摘要
目的:为完善高血压防治策略、提高高血压患者的生命质量提供合理建议和实证参考。方法:使用欧洲生命质量量表(EQ-5D)和调查问卷,对分别使用整群抽样和方便抽样方法从北京和杭州两地社区卫生服务中心抽取的1 006名高血压患者进行入户调查,包括调查对象的基本情况,生活习惯及健康状况,高血压监测、控制状况和治疗状况,高血压患者的疾病经济负担,用药情况和用药依从性等,数据录入后使用描述性分析和多因素回归分析方法进行分析,以研究高血压社区管理对患者生命质量的影响。结果:两地入户调查失访率均低于5%。杭州受访高血压患者EQ-5D生命质量得分为(0.85±0.13)分,显著高于北京受访高血压患者的(0.78±0.19)分(P<0.000);年龄、伴随慢性病数量、用药依从性、每周锻炼频率等对高血压患者生命质量有显著的影响;社会支持得分、患者对高血压相关知识的了解程度、对处方量的满意程度、对高血压的重视程度、精神状态等对高血压患者用药依从性有显著的影响。结论:在经济比较发达的城市,医保待遇、经济条件、文化程度不是影响高血压患者生命质量的重要因素,完善的高血压社区管理是提高患者生命质量的关键。用药依从性是影响高血压患者生命质量的重要因素,也是通过高血压社区管理重点干预的对象;提高患者社会支持程度、加强健康宣教、提供令患者满意的处方量、鼓励患者积极治疗是提高其用药依从性的有效措施。
OBJECTIVE： To provide reasonable suggestions and empirical reference for improving hypertension control strategy and the life quality of hypertension patients. METHODS： By using EQ-5D scale and questionnaires, 1 006 hypertension patients were collected and investigated from community health care center in Beijing and Hangzhou by cluster sampling and convenience sampling. The investigation contents, including the basic conditions of patients, living habits and health status, hypertension monitoring and control, treatment condition, the economic burden of hypertension patients, drug use and drug compliance, were analyzed by descriptive analysis and multi-factor regression to study the effects of hypertension community management on the quality of life. RESULTS： The lost rate of follow-up was lower than 5% both in Beijing and Hangzhou. EQ-5D of hypertension patients in Hangzhou was（0.85 ±0.13）, which was significantly higher than that in Beijing （0.78 ± 0.19）（P〈0.000）. Age, the number of chronic diseases, medication compliance and weekly exercise frequency had a significant influence on the quality of life. Social sup- port score, the understanding of patients to hypertension, the satisfaction degree of patients to prescriptions, the importance of patients to hypertension and mental state had significant effects on medication compliance. CONCLUSIONS： In fairly developed cities, health care condition, economic conditions, cultural degree are not the important factors that affect life quality of patients with hypettension; the perfect community management is the key to improve the quality of life. Medication compliance is the key factor that affects the quality of life, which need to be significantly intervened through the community management. The effective measures to improve medication adherence are to improve patients＇ social support degree, strengthen health publicity and education activities, provide patient with satisfaction prescription and encourage the patients to receive treatment actively.
出处
《中国药房》
CAS
CSCD
2014年第12期1080-1083,共4页
China Pharmacy
关键词
高血压
社区管理
生命质量
调查分析
Hypertension
Community management
Quality of life
Investigation and analysis
