社区卫生服务中心高血压人群国家慢性病管理服务治疗依从性现状及影响因素研究  

The Current Status and Influencing Factors of Treatment Adherence to National Chronic Disease Management Services for Hypertensive Population in a Community Healthcare Center in Guangzhou

作　　者：潘宏伟 刘莉[2] 马超 邓光璞[3] 方浩庭 黄书玮 朱宏 PAN Hongwei;LIU Li;MA Chao;DENG Guangpu;FANG Haoting;HUANG Shuwei;ZHU Hong(School of Health Management,Southern Medical University,Guangzhou 510515,China;Department of Medical Quality Management,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Health Commission of Guangdong Province,Guangzhou 510060,China)

机构地区：[1]南方医科大学卫生管理学院,广东省广州市510515 [2]南方医科大学南方医院医疗质量管理科,广东省广州市510515 [3]南方医科大学南方医院,广东省广州市510515 [4]广东省卫生健康委员会,广东省广州市510060

出　　处：《中国全科医学》2024年第1期59-66,共8页Chinese General Practice

基　　金：国家重点研发计划“主动健康和老龄化科技应对”重点专项项目(2020YFC2006400);广东省卫生经济学会2022年面上课题项目(2022-WJMF-92)。

摘　　要：背景高血压人群在我国基数较大,其防治措施主要依靠国家基本公共卫生服务内的慢性病管理服务项目。但目前研究显示其利用率并不高,因此针对参与者进行调查,确定影响其治疗依从性的因素,对提高高血压人群国家慢性病管理服务的参与度和患者健康水平具有重要意义。目的调查和分析国家基本公共卫生服务内高血压管理服务的治疗依从性现状及影响因素,为提高高血压患者治疗依从性提供参考依据。方法分多阶段抽取2022年6—9月广州市某社区卫生服务中心所服务社区的295名高血压管理服务参与者为研究对象,使用一般资料调查表、情绪平衡量表(正向情绪、负向情绪)调查研究对象的基本情况,使用高血压治疗依从性量表调查研究对象治疗依从性现状,采用多因素Logistic回归分析探讨高血压人群国家慢性病管理服务治疗依从性的影响因素,并探讨正负情绪合并状况对高血压人群国家慢性病管理服务治疗依从性的影响。结果发放问卷310份,回收有效问卷295份,有效率为95.2%;高血压治疗依从性量表总分为(94.24±8.67)分,其中遵医服药(21.06±2.45)分,不良服药(31.33±3.90)分,烟酒管理(8.44±1.88)分,日常生活管理(33.41±4.61)分,依从性较好率为52.2%(154/295);情绪平衡表中正向情绪得分为(3.76±1.02)分,负向情绪得分为(2.63±1.12)分;多因素Logistic回归分析结果显示,性别、年龄、BMI、受教育程度、血压控制情况、自我感觉身体状况、对就诊点满意度、正向情绪较多、负向情绪较少是高血压人群国家慢性病管理服务治疗依从性较好的影响因素(P<0.05);正负情绪合并状况为正多负少的高血压人群国家慢性病管理服务治疗依从性是正负情绪合并状况为正少负多者的15.867倍(P<0.05),正负情绪合并状况为正多负多的高血压人群国家慢性病管理服务治疗依从性是正负情绪合并状况为正少Background The hypertensive population has a large base in China,and its preventive and treatment measures rely mainly on the chronic disease management service program within the National Basic Public Health Service.However,current studies have shown low utilization rate of it,so it is of great significance for improving the participation of the National Chronic Disease Management Service and health level in the hypertensive population to conduct a survey of participants to determine the factors affecting their treatment adherence.Objective To investigate and analyze the current status and influencing factors of treatment adherence of hypertension management services within the National Basic Public Health Service,and provide reference for improving treatment adherence in hypertensive patients.Methods A total of 295 participants of hypertension management services in the community served by a community healthcare center in Guangzhou City from June to September 2022 as the study subjects by using a multi-stage sampling method.The General Information Questionnaire and the Emotional Balance Scale(positive and negative emotions)were used to investigate the basic information of the study subjects,and the Hypertension Treatment Adherence Scale was used to investigate the current status of treatment adherence among the study subjects.Multivariate Logistic regression analysis was used to explore the influencing factors of treatment adherence to the National Chronic Disease Management Service in the hypertensive population,and the influence of the combined positive and negative emotion status on treatment adherence to the National Chronic Disease Management Service in the hypertensive population.Results A total of 310 valid questionnaires were distributed,295 valid questionnaires were recovered,with a validity rate of 95.2%;the total score of the Hypertension Treatment Adherence Scale was(94.24±8.67),of which the score of medication adherence was(21.06±2.45),medication malpractice was(31.33±3.90),tobacco and alcohol m

关 键 词：高血压 治疗依从性 国家基本公共卫生服务 慢性病管理 正负情绪 影响因素分析 

分 类 号：R544.1[医药卫生—心血管疾病]