Adult Attachment And Self-management Behavior Among A Tertiary Hospital With Hypertension:medical Coping Modes As A Mediator

BackgroundThe prevalence rate of hypertension has been increasing year by year,which has brought heavy economic burden to individuals and society and become an important public health problem in the world.Practice has shown that adherence to hypertension treatment can effectively reduce the frequency of cardiovascular disease,thus reducing the adverse impact on individual health and the economy.However,in addition to taking antihypertensive medications,if you don’t adopt a healthy lifestyle,your blood pressure may still not reach the desired target.Therefore,hypertension treatment not only relies on drugs,but also requires patients to actively participate in hypertension self-management in daily life.How to promote hypertension patients to participate in disease management and improve the level of self-management is the key issue that medical staff should pay attention to.Therefore,it is necessary to understand the specific factors affecting the self-management behavior of hypertension patients and their internal influence path,so as to design personalized intervention measures.Previous research has shown that secure attachment helps individuals adopt positive coping styles to solve problems,whereas insecure attachment is associated with greater health risks and unhealthy behaviors.Therefore,the analysis of adult attachment status of hypertension patients and its influence on self-management behavior,and the analysis of relevant factors affecting patients’ self-management behavior from the perspective of adult attachment,is conducive to help medical staff to develop corresponding personalized intervention measures to improve the level of hypertension patients’ self-management,so as to achieve the goal of controlling blood pressure and improving health status.ObjectivesIn this study,through the field investigation of hypertension patients in the outpatient department of a Grade-Ⅲ general hospital in Jinan City,the status quo of adult attachment,medical coping style and self-management behavior level of hypertension patients was understood.Based on relevant theories,a research framework was constructed to explore the influence of different dimensions of adult attachment on self-management behavior with medical coping style as the medium.To provide theoretical basis and countermeasures for formulating intervention plan to improve self-management level and quality of life of hypertension patients.MethodsThis study adopted the method of convenience sampling,through the questionnaire survey of hypertension patients in the department of Cardiology outpatient of a third Class A hospital in Jinan,a total of 310 valid questionnaires were collected.EpiData3.1 self-built database was used for the collected data,and SPSS26.0 and Amos26.0 software were used for data analysis.A research framework was constructed on the basis of literature review and theoretical analysis,and descriptive analysis,single factor analysis,correlation analysis,multiple linear regression and mediation effect analysis were carried out on the data,so as to explore the status quo of research variables and their mutual relations.Results(1)The average score of self-management behavior of hypertension patients was 70.99±9.56 points.Univariate and correlation analysis showed that age,working status,self-rated health,blood pressure measurement times,smoking,drinking,attachment avoidance,attachment anxiety,facing,avoidance,and submission were the factors influencing the self-management behavior of hypertension patients(P<0.05).Multiple linear regression results showed that age(P<0.05),the number of blood pressure measurements(P<0.05),smoking(P<0.05),time of taking hypertension drugs(P<0.05),self-rated health(P<0.05),attachment avoidance(P<0.05)and face(P<0.001)was a significant factor affecting the level of self-management in hypertensive patients.(2)The score of attachment avoidance was 17.83±9.36,and the score of attachment anxiety was 18.20±9.28.Attachment anxiety score was higher than attachment avoidance score,and there were some differences in adult attachment with different social demographic characteristics.Specifically,there were significant differences in attachment avoidance seores by age,place of residence,work status,marital status,residential status,self-rated health,and alcohol consumption(P<0.05);There were significant differences in attachment anxiety scores of different places of residence,marital status,residence status,self-rated health and alcohol consumption(P<0.05).(3)To investigate attachment avoidance in adults with hypertension(P<0.001)and attachment anxiety(P<0.001)was negatively correlated with self-management behavior;Attachment avoidance(P<0.001)and attachment anxiety(P<0.001)was negatively correlated with the face dimension of medical coping style,attachment avoidance(P<0.001)and attachment anxiety(P<0.001)was positively correlated with the avoidance dimension of medical coping style,attachment avoidance(P<0.001)and attachment anxiety(P<0.001)was positively correlated with the yield dimension of medical coping style;There is a positive relationship between the face dimension and self-management behavior in medical coping style(P<0.001),there was a negative relationship between avoidance dimension and self-management behavior in medical coping style(P<0.001),there was a negative relationship between the yield dimension and self-management behavior in medical coping style(P<0.001).(4)The three dimensions of medical coping modes have partial mediating role between attachment avoidance and self-management behavior,and complete mediating role between attachment anxiety and self-management behavior.The mediating values of attachment avoidance and attachment anxiety to self-management behavior path were-0.235(95%CI=[-0.350,-0.245])and-0.152(95%CI=[-0.236,-0.090]),respectively.When avoidance coping style was used as the mediator,the mediating effect values of attachment avoidance and attachment anxiety to self-management behavior path were-0.173(95%CI=[-0.271,-0.101])and-0.107(95%CI=[-0.177,-0.061]),respectively.The mediating values of attachment avoidance and attachment anxiety to self-management behavior path were-0.143(95%CI=[-0.234,-0.084])and-0.095(95%CI=[-0.167,-0.051]),respectively.Conclusions and RecommendationsThe self-management behavior of the hypertensive patients was at a moderate level,and the attachment anxiety score of the patients was higher than the attachment avoidance score.There were some differences in adult attachment among different social demographic characteristics.Patients with hypertension tend to treat hypertension in a positive coping style.Both attachment avoidance in adult attachment and facing dimensions in medical coping modes can significantly affect hypertension self-management behavior.The mediating effect of different dimensions of medical coping modes on attachment avoidance and attachment anxiety on self-management behavior was significant.Based on the above findings,in order to promote the self-management behavior of hypertension patients,improve the level of self-management and improve the health status,this study puts forward the following suggestions:1.Assess the self-management level of hypertension patients,and help patients cope positively with hypertension;2.Identify the attachment style of hypertension patients,and take personalized measures to intervene self-management behavior;3.Understand the coping modes of hypertension patients and help them adopt positive coping strategies;4.Carry out self-management knowledge publicity to improve the awareness of hypertension patients’ personal blood pressure monitoring.