基于潜剖面分析的高血压患者自我管理类型及对血压的影响

陈平; 巩俐彤; 孙昕霙

doi:10.16462/j.cnki.zhjbkz.2023.06.009

基于潜剖面分析的高血压患者自我管理类型及对血压的影响

doi: 10.16462/j.cnki.zhjbkz.2023.06.009

1.
北京大学公共卫生学院社会医学与健康教育系, 北京 100191
2.
北京市大兴区疾病预防控制中心办公室, 北京 102600

基金项目:

北京市自然科学基金 7202087

详细信息

通讯作者:
孙昕霙，E-mail: xysun@bjmu.edu.cn

中图分类号: R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2022-05-22
- 修回日期: 2022-08-21
- 网络出版日期: 2023-07-10
- 刊出日期: 2023-06-10

Evaluating self-management types in hypertensive patients and their effect on blood pressure using latent profile analysis

1.
Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
2.
Office of Daxing Center for Disease Control and Prevention, Beijing 102600, China

Funds:

Beijing Municipal Natural Science Foundation 7202087

More Information

Corresponding author: SUN Xinying, E-mail: xysun@bjmu.edu.cn

摘要

摘要: 目的探究高血压患者的自我管理类型、血压控制现状及二者之间的关系。方法选取北京市大兴区的高血压患者作为研究对象, 对其进行问卷调查和身体检查。采用潜剖面分析探究高血压患者的自我管理类型, 采用一般线性回归探究其与血压水平的关系, 采用χ²检验探究自我管理类型的特征。结果共纳入高血压患者1 260名, 其自我管理类型可以分为消极管理(21.98%)、积极生活方式管理(9.68%)、积极药物管理(32.22%)、全面积极管理(36.12%)4类。相比于消极管理型, 全面积极管理的患者SBP水平降低(β=-4.948, t=-2.098, P=0.012)。男性、文化程度在小学及以下的、年龄在35岁及以下的患者更倾向为消极管理型。结论根据生活方式管理、药物管理行为的不同, 高血压患者自我管理类型可以分成4类。全面积极管理的患者SBP水平低于消极管理型, 未来对于高血压患者的管理应注重依需求提升患者自我管理能力。
- 高血压患者 /
- 自我管理类型 /
- 潜剖面分析 /
- 血压水平
Abstract: Objective This study aims to identify the types of self-management employed by hypertensive patients, to assess their blood pressure control status, and to examine the relationship between the two. Methods A questionnaire survey and physical examinations were administered to hypertensive patients from the Daxing District in Beijing.Latent profile analysis was used to explore the self-management types.General linear regression was used to investigate the relationships between self-management types and blood pressure levels.Chi-square tests were used to examine the characteristics of self-management types. Results A total of 1 260 patients with hypertension were included in this study.Their self-management types could be categorized into four types: negative management (21.98%), lifestyle-positive management (9.68%), medication-positive management (32.22%) and comprehensive-positively management (36.12%).Compared with negative management type, the level of SBP in patients with comprehensive-positively management was significantly lower (β=-4.948, t=-2.098, P=0.012).Male patients, those with education below primary school level, and individuals under 35 years of age showed a tendency toward negative management practices. Conclusions According to different behaviors in lifestyle management and medication-taking, the self-management types of patients with hypertension can be divided into four types.Notably, the SBP levels in patients utilizing comprehensive-positive management were significantly lower compared to those following negative management practices.Future efforts should concentrate on enhancing patients′ self-management capabilities according to their specific needs.
- Hypertensive patients /
- Self-management types /
- Latent profile analysis /
- Blood pressure

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图 1 高血压患者自我管理类型的潜剖面分析

Figure 1. Latent profile analysis of self-management types in hypertensive patients

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表 1 血压水平影响因素的一般线性回归

Table 1. General linear regression of factors influencing blood pressure

变量	SBP/mmHg			DBP/mmHg
变量	β	s_x	t值	β	s_x	t值
性别
男	4.003	1.199	3.338 ^①	5.168	0.778	6.639 ^①
女
年龄/岁	0.177	0.056	3.147 ^②	-0.304	0.036	-0.855 ^①
病程/年	0.168	0.073	2.285 ^②	0.087	0.478	1.821
文化程度
初中	-1.366	1.734	-0.787	0.660	1.122	0.588
高中	-3.580	1.912	-1.872	-0.885	1.235	-0.717
大专及以上	-6.014	2.262	-2.658 ^②	-3.043	1.466	-2.074 ^②
小学及以下
自我管理类型
全面积极管理	-4.948	2.358	-2.098 ^②
积极药物管理	-3.943	2.388	-1.651
积极生活方式管理	-0.047	2.614	-0.182
消极管理
注: ① P＜0.001。② P＜0.05。

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表 2 高血压患者自我管理类型与一般人口学特征的关系

Table 2. Relationship between self-management types and demographic characteristics in hypertensive patients

一般人口学特征	消极管理/[人数(占比/%)]	积极生活方式管理/[人数(占比/%)]	积极药物管理/[人数(占比/%)]	全面积极管理/[人数(占比/%)]	χ²值	P值
性别					11.516	0.009
男	175(24.93)	62(8.83)	232(33.05)	233(33.19)
女	102(18.28)	60(10.75)	174(31.18)	222(39.79)
年龄组/岁					188.120	＜0.001
≤35	81(53.64)	30(19.87)	17(11.26)	23(15.23)
＞35~45	40(24.54)	27(16.56)	39(23.93)	57(34.97)
＞45~55	63(18.64)	40(11.83)	105(31.07)	130(38.46)
＞55~65	44(13.97)	16(5.08)	127(40.32)	128(40.63)
＞65	49(16.73)	9(3.07)	118(40.27)	117(39.93)
人均月收入/元					18.400	0.005
＜3 000	133(21.66)	42(6.84)	217(35.34)	222(36.16)
3 000~＜5 000	94(21.66)	47(10.83)	134(30.87)	159(36.64)
≥5 000	50(23.58)	33(15.57)	55(25.94)	74(34.91)
文化程度					32.738	＜0.001
小学及以下	38(18.10)	15(7.14)	92(43.81)	65(30.95)
初中	116(22.18)	44(8.41)	178(34.04)	185(35.37)
高中	59(20.07)	31(10.54)	80(27.21)	124(42.18)
大专及以上	27(16.98)	19(11.95)	50(31.45)	63(39.62)
婚姻状况					3.121	0.373
已婚	260(21.96)	119(10.05)	379(32.01)	426(35.98)
未婚	17(22.36)	3(3.95)	27(35.53)	29(38.16)
病程^① /年					48.243	＜0.001
≤5	84(18.58)	53(11.73)	153(33.85)	162(35.84)
＞5~10	38(13.29)	8(2.80)	105(36.71)	135(47.20)
＞10	17(7.30)	9(3.86)	99(42.49)	108(46.35)
注：①表示采用有效应答样本。

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