Integrating factors associated with hypertensive patients' self-management using structural equation model: a cross-sectional study in Guangdong, China
Received 15 July 2018
Accepted for publication 21 September 2018
Published 15 October 2018 Volume 2018:12 Pages 2169—2178
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 4
Editor who approved publication: Dr Naifeng Liu
Weiwei Ding,1 Tong Li,1 Qiying Su,2 Maohua Yuan,2 Aihua Lin1
1Department of Epidemiology and Health Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China; 2Department of Chronic Disease Management, Dadong Community Healthcare Center, Guangzhou, Guangdong, China
Purpose: Hypertension is considered a major public health issue worldwide because of its high frequency and concomitant risk of cardiovascular disease (CVD). Chronic-disease self-management has been proven to be cost-effective, but influencing factors and pathways remain complex and unclear. The purpose of this study was to integrate factors associated with hypertension self-management to provide a theoretical reference for community hypertension management.
Methods: A total of 268 community-dwelling hypertensive patients were enrolled in a cross-sectional study conducted from July to September in 2017. A questionnaire on demographic–disease characteristics, disease knowledge, social support, self-efficacy, and self-management was completed by patients. Structural equation modeling was performed to verify multiple factors in self-management based on the self-efficacy theory.
Results: The final model showed a good fit to sample data, ie, younger patients with lower CVD risk, shorter disease course, and less disease knowledge and social support predicted less self-efficacy, less hypertension self-management, and less controlled hypertension. Furthermore, social support was negatively correlated with age, CVD risk, and disease course and positively with disease knowledge.
Conclusion: Medication adherence is the lowest dimension in self-management, and self-efficacy is vital to consider in the development of self-management interventions. Self-management education and mutual-help groups may be potential solutions with the power of technology. Younger patients with lower CVD risk and shorter disease course are vulnerable and need more attention.
Keywords: hypertension, self-management, associated factors, structural equation model, China, disease knowledge, social support, self-efficacy
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