Effects Of Wechat Intervention Based On BCW+BCTs On The Treatment Compliance Of Young And Middle-aged Patients With Hypertension

ObjectiveTo explore the status of treatment compliance and its influencing factors of the young and middle-aged patients with hypertension,and analyze the relationships between treatment compliance and hypertension knowledge,medical social support and hypertension self-care motivation.Further,The efficacy of We Chat intervention based on behavior change wheel and behavior change techniques on blood pressure control,body mass index,waist circumference,hypertension knowledge level,medical social support utilization,hypertension self-care motivation and hypertension treatment compliance was explored to provide references for hypertension management of young and middle-aged population.Methods1.The multistage sampling method was adopted in May 2020 to June 2020 to randomly select 227 young and middle-aged patients with hypertension from three community healthcare centers in Hengyang.The general information questionnaire,Hypertension Knowledge-Level Scale,Medical Outcomes Study Social Support Survey,Hypertension Self-care Profile and Therapeutic Adherence Scale for Hypertensive Patients were used to investigate the status and influencing factors of hypertension treatment adherence,and explore the relationships between above variables.2.Totally 80 young and middle-aged patients with hypertension were selected by a random number software from two community healthcare centers with similar hypertension management,and were randomly divided into the intervention group(n=40)and the control group(n=40)by coin-tossing.Control group patients were given regular hypertension management for six months,while intervention group patients were given We Chat intervention based on BCW+BCTs and regular management for six months.Blood pressure,BMI,waist circumference,hypertension knowledge,medical social support,hypertension self-care motivation and hypertension treatment compliance between two groups were compared respectively before the intervention,3 months post-intervention and 6 months post-intervention.3.Data were analyzed by the Statistical Package for the Social Sciences(SPSS)18.0.The enumeration data were described by frequency and composition ratio,and measurement data were described by mean and standard deviation.Two independent samples t-test,one-way analysis of variance,Pearson correlation analysis,multiple stepwise regression analysis,χ~2 test,repeated measurement analysis of variance and generalized estimation equation were used to analyze the data.The significance level was 0.05.Results1.The total score of treatment compliance was(93.00±11.66),which was at a low level.Patients with different genders,smoking,drinking,and comorbidities had statistically significant differences in hypertension treatment compliance(P<0.05).There were positive correlations between hypertension treatment compliance and hypertension knowledge,medical social support and hypertension self-care motivation respectively(r=0.284,0.379,0.570,P<0.01).Smoking,comorbidities,hypertension self-care motivation,and medical social support accounted for 37.3%of the variations in hypertension treatment compliance(R~2=0.384).2.The total score of hypertension knowledge was(15.55±3.52),medical social support was(49.08±10.31),and hypertension self-care motivation was(49.83±6.42).3.There was no statistically significant difference in the inter-group effect of the total score of hypertension knowledge(P>0.05),while the main effect of intervention time and the interaction effect were statistically significant(P<0.001).With the increase of intervention time,the total scores of hypertension knowledge in the two groups both showed upward trends,and the level of hypertension knowledge in the intervention group was higher significantly than that in the control group at 3 and 6 months after intervention(P<0.05).4.There was no statistically significant difference in the inter-group effect of the total score of medical social support(P>0.05),while the main effect of intervention time and the interaction effect were statistically significant(P<0.001).The increase of the score of medical social support in the intervention group was greater than that in the control group after 6 months of intervention.There was no statistically significant difference in the scores of medical social support between the two groups at 3 months after intervention(P>0.05),while the difference was statistically significant at 6 months after intervention(P<0.05).5.There was no statistically significant difference in the inter-group effect of the total score of hypertension self-care motivation(P>0.05),while the main effect of intervention time and the interaction effect were statistically significant(P<0.001).The increase of the score of hypertension self-care motivation in the intervention group was greater than that in the control group after 6 months of intervention,with a lower growth rate both in the two groups after 3 months of intervention.The scores of hypertension self-care motivation in the intervention group were both significantly higher than that in the control group(P<0.05)at 3 and6 months after intervention.6.There was no statistically significant difference in the inter-group effect of the total score of hypertension treatment compliance(P>0.05),while the main effect of intervention time and the interaction effect were statistically significant(P<0.001).The scores of hypertension treatment compliance in the intervention group were both significantly higher than that in the control group at 3 and 6 months after intervention(P<0.05).The increase of the score of hypertension treatment compliance in the intervention group was greater than that in the control group after 6months of intervention,with a lower growth rate both in the two groups after 3 months of intervention.7.There were statistically significant differences in the inter-group effect of systolic blood pressure and diastolic blood pressure(P<0.05),and the main effect of intervention time and the interaction effect were statistically significant(P<0.001).The systolic blood pressure and diastolic blood pressure in the intervention group were both significantly lower than those in the control group at 3 and 6 months after intervention(P<0.05).The decreases of systolic and diastolic blood pressure in the intervention group were greater than those in the control group after 6 months of intervention.8.There was no statistically significant difference in the inter-group effect of the value of BMI(P>0.05),while the main effect of intervention time and the interaction effect were statistically significant(P<0.001).The value of BMI in the intervention group was significantly lower than that in the control group at 6 months after intervention(P<0.05).The decrease of the value of BMI in the intervention group was greater than that in the control group after 6 months of intervention.9.There was no statistically significant difference in the inter-group effect of the waist circumference(P>0.05),while the main effect of intervention time and the interaction effect were statistically significant(P<0.001).There were no statistically significant differences between the two groups at 3 and 6 months after intervention(P>0.05).The decrease of the waist circumference in the intervention group was greater than that in the control group after 6 months of intervention.Conclusions1.Hypertension treatment compliance of young and middle-aged hypertensive patients was at a low level.Hypertension treatment compliance was positively associated with hypertension knowledge,medical social support and self-care hypertension.There were differences in hypertension treatment compliance among patients with different genders,smoking,drinking,and with or without complications.Smoking,comorbidities,hypertension self-care motivation and medical social support were the main influencing factors for hypertension treatment compliance of young and middle-aged hypertensive patients.2.We Chat intervention based on BCW+BCTs could improve the level of hypertension knowledge,medical social support,hypertension self-care motivation and hypertension treatment compliance,and improve the blood pressure,reduce BMI and waist circumference of young and middle-aged patients with hypertension.