Heymann Anthony D, Gross Revital, Tabenkin Hava, Porter Boaz, Porath Avi
Department of Community Medicine, Maccabi Healthcare Services, Tel Aviv, Israel.
Isr Med Assoc J. 2011 Sep;13(9):553-7.
A crucial element in controlling blood pressure is non-pharmaceutical treatment. However, only a few studies specifically address the question of hypertensive patients' compliance with physicians' recommendations for a healthy lifestyle.
To explore factors associated with hypertensive patients' compliance with lifestyle recommendations regarding physical activity, smoking cessation and proper diet.
We performed a secondary data analysis of a representative sample of 1125 hypertensive patients in Israel's two largest health funds. Data were collected in 2002-2003 by telephone interviews using structured questionnaires. The response rate was 77%. Bivariate and multivariate analysis was conducted.
About half of the hypertensive patients reported doing regular exercise and adhering to a special diet; 13% were smokers. About half reported receiving counseling on smoking cessation and diet and a third on physical exercise. A quarter reported receiving explanations regarding self-measurement of blood pressure and signs of deterioration. Multivariate analysis revealed that patients' beliefs about hypertension management, their knowledge on hypertension and its management, and physician counseling on a healthy lifestyle and self-care, have an independent effect on compliance with recommended lifestyle behaviors.
The low counseling rates suggest that there may be a need to improve physicians' counseling skills so that they will be more confident and effective in delivering this service to their patients. A model based on educating both physicians and patients may contribute to improving the care of hypertensive patients.
控制血压的一个关键要素是非药物治疗。然而，只有少数研究专门探讨高血压患者对医生关于健康生活方式建议的依从性问题。
探讨与高血压患者在体育活动、戒烟和合理饮食等生活方式建议方面的依从性相关的因素。
我们对以色列两大健康基金中1125名高血压患者的代表性样本进行了二次数据分析。2002年至2003年通过使用结构化问卷的电话访谈收集数据。应答率为77%。进行了双变量和多变量分析。
约一半的高血压患者报告定期锻炼并坚持特殊饮食；13%为吸烟者。约一半的患者报告接受了戒烟和饮食方面的咨询，三分之一接受了体育锻炼方面的咨询。四分之一的患者报告接受了关于血压自我测量和病情恶化迹象的解释。多变量分析显示，患者对高血压管理的信念、对高血压及其管理的知识，以及医生关于健康生活方式和自我护理的咨询，对推荐生活方式行为的依从性有独立影响。
咨询率较低表明可能需要提高医生的咨询技能，以便他们在为患者提供这项服务时更有信心和成效。一个基于对医生和患者进行教育的模式可能有助于改善高血压患者的护理。
