Andualem Atsedemariam, Gelaye Habtam, Damtie Yitayish
Department of Nursing, School of Nursing and Midwifery, Wollo University, Dessie, Ethiopia.
Department of Psychiatric Nursing, School of Nursing and Midwifery, Wollo University, Dessie, Ethiopia.
Integr Blood Press Control. 2020 Oct 23;13:145-156. doi: 10.2147/IBPC.S275575. eCollection 2020.
Hypertension is a major health problem throughout the world which affects over one billion people due to severe complications and inadequate control. Even though lifestyle modification is one of the most effective ways to prevent and control hypertension, only little emphasis has been given for it compared with treating hypertension with medication. Therefore, the aim of this study was to assess adherence to lifestyle modifications and associated factors among hypertensive patients attending Dessie referral hospital.
Institutional-based cross-sectional study design was conducted among 301 hypertensive patients during May and June, 2020. The study participants were selected with a convenient sampling technique due to the COVID-19 pandemic. Data were collected using pre-tested and structured face to face interviewer-administered questionnaire and checked, cleaned and entered into Epi data version 4.4 and exported to SPSS version 25.0 software for analysis. The associations between independent variables and dependent variable were analyzed using binary logistic regression models.
A total of 301 respondents participated in the study yielding a response of 100%. The overall adherence in this study was only 23.6%. Independent predictors of adherence to lifestyle modifications were divorced (AOR=0.35; 95% CI (0.13-0.94)) and widowed (AOR=0.27; 95% CI (0.10-0.75)), secondary school education (AOR=4.85; 95% CI (1.54-15.22)), no regular income (AOR=0.22; 95% CI (0.08-0.65)) or monthly income of ≥3000 ETB (AOR=5.58; 95% CI (2.46-12.66)), having co-morbidities (AOR=2.37; CI (1.23-4.57)), good knowledge about the disease (AOR=1.83; CI (0.92-3.65)) and good self-efficacy (AOR=3.64; CI (1.75-7.55)).
The overall adherence to recommended lifestyle modifications was very low. The independent predictors were marital status, educational level, monthly income, having co-morbidities, knowledge and self-efficacy. Therefore, multifaceted and collaborative implementation of strategies about lifestyle modifications for hypertension prevention and control are needed to address barriers at the patient, provider, system and community levels.
高血压是全球主要的健康问题,由于严重并发症和控制不足,影响着超过10亿人。尽管生活方式改变是预防和控制高血压最有效的方法之一,但与药物治疗高血压相比,对其重视程度却很低。因此,本研究的目的是评估德西转诊医院高血压患者对生活方式改变的依从性及其相关因素。
2020年5月至6月期间,对301名高血压患者进行了基于机构的横断面研究设计。由于新冠疫情,采用方便抽样技术选取研究参与者。通过预先测试和结构化的面对面访谈问卷收集数据,并进行检查、清理,录入Epi数据4.4版本,然后导出到SPSS 25.0软件进行分析。使用二元逻辑回归模型分析自变量和因变量之间的关联。
共有301名受访者参与研究,应答率为100%。本研究中的总体依从率仅为23.6%。生活方式改变依从性的独立预测因素为离婚(比值比=0.35;95%置信区间(0.13 - 0.94))和丧偶(比值比=0.27;95%置信区间(0.10 - 0.75))、中学教育程度(比值比=4.85;95%置信区间(1.54 - 15.22))、无固定收入(比值比=0.22;95%置信区间(0.08 - 0.65))或月收入≥3000埃塞俄比亚比尔(比值比=5.58;95%置信区间(2.46 - 12.66))、患有合并症(比值比=2.37;置信区间(1.23 - 4.57))、对疾病有良好认知(比值比=1.83;置信区间(0.92 - 3.65))和良好的自我效能感(比值比=3.64;置信区间(1.75 - 7.55))。
对推荐的生活方式改变的总体依从性非常低。独立预测因素为婚姻状况、教育水平、月收入、患有合并症、知识和自我效能感。因此,需要多方面协作实施高血压预防和控制生活方式改变的策略,以解决患者、提供者、系统和社区层面的障碍。