高血压患者医疗负担与自我管理体验的相关性研究  

Study on Correlation Between Medical Treatment Burden and Self-Management Experience in Patients with Hypertension

作　　者：胡大兰 Hu Dalan(Department of Internal Medicine,Qinghe Community Health Service Center in Haidian District,Beijing 100085,China)

机构地区：[1]北京市海淀区清河社区卫生服务中心内科,北京100085

出　　处：《中国社区医师》2024年第23期22-25,共4页Chinese Community Doctors

摘　　要：目的:探讨高血压患者主观医疗负担与疾病自我管理体验之间的相关性,为开展少困扰医疗和改善患者疾病自我管理体验提供依据。方法:选取2023年5—9月在北京市海淀区清河社区卫生服务中心就诊的高血压患者340例,收集患者的临床资料,以问卷形式进行断面调查,采用《患者医疗和自我管理体验问卷》对参与者的主观医疗负担进行测评和量化。同时还在主观自我效能、健康素养、经济状况以及就医体验4个方面,对患者的疾病自我管理体验进行测评和量化。在控制人口学特征条件下,采用偏相关分析法,考察主观医疗负担与疾病自我管理体验之间的关联性。结果:340例患者中答卷合格者260例。患者疾病自我管理评分中主观自我效能评分平均51.8分,健康素养评分平均36.3分,经济困难评分平均16.8分,就医体验评分平均22.7分。患者医疗和自我管理评分中,得分最高为就医困难,其次为医疗预约。控制年龄、性别和教育状况,进行相关性分析,较低的主观自我效能、较差的健康素养、不同程度的经济困难和较差的就医体验,都与较大的主观医疗负担相关(P<0.05)。医疗负担的10个类别中,获得医疗信息、医疗预约、就医困难、人际交往、身心疲惫和角色与社会活动受限都与疾病自我管理体验的4个方面显著相关(P<0.05)。其中以获得医疗信息、身心疲惫及医疗预约与疾病自我管理体验的相关性最强(P<0.001)。另外,所有医疗负担类别都与患者的主观自我效能以及经济困难强相关。结论:遵从更严格的高血压管理目标,会加重患者的主观医疗负担,并使其疾病自我管理体验变差,临床实践中应注意化解可能由此带来的负面影响。Objective:To explore the correlation between the subjective medical treatment burden and the disease self management experience in patients with hypertension,so as to provide a basis for carrying out less-trouble medical care and improving patients'disease self-management experience.Methods:A total of 340 patients with hypertension who were treated at Qinghe Community Health Service Center in Haidian District of Beijing from May 2023 to September 2023 were selected.The clinical data of these patients were collected.A cross-sectional survey was conducted in the form of questionnaires.The subjective medical treatment burden of the participants was evaluated and quantified using the“Questionnaire for Patient Experience with Medical Treatment and Self-Management”.At the same time,the patients'disease self-management experience was evaluated and quantified in four aspects:subjective self-efficacy,health literacy,economic status and medical treatment experience.Under the condition of controlling demographic characteristics,partial correlation analysis was used to investigate the correlation between subjective medical treatment burden and disease self-management experience.Results:Among the 340 patients,260 cases were eligible for questionnaires.For the scores of disease self-management of patients,the average score of subjective self-efficacy was 51.8 points,the average score of health literacy was 36.3 points,the average score of financial difficulties was 16.8 points,and the average score of medical treatment experience was 22.7 points.For the patients'medical treatment and self-management scores,the highest score was difficulty in seeking medical care,followed by medical appointments.Age,gender,and education status were controlled to perform the correlation analysis.Lower subjective self-efficacy,poor health literacy,different degrees of financial difficulties,and poor medical treatment experience were all associated with greater subjective medical treatment burden(P<0.05).Among the 10 categories of medical trea

关 键 词：主观医疗负担 慢性病自我管理体验 心血管疾病 断面调查 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]