Jokisalo E, Kumpusalo E, Enlund H, Takala J
Department of Social Pharmacy, University of Kuopio, Finland.
J Hum Hypertens. 2001 Nov;15(11):755-61. doi: 10.1038/sj.jhh.1001276.
To study perceived problems and attitudes in hypertension treatment in primary health care.
A cross-sectional survey of 2219 hypertensive patients, identified by general practitioners, in 26 health centres was carried out during 1 week in 1996. A total of 1782 patients (80%) returned two questionnaires and participated in a health examination. The final study population consisted of 1561 patients currently being medically treated for hypertension and 220 patients not currently on medical treatment. The questionnaires contained 82 questions on different aspects of hypertension care and treatment, which were further elaborated using factor analysis. On the basis of reliability and internal validity analyses, 14 problem indices related to medical treatment of hypertension were formed.
The most common perceived problem was related to lack of motivation for follow-up of hypertension (72%). Many patients had difficulties to accept being hypertensive (66%). A careless attitude towards hypertension was also common (63%). Lack of information was experienced by 56% of the patients. About 33% felt hopeless about their hypertension, reported adverse effects of hypertension treatment on sexual functions and lack of support by health care personnel. The least frequent problems were reimbursement problems and modification of dosage instructions. The number of problems identified per person varied between zero and 14 with a mean of 4.9 +/- 2.6 (s.d.).
Perceived problems concerning hypertension, negative attitudes and experiences are very common among hypertensive patients in primary health care.
研究初级卫生保健中高血压治疗方面的感知问题和态度。
1996年,在1周内对26个健康中心的2219名经全科医生确诊的高血压患者进行了横断面调查。共有1782名患者(80%)返回了两份问卷并参加了健康检查。最终的研究人群包括1561名正在接受高血压药物治疗的患者和220名目前未接受药物治疗的患者。问卷包含82个关于高血压护理和治疗不同方面的问题,并通过因子分析进一步细化。基于信度和内部效度分析,形成了14个与高血压药物治疗相关的问题指标。
最常见的感知问题与缺乏高血压随访动力有关(72%)。许多患者难以接受自己患有高血压(66%)。对高血压满不在乎的态度也很常见(63%)。56%的患者表示缺乏信息。约33%的患者对自己的高血压感到绝望,报告了高血压治疗对性功能的不良影响以及缺乏医护人员的支持。最不常见的问题是报销问题和剂量说明修改。每人发现的问题数量在0至14个之间,平均为4.9±2.6(标准差)。
在初级卫生保健中,高血压患者中关于高血压的感知问题、消极态度和经历非常普遍。