Relationship Between Health Beliefs And Treatment Adherence Behavior In Hypertensive Patients:Time Preference As A Moderator

BackgroundWith the development of urbanization and industrialization in China,great changes have taken place in people’s living habits and living environment.The incidence rate of chronic diseases has gradually increased,posing a serious challenge to health care system of China.Hypertension is one of the most common chronic noninfectious diseases,and also the most dangerous factor of cardiovascular and cerebrovascular disease in China,seriously affecting the physical and mental health of residents.Then the adherence of hypertension treatment in our country is not optimistic,causing huge health and economic losses.In practice,there are still many problems in the prevention and control of chronic diseases,especially hypertension.Health beliefs refer to how people perceive an illness,how serious it is,how effective it will be if they take action,and what obstacles they may encounter.Therefore,health beliefs are considered as an interventionable indicator to improve the health status of patients.It is a consensus of researchers at home and abroad that health beliefs affect the treatment adherence of hypertension patients,and the conclusion is that the better the health beliefs of hypertension patients,the better the treatment adherence.However,relevant studies have found that some patients with hypertension have high health beliefs,but poor treatment adherence.This phenomenon has aroused the attention of researchers,and began to explore the internal psychological characteristics of patients with hypertension.Time preference theory holds that individuals always attach importance to the immediate results of their behavior,while ignoring the future health benefits.Therefore,the introduction of time preference theory into hypertensive patients’ treatment adherence has great practical significance for the government to formulate chronic disease management plans,medical personnel to develop personalized diagnosis and treatment services for patients and patients to improve treatment adherence.ObjectiveThis study explored the relationship between health beliefs and treatment adherence behavior in patients with hypertension,and the potential role of time preference in the relationship between them.The specific objectives are as follows:(1)To analyze the status of treatment adherence of hypertension in a hospital in Shandong Province;(2)To analyze the influence of hypertension patients’ health beliefs on treatment adherence behavior;(3)To explore the moderating role of time preference in the influence of health beliefs on treatment adherence of hypertensive patients.MethodsIn this study,307 patients with hypertension were selected from a tertiary A hospital in Shandong Province.The field survey was conducted from July 1 to September 30,2022,using a convenient sampling method.Analyze with Stata15.0.Descriptive analysis was made on the basic situation of treatment adherence of hypertensive patients over 18 years old;Multivariate linear regression was used to analyze the relationship between five dimensions of health belief(personal health belief,feeling capable of implementation,feeling controlled,feeling resource utilization and feeling threatened and treatment adherence);Linear regression and marginal effect analysis were used to test the moderating effect of time preference.Results(1)307 questionnaires were finally valid in this survey.The average score of treatment adherence in patients with hypertension was 40.75.150 males,accounting for 51.14%;The average age was 61.36 years;203 urban residents,accounting for 66.12%;134 outpatients,accounting for 43.65%;192 patients had complications,accounting for 62.54%;The average score of health belief of hypertension patients was 162.61;The average short-term discount factor and long-term discount factor of time preference are 2.92 and 0.3 respectively.(2)The univariate regression analysis on the characteristics of patients with hypertension showed that in the sociodemographic characteristics:gender,residence,age,marital status,education level,occupation and medical insurance;in the disease characteristics:type of visit,complications,number of antihypertensive drugs and time of illness;in the health belief:the total score of health belief includes five dimensions:personal health belief,feeling capable of implementation,feeling in control The influence of perceived resource utilization and perceived threat on the treatment adherence of hypertensive patients was statistically significant(P<0.05).(3)Multivariate regression analysis showed that the influence of health belief(personal health belief and feeling controlled),place of residence,occupation,medical insurance,type of visit and complications on the treatment adherence of hypertension patients was statistically significant(P<0.05).(4)The moderating effect analysis found that the long-term discount factor had a protective effect on treatment adherence,and the effect of health belief on treatment adherence would increase by 0.03 units every time the long-term discount factor increased by 1 unit.However,short-term discount factor had no significant effect on treatment adherence(p>0.05).Conclusions and suggestionsThe conclusion of this study is that the better the health belief of hypertension patients,the better their treatment compliance.The long-term discount factor,which reflects the ability of intertemporal selective self-control,plays a positive moderating role in this relationship.Based on this,the following suggestions are put forward:(1)Take targeted measures for hypertensive patients with different characteristics;(2)Explore multi-channel hypertension management measures;(3)Increase psychological support to improve hypertension patients’ confidence in disease control;(4)Increase the time preference level of hypertensive patients with material incentives.