, medical expense, working status and course of disease and degree of knowledge mastery of disease were the main influence factors of health locus of control. Therefore, community medical staff should provide personalized health guidance for patients to help enhance their health and improve the self-management level.