老年华裔移民的高血压控制、药物依从性预测因素及性别差异

Hypertension control, predictors for medication adherence and gender differences in older Chinese immigrants.

作者信息

Li Wen-Wen, Wallhagen Margaret I, Froelicher Erika S

机构信息

Department of Community Health Systems, School of Nursing, University of California, San Francisco, California, USA.

出版信息

J Adv Nurs. 2008 Feb;61(3):326-35. doi: 10.1111/j.1365-2648.2007.04537.x.

DOI:10.1111/j.1365-2648.2007.04537.x

PMID:18197867

Abstract

AIM

This paper is a report of a study to explore the relationship between demographic and cultural factors and antihypertensive medication adherence in older Chinese immigrants.

BACKGROUND

Hypertension is a well-known controllable risk factor for cardiovascular diseases worldwide, but only 20-80% of patients who take antihypertensive medications adhere adequately to their treatment regimen.

METHODS

A cross-sectional study was conducted between 2002 and 2003, with a convenience sample of 75 older men and 69 older women (n = 144, response rate 80%). Medication adherence was defined as > or =80% of the total score on the Morisky scale.

FINDINGS

Age (75.2 +/- 5.7 vs. 75.9 +/- 7.0 years, P = 0.51) and length of stay in the United States of America (12.7 +/- 6.4 vs. 12.7 +/- 6.6 years, P = 0.97) were similar for men and women. More men were married (85% vs. 46%, P < 0.01). A smaller proportion of men were poor (39% vs. 65%, P < 0.01), believed in religion (49% vs. 70%, P = 0.01), and could speak no English (32% vs. 57%, P < 0.01). Fewer men used Chinese herbs to treat hypertension (4% vs.13%). Hypertension control was low for men and women (53% and 48%, P = 0.51). Adherence in men and women was 69% and 75% (P = 0.42) respectively. For men, shorter length of stay in the United States of America was negatively associated with non-adherence (OR = 0.16; 95% CI: 0.05, 0.57). No association between length of stay and non-adherence was found for women.

CONCLUSION

More research, including gender-specific studies, is needed to understand better how to develop an effective and culturally sensitive strategy to help older Chinese immigrants manage their hypertension.

摘要

目的

本文是一项关于探究中国老年移民人口统计学和文化因素与抗高血压药物依从性之间关系的研究报告。

背景

高血压是全球范围内众所周知的心血管疾病可控风险因素，但服用抗高血压药物的患者中只有20%-80%能充分坚持其治疗方案。

方法

2002年至2003年进行了一项横断面研究，便利样本包括75名老年男性和69名老年女性（n = 144，应答率80%）。药物依从性定义为Morisky量表总分的≥80%。

研究结果

男性和女性的年龄（75.2±5.7岁对75.9±7.0岁，P = 0.51）以及在美国的停留时间（12.7±6.4年对12.7±6.6年，P = 0.97）相似。已婚男性更多（85%对46%，P < 0.01）。贫困男性比例较小（39%对65%，P < 0.01），信教男性比例较小（49%对70%，P = 0.01），不会说英语的男性比例较小（32%对57%，P < 0.01）。使用中药治疗高血压的男性较少（4%对13%）。男性和女性的高血压控制率都较低（分别为53%和48%，P = 0.51）。男性和女性的依从率分别为69%和75%（P = 0.42）。对于男性，在美国停留时间较短与不依从呈负相关（OR = 0.16；95%CI：0.05，0.57）。未发现女性停留时间与不依从之间存在关联。