社会支持和健康素养对农村高血压患者抑郁的影响

The Effects of Social Support and Health Literacy on Depression among Rural Patients with Hypertension

目的探讨社会支持和健康素养对农村地区高血压患者抑郁的影响,为改善高血压患者抑郁状况提供参考。方法采用多阶段随机抽样方法抽取成都市某农村地区549名高血压患者进行问卷调查;应用结构方程模型分析社会支持和健康素养对高血压患者抑郁的影响。结果社会支持(β=-0.116,95%CI:-0.198^-0.132)和健康素养(β=-0.209,95%CI:-0.289^-0.132)对高血压患者抑郁均有直接的负向影响;社会支持对健康素养有直接的正向影响(β=0.146,95%CI:0.064~0.229);健康素养在社会支持与抑郁之间起中介作用(β=-0.030,95%CI:-0.054^-0.013)。此外,患者的性别、就业状况和家庭人均年收入情况影响其抑郁的发生(P<0.05)。结论社会支持和健康素养是高血压患者抑郁的重要预测因素,应积极构建良好的社会支持网络,加强健康知识的宣传普及,提高社会支持和健康素养水平以缓解高血压患者的抑郁。同时,对女性、家庭人均年收入低及在业高血压患者应给予更多关注。

Objective To explore the effects of social support and health literacy on depression among hypertensive patients in rural areas and to provide reference for improving depression in hypertensive patients.Methods A multi-stage stratified sampling method was used to select 549 hypertensive patients in a rural area of Chengdu city for a questionnaire survey.Structural equation model was used to analyze the effects of social support and health literacy on depression in hypertensive patients.Results Social support(β=-0.116,95%CI:(-0.198)-(-0.132))and health literacy(β=-0.209,95%CI:(-0.289)-(-0.132))had a direct negative effect on depression,and social support had a direct positive effect on health literacy(β=0.146,95%CI:0.064-0.229).Health literacy was a mediator between social support and depression(β=-0.030,95%CI:(-0.054)-(-0.013)).The gender,employment status and per capita annual income of the patients affected the incidence of depression(P<0.05).Conclusions Social support and health literacy are important predictors of depression among hypertensive patients.We should construct a good social support network,strengthen the publicity of health knowledge,and improve social support and health literacy to alleviate the depression in hypertensive patients.At the same time,more attention should be paid to women,people with low per capita annual income and working hypertensive patients.