School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China.
School of Medicine and Health Management, Tongji Medical College,Huazhong University of Science and Technology, Wuhan, Hubei, China.
Inquiry. 2024 Jan-Dec;61:469580241277445. doi: 10.1177/00469580241277445.
The Chronic Care Model (CCM) is a framework that supports the proactive, planned, coordinated and patient-centered care of chronic diseases. The Patient Assessment of Chronic Illness Care (PACIC) scale is a valuable tool for evaluating patients' perspectives on chronic care delivery based on the CCM. Few studies have examined its application in China. This study assesses hypertension care in Chinese patients and explores how PACIC scores relate to patient compliance. A cross-sectional study was conducted in Hangzhou, China, from June to August 2021, including 253 hypertensive patients from 5 county hospitals and 13 primary healthcare centers. The study used the PACIC scale to assess hypertension care delivery and the Compliance of Hypertensive Patients scale (CHPS) to measure patient compliance. Multiple linear regression analyses were used to explore the relationship between demographic characteristics and the total and domain scores of PACIC, as well as the association between CHPS and the domain scores of PACIC. The mean value of overall the PACIC score was 3.12 (out of 5). Problem solving/contextual domain had the highest average score for each item, while follow up/coordination domain had the lowest. Patient activation had negative effects on intention (β = -.18, < .05), attitude (β = -.21, < .05), responsibility (β = -.17, < .05), and the total score of CHPS (β = -.24, < .01). Delivery system design/decision support was negatively associated with lifestyle (β = -.21, < .05) and the total score of CHPS (β = -.26, < .01). Hypertensive patients perceived that they sometimes received hypertension care consistent with the CCM in Chinese primary healthcare settings. A higher level of PACIC score was beneficial for improving hypertensive patient compliance.
慢性病管理模式（CCM）是一种支持主动、计划、协调和以患者为中心的慢性病管理的框架。慢性病患者评估慢性病照护（PACIC）量表是一种评估患者基于 CCM 的慢性病照护体验的有价值工具。很少有研究在中国进行过应用研究。本研究评估了中国高血压患者的照护情况，并探讨了 PACIC 评分与患者依从性的关系。本研究采用横断面研究方法，于 2021 年 6 月至 8 月在杭州市 5 家县级医院和 13 家基层医疗卫生中心纳入 253 例高血压患者。研究使用 PACIC 量表评估高血压照护的提供情况，使用高血压患者依从性量表（CHPS）评估患者的依从性。采用多元线性回归分析方法，探讨人口统计学特征与 PACIC 总分和各维度得分之间的关系，以及 CHPS 与 PACIC 各维度得分之间的关系。PACIC 总分的平均值为 3.12（满分 5 分）。每个项目中，解决问题/情境维度的平均分最高，而后续/协调维度的平均分最低。患者激活对意图（β=-0.18，<0.05）、态度（β=-0.21，<0.05）、责任（β=-0.17，<0.05）和 CHPS 总分（β=-0.24，<0.01）有负面影响。交付系统设计/决策支持与生活方式（β=-0.21，<0.05）和 CHPS 总分（β=-0.26，<0.01）呈负相关。高血压患者认为，他们在基层医疗卫生机构有时会接受符合 CCM 的高血压照护。较高的 PACIC 评分有助于提高高血压患者的依从性。
