北京市顺义区高血压患者药物治疗依从性及其影响因素

Abstract

目的：调查北京市顺义区高血压药物治疗依从性现状，分析依从性的影响因素，为后续的政策制定和干预研究提供依据。方法采用自行设计的基于健康信念模式的调查问卷，问卷信效度均良好。通过对服药的信念因子和依从性建立结构方程模型来探讨影响依从性的信念因素及可能存在的中介效应。结果纳入本研究的745例高血压患者平均年龄（56．4±10．8）岁，药物治疗依从性好的比例为43．5％，依从性随着年龄的增加逐渐提高（P ＜0．001）；结构方程模型对依从性的解释程度为59．3％，感知到的障碍和自我效能对依从性影响显著（P ＜0．001），自我效能是感知到的障碍、提示因素以及感知到严重性作用于依从性的中介变量，其中感知到障碍的中介效应最强为－0．355（P ＜0．001），占总效应的70．7％。结论顺义区高血压患者药物治疗的依从性不容乐观，提高依从性的任务仍然艰巨，需要有关各方的共同努力。

Objective To research them edication compliance and its determinants among hypertensive patients in Shunyi District,so as to provide reference for policy-making and intervention studies in the future.Methods A self-de-signed questionnaire with acceptable validity and reliability was conducted based on Health Belief Model.Medication compli-ance and scores of perception were compared among different groups.Thereafter,the determinants of medication compliance and indirect effects were illustrated by Structural Equation Modeling.Results The average age of 745 hypertensive patient was 56.4 ±10.8 years old and 43.5% of them complied with their medical regimens well.The proportion of compliance was higher within older group (P <0.001).SEMmodel explained 59.3% variance of medication compliance.Perceived barriers and self-efficacy were statistically significant determinants.Self-efficacy was the only mediating variable connecting perceived barriers,cues to action and perceived severity with adherence.The indirect effect of perceived barriers was the strongest of-0.355 (P <0.001),70.7% of the total effect.Conclusion The prevalence of medication compliance in Shunyi Dis-trict was unoptimistic.All stakeholders should take their effort to promote medication compliance of hypertensive patients.