Jankowska-Polańska Beata, Blicharska Katarzyna, Uchmanowicz Izabella, Morisky Donald E
Department of Clinical Nursing, Wrocław Medical University, Poland
Hypertension clinic at a University Teaching Hospital in Wrocław, Poland.
Eur J Cardiovasc Nurs. 2016 Dec;15(7):559-568. doi: 10.1177/1474515115626878. Epub 2016 Jan 7.
The available publications show that 50% of patients with hypertension discontinue their medications within the first 12 months after the beginning of treatment.
The aim of the study was to analyse the relationship between the acceptance of illness and the adherence to pharmacological and non-pharmacological therapy in patients with hypertension.
The study included 102 patients with hypertension examined with validated instruments: Acceptance of Illness Scale (AIS), Health Behavior Inventory (HBI) and Morisky Medication Adherence Scale (MMAS-8).
High (>30 points) and moderate (19-29 points) levels of AIS were presented respectively by 59 and 43 patients. In a univariate analysis, the level of AIS had a statistically significant, independent, positive influence on all domains of the HBI questionnaire: HBI (Spearman's coefficient of rank correlation (r) =+0.3997), healthy eating habits (r=+ 0.376), preventive behaviours (r=+0.242), positive mental attitude (r=+0.504), health practices (r=+0.264). In univariate analysis the level of MMAS-8 was influenced by female gender (r=+0.325; p=0.001), higher education level (r=+0.241; p=0.015), employment (r=+0.217; p=0.029) and short duration of illness (r=+0.229; p=0.022). Multiple regression analysis showed that female gender was an independent predictor of pharmacological adherence (β=+0.325; p=0.001). Illness acceptance was an independent predictor in two domains of the HBI: positive mental attitude HBI domain (β=+0.468; p<0.001) and healthy eating habits (β=+0.321; p=0.001).
(1) Correlation analysis shows that illness acceptance is an important factor contributing to a higher level of adherence to non-pharmacological therapy of hypertension (total index of health behaviours: healthy eating habits, preventive behaviours, positive mental attitude, health practice) but has no influence on adherence to pharmacological treatment. (2) Female gender, higher levels of education, and the short duration of the disease significantly improve patients' adherence to the prescribed pharmacological and non-pharmacological therapy of hypertension.
现有出版物表明，50%的高血压患者在开始治疗后的前12个月内停止用药。
本研究旨在分析高血压患者对疾病的接受程度与药物和非药物治疗依从性之间的关系。
本研究纳入了102例高血压患者，使用经过验证的工具进行检查：疾病接受量表（AIS）、健康行为量表（HBI）和Morisky药物治疗依从性量表（MMAS-8）。
分别有59例和43例患者的AIS水平为高（>30分）和中（19 - 29分）。在单因素分析中，AIS水平对HBI问卷的所有领域均有统计学显著的、独立的正向影响：HBI（斯皮尔曼等级相关系数（r）= +0.3997）、健康饮食习惯（r = +0.376）、预防行为（r = +0.242）、积极心态（r = +0.504）、健康行为（r = +0.264）。在单因素分析中，MMAS-8水平受女性性别（r = +0.325；p = 0.001）、高等教育水平（r = +0.241；p = 0.015）、就业情况（r = +0.217；p = 0.029）和病程短（r = +0.229；p = 0.022）的影响。多元回归分析表明，女性性别是药物治疗依从性的独立预测因素（β = +0.325；p = 0.001）。疾病接受程度是HBI两个领域的独立预测因素：积极心态HBI领域（β = +0.468；p < 0.001）和健康饮食习惯（β = +0.321；p = 0.001）。
（1）相关性分析表明，疾病接受程度是导致高血压非药物治疗依从性较高的一个重要因素（健康行为总指数：健康饮食习惯、预防行为、积极心态、健康行为），但对药物治疗依从性没有影响。（2）女性性别、较高的教育水平和较短的病程显著提高了患者对规定的高血压药物和非药物治疗的依从性。
