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Social Ecology of Adherence to Hypertension Treatment in Latino Migrant and Seasonal Farmworkers

机译:拉丁裔移民和季节性农民工坚持高血压治疗的社会生态学

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摘要

The prevalence of hypertension (HTN) is high in Latinos (Latino/Latina) Americans due to social and ecological factors. Increased migration of Latino migrant/seasonal farmworkers (MSFW) to the U.S. augments the social, economic, environmental, and psychosocial factors associated with health and illness. Bronfenbrenner’s Ecological Systems Theory was used to guide this study. The purposes of this cross-sectional, correlational study were to explore Latino MSFWs’ adherence to HTN treatment (medication adherence, blood pressure [BP] self-care, and BP control) and to examine the influence of BP knowledge, perceived stress, acculturation, health literacy, and health care access (HCA) on adherence to HTN treatment.A total of 45 Latino (mean age 45 + 9) MSFWs receiving HTN treatment participated in this study. Spanish and English questionnaires were available for participants to measure adherence to HTN treatment and the five independent variables. Analysis included correlations, t-tests, hierarchical multiple regression, and hierarchical logistic regression.The majority of MSFWs were from Mexico, female (55.6%), had less than a 6th grade education. Most (82%) of the MSFWs had uncontrolled BP, and were not adherent to medications (42%), even with high BP knowledge scores (M = 6.5 ±1.3). MSFWs perceived a high level of stress (M = 16 + 6.9), low acculturation level (Anglo orientation: M = 2.9 + 0.9), and no employer-provided health insurance for personal illnesses or injuries (93%). Blood pressure knowledge, perceived stress, acculturation, health literacy, and HCA accounted for 49% of the variance in the BP self-care; however, only higher BP knowledge was a significant predictor of better BP self-care (p \u3c .001). Furthermore, acculturation was a significant predictor of BP control (p \u3c .01).This study explored select determinants of adherence to HTN treatment in Latino MSFWs in a culturally informed way. Although BP self-care behaviors appeared to be a consequence of BP knowledge, this study found low medication adherence in Latino MSFWs and uncontrolled BP explained by the two predictors, acculturation and health literacy. Perceived stress and health care access did not influence the adherence to HTN treatment. MSFWs had poor BP control and HTN treatment adherence. A culturally appropriate educational program is needed to help the MSFWs adherence to HTN treatment.
机译:由于社会和生态因素,拉丁美洲人(Latino / Latina)美国人的高血压(HTN)患病率很高。拉丁美洲移民/季节性农工(MSFW)向美国的移民增加,增加了与健康和疾病相关的社会,经济,环境和社会心理因素。 Bronfenbrenner的生态系统理论被用来指导这项研究。这项横断面相关研究的目的是探讨拉丁裔无国界医生对HTN治疗的依从性(药物依从性,血压[BP]自我护理和血压控制),并检查BP知识,感知的压力,适应性的影响,接受HTN治疗的健康素养和医疗保健途径(HCA)。接受HTN治疗的45名拉丁裔(平均年龄45 + 9)无国界医生组织参加了这项研究。参与者可以使用西班牙语和英语问卷来衡量对HTN治疗的依从性和五个独立变量。分析包括相关性,t检验,层次多元回归和层次Logistic回归。大多数MSFW来自墨西哥,女性(55.6%),其六年级以下。即使有较高的BP知识得分(M = 6.5±1.3),大多数(82%)的MSFW血压均不受控制,并且不依从药物(42%)。无国界医生的员工承受的压力很大(M = 16 + 6.9),适应力很低(Anglo方向:M = 2.9 + 0.9),没有雇主为个人疾病或伤害提供的健康保险(93%)。血压知识,感知压力,适应能力,健康素养和HCA占BP自我护理差异的49%;但是,只有较高的BP知识才是更好的BP自我护理的重要预测因子(p \ u3c .001)。此外,文化适应是血压控制的重要预测指标(p \ u3c .01)。本研究以文化上的了解方式探索了拉丁美洲MSFW坚持HTN治疗依从性的决定因素。尽管BP的自我护理行为似乎是BP知识的结果,但该研究发现拉丁裔MSFW的药物依从性较低,而BP却不受控制,这是由两个预测因素-适应和健康素养所解释的。知觉到的压力和卫生保健的使用不会影响对HTN治疗的依从性。无国界医生的血压控制和HTN治疗依从性差。需要一种文化上适当的教育计划,以帮助无国界医生接受HTN治疗。

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    Hall, Eleanor M;

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  • 年度 2011
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