Wang Qingqing, Xin Xiao, Li Xianhua
School of Nursing, Shanghai Jiao Tong University, School of Nursing, Shanghai, People's Republic of China.
Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University, School of Nursing, Shanghai, People's Republic of China.
Patient Prefer Adherence. 2025 Aug 26;19:2635-2645. doi: 10.2147/PPA.S524968. eCollection 2025.
Hypertension constitutes a significant global health issue, requiring active patient participation in self-management and health-related behaviors. Patient activation is defined as the knowledge, skills, and confidence in the management of their health. Prior studies have primarily employed total-score methods, potentially overlooking the variability in patient engagement. This study employs Latent Profile Analysis (LPA) to identify distinct patient activation profiles and investigate key predictors influencing activation levels in individuals with hypertension.
A convenience sampling method was employed to select 301 patients with essential hypertension from an outpatient clinic in a tertiary care hospital located in Shanghai for a cross-sectional study. A general demographic questionnaire, the Patient Activation Measure (PAM), the General Self-Efficacy Scale (GSES), the Health Literacy Scale for patients with chronic diseases (HLSCP), and the Hypertension Adherence Scale (TASHP) were utilized. Latent profile analysis was employed to investigate the latent profiles of patient activation, while univariate analysis and binomial logistic regression were used to identify significant predictors of patient activation types, based on factors found significant in univariate analysis.
The research revealed two distinct latent profiles of patient activation in individuals with essential hypertension: High Cognition-Proactive Action Type (33.9%) and Passive Cognition-Low Skills Type (66.1%). The logistic regression analysis indicated that monthly income (=1.725, <0.05), self-efficacy (=1.162, <0.01), and health literacy (=1.027, <0.05) are significant predictors of patient activation.
Patients with essential hypertension exhibit diverse activation levels, with a majority (66.1%) demonstrating low skills and passive cognition, indicating the need for targeted interventions. Increased income, health literacy and self-efficacy facilitate activation. Interventions must improve self-efficacy and refine health education to enhance patient engagement and self-management.
高血压是一个重大的全球健康问题,需要患者积极参与自我管理和与健康相关的行为。患者激活被定义为在健康管理方面的知识、技能和信心。先前的研究主要采用总分法,可能忽略了患者参与度的差异。本研究采用潜在剖面分析(LPA)来识别不同的患者激活剖面,并调查影响高血压患者激活水平的关键预测因素。
采用便利抽样法,从上海一家三级医院的门诊中选取301例原发性高血压患者进行横断面研究。使用了一份一般人口统计学问卷、患者激活量表(PAM)、一般自我效能量表(GSES)、慢性病患者健康素养量表(HLSCP)和高血压依从性量表(TASHP)。采用潜在剖面分析来研究患者激活的潜在剖面,而单因素分析和二项逻辑回归则用于根据单因素分析中发现的显著因素来识别患者激活类型的显著预测因素。
研究发现原发性高血压患者存在两种不同的潜在患者激活剖面:高认知-积极行动型(33.9%)和被动认知-低技能型(66.1%)。逻辑回归分析表明,月收入(=1.725,<0.05)、自我效能(=1.162,<0.01)和健康素养(=1.027,<0.05)是患者激活的显著预测因素。
原发性高血压患者表现出不同的激活水平,大多数(66.1%)表现出低技能和被动认知,这表明需要进行有针对性的干预。增加收入、健康素养和自我效能有助于激活。干预措施必须提高自我效能并完善健康教育,以增强患者的参与度和自我管理能力。