The Influencing Factors of Self-rated Health Status of Elderly Patients with Hypertension in Yi Rural Areas of Yunnan Province
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摘要:
目的 了解云南省彝族聚集农村地区高血压老年患者自评健康现状,并探究其影响因素。 方法 采取方便抽样,在云南省彝族聚集农村地区选取高血压老年患者980例,通过问卷调查收集其基本信息、自我管理和自测健康水平。通过Pearson相关性分析探究自我管理和自测健康水平之间的关系,采用多因素线性回归分析探究高血压老年患者自评健康水平的影响因素。 结果 云南省彝族聚集农村地区高血压老年患者自测健康水平和自我管理水平都较差,汉族和彝族高血压老年患者的自评健康总分比较差异无统计学意义(t = 1.458,P = 0.145),汉族高血压老年患者的自我管理总分(66.50±9.60)分,高于彝族高血压老年患者(64.93±8.69)分;上过学(b = 10.408,P < 0.001)、经济状况好(b = 8.309,P < 0.001)和自我管理总分高(b = 1.911,P < 0.001)是自评健康水平的保护因素,而独居(b = -7.052,P = 0.039)、最近2周看过病(b = -5.950,P = 0.049)、身体残障(b = -17.445,P < 0.001)和患有其他慢病(b = -14.014,P < 0.001)是自评健康的危险因素。 结论 云南省彝族聚集农村地区高血压老年患者自测健康状况较差,应加强高血压老年患者自我管理能力的指导和培训,并重点关注独居、身体状况差的高血压老年患者,以增进该类地区高血压老年患者身心健康。 Abstract:Objective To investigate the self-rated health status of elderly hypertensive patients in rural areas of Yi people, Yunnan province, and explore the influencing factors. Methods A convenience sample of 980 elderly hypertensive patients from rural areas where Yi ethnic groups gather in Yunnan Province was selected and their basic information, self-management and self-rated health level were investigated through a questionnaire survey. The relationship between self-management and self-rated health level was explored by Pearson correlation analysis. Finally, the influencing factors of the self-rated health level of elderly hypertensive patients were explored by multiple linear regression analysis. Results The participants reported low levels of self-rated health and self-management behavior. There was no significant difference in self-rated health scores between Han and Yi hypertensive elders (t = 1.458, P = 0.145). However, Han hypertensive elders had significantly higher self-management scores than Yi hypertensive elders (t = 2.577, P = 0.010). Accepted education (b = 10.408, P < 0.001), good economic situation (b = 8.309, P < 0.001), and high self-management score (b = 1.911, P < 0.001) were protective factors for self-rated health, while living alone (b = -7.052, P = 0.039), having a disease in the past two weeks (b = -5.950, P = 0.049), being physically disabled (b = -17.445, P < 0.001), and having other chronic diseases (b = -14.014, P < 0.001) were risk factors for self-rated health. Conclusions The findings suggest that elderly hypertensive patients in rural Yi areas have poor self-rated health. Interventions are recommended to enhance their self-management skills and to address their specific needs, especially for those who live alone or have poor physical condition. -
Key words:
- Yi rural areas /
- Elderly people with hypertension /
- Self-management /
- Self-rated health
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表 1 汉族和彝族高血压患者的基本情况[n(%)/(
$\bar x \pm s $ )]Table 1. Characteristics of hypertensive patients in Han and Yi people [n(%)/(
$\bar x \pm s $ )]特征 汉族(n = 606) 彝族(n = 374) χ2/t P 性别 3.492 0.062 男 280 (46.20) 150 (40.11) 女 326 (53.80) 224 (59.89) 年龄 72.89 ± 7.43 72.94 ± 8.17 −0.095 0.924 上过学 0.007 0.934 是 269 (44.39) 165 (44.12) 否 337 (55.61) 209 (55.88) 独居 10.506 0.001* 是 154 (25.41) 62 (16.58) 否 452 (74.59) 312 (83.42) 自评经济状况 5.605 0.132 非常困难 111 (18.32) 75 (20.05) 比较困难 139 (22.94) 107 (28.61) 中等水平 325 (53.63) 175 (46.79) 比较富裕 31 (5.12) 17 (4.55) 吸烟 0.025 0.873 是 75 (12.38) 45 (12.03) 否 531 (87.62) 329 (87.97) 饮酒 3.063 0.080 是 33 (5.45) 31 (8.29) 否 573 (94.55) 343 (91.71) 2周是否看病 0.489 0.484 是 405 (66.83) 258 (68.98) 否 201 (33.17) 116 (31.02) 身体残障 1.834 0.176 是 104 (17.16) 52 (13.90) 否 502 (82.84) 322 (86.10) 其他慢病 3.226 0.072 有 430 (70.96) 285 (76.20) 无 176 (29.04) 89 (23.80) *P < 0.05。 表 2 汉族和彝族高血压患者的自评健康和自我管理差异性分析[(
$\bar x \pm s $ ,分]Table 2. Difference analysis in self-rated health and self-management between Han and Yi people hypertensive patients [(
$\bar x \pm s $ ,scores)项目 汉族(n = 606) 彝族(n = 374) t P 自评健康总分 278.28 ± 53.13 273.35 ± 48.48 1.458 0.145 心理健康状况 88.87 ± 19.84 85.60 ± 17.70 2.610 0.009* 社会健康状况 78.83 ± 20.32 77.25 ± 17.16 1.253 0.211 身体健康状况 110.57 ± 25.27 110.50 ± 26.02 0.042 0.967 自我管理总分 66.50 ± 9.60 64.93 ± 8.69 2.577 0.010* 治疗管理 20.67 ± 3.93 19.83 ± 3.34 3.438 <0.001* 饮食运动管理 13.36 ± 3.55 13.10 ± 3.35 1.138 0.255 生活习惯管理 21.00 ± 4.00 20.53 ± 3.83 1.816 0.070 危险因素管理 11.47 ± 2.65 11.47 ± 2.49 0.000 1.000 *P < 0.05。 表 3 高血压老年患者的自评健康的单因素分析[(
$\bar x \pm s $ ),分]Table 3. Single factor analysis of self-rated health in elderly patients with hypertension [(
$\bar x \pm s $ ),scores]项目 自评健康总分 t/F P 民族 1.457 0.145 汉族 278.28 ± 53.13 彝族 273.35 ± 48.48 性别 0.951 0.342 男 278.16 ± 51.61 女 275.01 ± 51.31 上过学 7.122 < 0.001* 是 289.20 ± 47.79 否 266.22 ± 52.01 独居 −3.745 < 0.001* 是 264.90 ± 51.10 否 279.65 ± 51.10 退休金 3.461 < 0.001* 有 291.46 ± 49.80 无 274.27 ± 51.34 自评经济状况 34.830 < 0.001* 非常困难 253.30 ± 54.35 比较困难 263.40 ± 43.77 中等水平 288.93 ± 49.59 比较富裕 301.88 ± 45.40 吸烟 1.280 0.201 是 282.03 ± 52.18 否 275.61 ± 51.32 饮酒 1.685 0.092 是 286.86 ± 44.91 否 275.66 ± 51.81 2周是否看病 −3.171 0.002* 是 183.90 ± 53.43 否 272.81 ± 51.10 身体残障 −7.891 < 0.001* 是 247.49 ± 59.25 否 281.87 ± 47.94 其他慢病 −7.479 < 0.001* 有 269.12 ± 50.50 无 296.04 ± 48.81 *P < 0.05。 表 4 高血压老年患者的自评健康和自我管理得分的相关性分析
Table 4. Correlation between self-rated health and self-management scores in elderly hypertensive patients
项目 自评健康总分 心理健康状况 社会健康状况 身体健康状况 自我管理总分 0.452*** 0.312*** 0.493*** 0.307*** 治疗管理 0.299*** 0.187*** 0.314*** 0.225*** 饮食运动管理 0.367*** 0.255*** 0.384*** 0.260*** 生活习惯管理 0.658*** 0.421*** 0.630*** 0.538*** 危险因素管理 0.302*** 0.132*** 0.156*** 0.391*** ***P < 0.001。 表 5 变量赋值表
Table 5. Variable assignment table
变量 赋值 上过学 1=是 0=否 独居 1 = 是 0 = 否 退休金 1 = 有 0 = 无 经济状况 1 = 很困难 2 = 经济比较困难 3 = 中等水平
4 = 富裕2周看病 1 = 是 0 = 否 身体残障 1 = 是 0 = 否 其他慢病 1 = 有 0 = 无 自我管理总分 连续变量 表 6 高血压老年患者的自评健康总分的多因素回归分析
Table 6. Multivariate regression analysis of self-rated health total score in elderly hypertensive patients
变量 b SE P 95%CI 上过学 10.408 2.914 < 0.001* 4.690~16.127 独居 −7.052 3.406 0.039* −13.736~−0.367 退休金 3.464 4.381 0.429 −5.133~12.060 经济状况 8.309 1.777 < 0.001* 4.821~11.797 2周看病 −5.950 3.018 0.049* −11.872~−0.028 身体残障 −17.445 3.927 < 0.001* −25.152~−9.738 其他慢病 −14.014 3.232 < 0.001* −20.357~−7.671 自我管理总分 1.911 0.160 < 0.001* 1.597~2.224 常数项 149.872 12.165 < 0.001* 126.000~173.744 *P < 0.05。 -
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