山东农村高血压患者防治知识知晓程度及服药依从性相关研究

目的了解山东农村地区高血压患者防治知识知晓情况,分析其影响因素,并探索其与服药依从性的关系,为针对性开展农村高血压健康教育工作提供依据。方法于2018年5-6月采用多阶段分层随机抽样方法,在山东省农村地区抽取高血压患者,进行问卷调查,评估其高血压防治知识知晓和服药依从性情况,共有511例高血压患者纳入本研究。用SPSS 20.0软件进行χ²检验、多因素logistic回归分析和Spearman等级相关分析。结果511例调查对象高血压相关知识总体知晓率为47.60%,其中,高血压危险因素知晓率最高,为69.94%,其次依次为药物治疗(55.06%)、基础知识(39.20%)、危害认知(29.45%)和血压管理知识(29.45%)。服药依从性好的高血压患者有187人,占36.59%,服药依从性差者324人,占63.41%。多因素logistic回归分析结果显示,较高文化程度(初中OR=2.85,95%CI:1.32~6.13;高中及以上OR=7.39,95%CI:2.70~20.23)、病程长(2~年OR=4.77,95%CI:1.35~16.89;6~年OR=6.44,95%CI:1.80~23.04;>10年OR=12.08,95%CI:3.19~45.73)、药物治疗方案由省市级(OR=2.81,95%CI:1.10~7.20)或乡镇医院制定(OR=1.85,95%CI:1.08~3.16)、人均月收入较高(501~1500元OR=1.84,95%CI:1.07~3.18)的患者高血压相关知识知晓程度好,均有统计学意义(P<0.05)。χ²检验结果显示,高血压危险因素、危害认知、药物治疗等知识知晓程度不同的患者服药依从性差异均有统计学意义(P<0.01),且Spearman等级相关分析显示三者与服药依从性呈正相关(rs值分别为0.130、0.169和0.142),均有统计学意义(P<0.05)。结论山东省农村高血压患者的高血压防治知识知晓程度和服药依从性均有待进一步提高,应继续加强高血压危险因素、危害认知、药物治疗等相关知识的宣传教育。

Study on the prevention and treatment knowledge of rural hypertension patients and the correlation with medication compliance in Shandong Province

Objective To understand the awareness of the prevention and treatment of hypertension in rural patients in Shandong Province,to analyze its influencing factors,to explore its relationship with medication compliance,and to provide the basis for the targeted development of rural hypertension health education.Methods From May to June 2018,the multi-stage stratified random sampling method was used to select the rural patients with hypertension in Shandong Province as the subjects.The investigation was performed with the questionnaire to assess their awareness of hypertension prevention and treatment knowledge and medication compliance.Five hundreds and eleven patients with hypertension were included in present study.Theχ² test,multi-factor logistic regress analysis and Spearman rank correlation analysis were used to analyze the data,the used software was SPSS 20.0.Results The total awareness rate of hypertension-related knowledge in 511 subjects was 47.60%.Among them,the awareness rate(69.94%)of hypertension risk factors was the highest,followed by medication therapy(55.06%),basic knowledge(39.20%),hazard awareness(29.45%)and blood pressure management knowledge(29.45%).There were 187 hypertension patients with good medication compliance(36.59%),and 324 patients with poor medication compliance(63.41%).The results of multi-factor logistic regression analysis showed that the patients with higher education level(junior high school,OR=2.85,95%CI:1.32-6.13;≥high school level,OR=7.39,95%CI:2.70-20.23),long disease duration(2-years OR=4.77,95%CI:1.35-16.89;6-years OR=6.44,95%CI:1.80-23.04;>10 years OR=12.08,95%CI:3.19-45.73),the medication treatment plan formulated by the provincial and municipal levels(OR=2.81,95%CI:1.10-7.20)or the township hospital(OR=1.85,95%CI:1.08-3.16),higher income(501~1500 Yuan,OR=1.84,95%CI:1.07-3.18)had the good awareness level of hypertension-related knowledge(P<0.05).The results ofχ² test showed that there was a significant difference of the medication compliance in patients with different knowledge of hypertension risk factors,hazard awareness and medication treatment(P<0.01),and Spearman rank correlation analysis showed that the knowledge of hypertension risk factors,hazard awareness and medication treatment positively correlated with medication compliance(rs values were 0.130,0.169 and 0.142,P<0.05).Conclusion The hypertension prevention or treatment knowledge and medication compliance of rural patients with hypertension in Shandong Province should be further improved.The publicity and education of hypertension risk factors,hazard awareness,medication treatment and other related knowledge should be strengthened.