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患者认知对高血压治疗依从性的影响。

Impact of patient perceptions on compliance with treatment for hypertension.

作者信息

Nelson E C, Stason W B, Neutra R R, Solomon H S, McArdle P J

出版信息

Med Care. 1978 Nov;16(11):893-906. doi: 10.1097/00005650-197811000-00001.

Abstract

Patient noncompliance with medical regimens is a major obstacle in achieving hypertension control. In this study the relationships between patients' perceptions of health, disease and medical treatment and compliance were examined in personal interviews with 142 patients under treatment for hypertension. Compliance was measured in terms of blood pressure control, self-reported medication-taking, and appointment keeping. A multivariate log linear technique was used to control confounding. Blood pressure control was found to be associated with the perceived effficacy of the antihypertensive regimen, having medications prescribed for other chronic conditions, a high level of anxiety when hypertension was first diagnosed, the impact of hypertension and its treatment on lifestyle, and a higher educational level. For self-reported medication-taking, the perceived severity of hypertension, having medications prescribed for other chronic conditions and older age were predictive. Blood pressure control and self-reported medication-taking were highly correlated with each other(p = .02). Older age and being employed were the only variables that contributed independently to improved appointment keeping behavior. From these findings, it might be expected that emphasis on the effectiveness of treatment and on the potential threat posed by hypertension would motivate improved blood pressure control.

摘要

患者不遵守医疗方案是实现高血压控制的主要障碍。在本研究中,通过对142名接受高血压治疗的患者进行个人访谈,考察了患者对健康、疾病和医疗治疗的认知与依从性之间的关系。依从性通过血压控制、自我报告的服药情况和预约就诊情况来衡量。采用多元对数线性技术来控制混杂因素。结果发现,血压控制与抗高血压方案的感知疗效、患有其他慢性病的处方用药、首次诊断高血压时的高度焦虑、高血压及其治疗对生活方式的影响以及较高的教育水平有关。对于自我报告的服药情况,高血压的感知严重程度、患有其他慢性病的处方用药和年龄较大具有预测作用。血压控制和自我报告的服药情况彼此高度相关(p = 0.02)。年龄较大和就业是仅有的对改善预约就诊行为有独立贡献的变量。从这些发现来看,可以预期强调治疗效果以及高血压所构成的潜在威胁会促使血压控制得到改善。

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