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首页> 外文期刊>International journal for equity in health >The effect of health literacy and self-management efficacy on the health-related quality of life of hypertensive patients in a western rural area of China: a cross-sectional study
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The effect of health literacy and self-management efficacy on the health-related quality of life of hypertensive patients in a western rural area of China: a cross-sectional study

机译：健康素养和自我管理效能对中国西部农村地区高血压患者健康相关生活质量的影响：横断面研究

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BackgroundHypertension is a common and frequently occurring chronic disease of the cardiovascular system. Besides the pathological factors, the occurrence and exacerbation of hypertension are also associated with many factors of lifestyle and behaviors. Thus hypertensive patients’ Health-related quality of life (HRQL) is not only influenced by the disease itself but also by many subjective factors such as health literacy and self-management efficacy, especially in the deeper part of southwestern China and thus is less developed compared to the other places. The purpose of this study was to examine the association between the HRQL of hypertensive patients and health literacy and self-management efficacy as well as how they affect the HRQL, so as to provide a theoretical reference for improving the HRQL of patients with hypertension in less developed areas. MethodsThis was a cross-sectional study of baseline data from a clustered randomized controlled trial. The study design had passed a cross-national peer review and accepted grants by the China Medical Board. It was also registered in the Chinese Clinical Trial Registry (ChiCTR-OOR-14005563).A standardized questionnaire adapted from a previous validated WHO questionnaire was used for the survey which included detailed questions about patient’s socio-demographic characteristics and self-reported information.Patients’ HRQL was measured by the Mandarin version of the 36-item Short Form. We used the validated Mandarin version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale to assess patients’ self-management efficacy. The validated three-item Brief Health Literacy Screening (BHLS) was used to measure the patients’ health literacy.A structural equation model was constructed, and p ≤?0.05 was taken as significant. ResultsDemographic characteristics, health literacy and self-management efficacy have all significant effects on HRQL. Age, education level, self-management efficacy and health literacy were significantly related to the HRQL. The constructed model had a good fit for the data according to the model fit indices. Based on the model, health literacy ( r =?0.604, p =?0.029) and Self-management efficacy ( r =?0.714, p =?0.018) have a significant impact on HRQL. Demographic characteristics were inversely related to HRQL ( r =??0.419, p =?0.007), but have a significant impact on health literacy ( r =?0.675, p =?0.029) and self-management efficacy ( r =?0.379, p =?0.029). At the same time, self-management efficacy was positively correlated to health literacy ( r =?0.413, p ConclusionsAge, education level, self-management efficacy and health literacy were all related to the HRQL of patient with hypertension, which means that patients who are more elderly and have lower education level, low self-management efficacy and poor health literacy get worse HRQL. This may imply the necessary to introduce routine assessment of health literacy and self-management efficacy into assessment procedures for hypertensive patients’ health management. Such assessment can help professionals to identify the population at greatest risk for poor health outcomes and low well-being in the future. In clinical practice, effective interventions such as direct guidance and education to raise the self-management efficacy and enhance health literacy might improve the HRQL of patients with hypertension. Trial registrationRetrospectively registered Chinese Clinical Trial Registry ( ChiCTR-OOR-14005563 ).Name of registry: Effects of the integrated delivery system and payment system of community-based intervention on rural patients of chronic diseases in Qianjiang District, ChinaDate of registration: Retrospectively registered 23 November 2014.Date of enrolment of the first participant to the trial: 5 July 2012
机译：背景技术高血压是心血管系统的常见且频繁发生的慢性疾病。除病理因素外，高血压的发生和加重还与生活方式和行为的许多因素有关。因此，高血压患者的健康相关生活质量（HRQL）不仅受疾病本身的影响，而且还受许多主观因素的影响，例如健康素养和自我管理的有效性，尤其是在中国西南部较深的地区，因此欠发达与其他地方相比。这项研究的目的是研究高血压患者的HRQL与健康素养和自我管理效能之间的关系，以及它们如何影响HRQL，从而为在不超过20岁的时间内提高高血压患者的HRQL提供理论参考。发达地区。方法这是对一项随机对照试验的基线数据进行的横断面研究。该研究设计已通过跨国同行评审，并获得了中国医学委员会的资助。该调查表也已在中国临床试验注册中心（ChiCTR-OOR-14005563）中进行了注册，该调查表采用了先前经WHO验证的标准化调查表进行调查，其中包括有关患者的社会人口统计学特征和自我报告信息的详细问题。 HRQL通过36项简短表格的普通话版本进行衡量。我们使用经验证的普通话版“管理慢性病6项量表的自我效能感”来评估患者的自我管理功效。采用经过验证的三项简短的健康素养筛查（BHLS）来测量患者的健康素养。构建了结构方程模型，p≤？0.05为显着。结果人口统计学特征，健康素养和自我管理效能均对HRQL产生重要影响。年龄，文化程度，自我管理效能和健康素养与HRQL显着相关。根据模型拟合指数，所构建的模型对数据具有很好的拟合性。根据该模型，健康素养（r =？0.604，p =？0.029）和自我管理效能（r =？0.714，p =？0.018）对HRQL有重要影响。人口统计学特征与HRQL呈负相关（r = ?? 0.419，p =？0.007），但对健康素养（r =？0.675，p =？0.029）和自我管理效能有显着影响（r =？0.379， p =？0.029）。同时，自我管理效能与健康素养呈正相关（r =？0.413，p结论）年龄，教育水平，自我管理效能和健康素养都与高血压患者的HRQL相关，这意味着老年人多，文化程度低，自我管理效能低，健康素养差会导致HRQL恶化，这可能意味着有必要将健康素养和自我管理效能的常规评估纳入高血压患者健康管理评估程序中。评估可以帮助专业人员确定将来健康状况不佳和幸福感低下的风险最大的人群;在临床实践中，有效的干预措施，例如直接指导和教育，以提高自我管理的效力和增强健康素养，可能会改善高血压患者的HRQL。试验注册回顾性注册中国临床试验注册中心（ChiC TR-OOR-14005563）。注册名称：社区干预的综合交付系统和支付系统对中国潜江区农村慢性病患者的影响注册日期：2014年11月23日进行追溯注册。该试验的第一位参与者：2012年7月5日

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