广西城市社区与农村社区老年高血压患者居家服药依从性及影响因素差异分析

目的：探讨广西城市和少数民族农村社区老年高血压患者居家服药依从性及影响因素差异。方法采取简单随机抽样方法，在广西南宁市社区医院和环江县乡镇卫生院现存高血压患者档案库中，分别选取350例老年高血压患者，采用Morisky服药依从性量表进行问卷调查。结果城市社区和农村社区老年高血压患者居家服药依从性高分别为119例(34.0%)、42例(12.0%)，城市社区老年患者依从性比农村社区老年患者高( P<0.05)。年龄大、家庭收入低、记忆力差为共同因素外，影响城市社区患者服药依从性的因素还有BMI值高、独居、运动频率少、未按时测量血压，影响农村社区患者服药依从性的因素还有男性、自我管理差、高血压知识缺乏、血压等级高、医疗条件差。结论农村社区老年高血压患者居家服药依从性较低，两地服药依从性影响因素有差异，对城市社区注重个体化干预措施，对农村社区强调健康宣教重要性，高血压防治工作不仅要在城市大医院取得进展，更应该落实到基层医疗单位的医疗工作中。

Difference analysis on medication complicance and influencing factors of elderly hy-pertension patients in urban community and rural community in Guangxi

Objective To understand the differences of medication complicance and influencing factors of eld-erly hypertension patients in urban community and rural community in Guangxi. Methods The method of simple random sampling was used to select research object. A total of 350 elderly hypertension patients were selected from archives of Nanning community hospitals and Huanjiang township hospital. The Morisky Medication Adherence Scale was used for questionnaire survey. Results The number of patients with good compliance in urban and rural communities were re-spectively 119 (34. 0%) and 42 (12. 0%) , and the compliance of the elderly patients in urban community was better than that in the rural community (P<0. 05) . In addition to the age, low family income and poor memory, the common factors affecting the patients' medication compliance also included high BMI, living alone, less exercises and unsched-uled measurement of blood pressure for the patients in urban community. And the gender, poor self-management, lacking knowledge of high blood pressure and bad health care also influenced the compliance of patients in rural communi-ties. Conclusions Elderly patients with essential hypertension living at home in rural community have lower medication compliance, medication compliance of the two places are different in the influencing factors. The urban communities fo-cus on individualized interventions while rural communities emphasize the importance of health education. Prevention and treatment of high blood pressure will not only make progress in hospital in big cities, but also implement in the medical work in primary health care units.