Investigating And Intervening Stage Of Change To Improve Community Hypertensive Patients’ Adherence To Medication

ObjectiveTo evaluate the compliance of patients with antihypertensive therapy (CPAT)and itsstage of change, analyze the factors affect stage of change. Our study is to improvethe CPAT through six months intervention base on the transtheoretical theory, so thatwe can get the theory base for the further prevention of hypertension in community.Methods1.215hypertensive patients who met the study criteria were taken by convenientsampling. Questionnaires were utilized to assess the demographic data, diseaseknowledge, social support, CPAT and its stage of change among hypertensives. Toanalyze the influence factors affecting the stage of change of CPAT.2. A paired study was carried out in community hypertensives, taking age, sex, diseaseduration as paired condition. Selected patients were distributed into interventiongroup (n=55) or control group (n=55). The intervention group received theintervention based on the transtheoretical theory, while the control group received theregular nursing. Recollect the data after6months intervention and compare thechange of the score indicators.Results1. The hypertension knowledge score was a little under the middle level. Theminimum is zero, while the maximum is21points, with an average score of8.25±5.68, and0.39out of ratio.2. The CPAT should be improved.56.2%(118/210) patients was partial compliance,4.8%（10/210) patients was totally non-compliance.3. There are stages of readiness for drug compliance:17.1%(36/210) patients was inprecontemplation stage,8.6%(18/210) patients was in contemplation stage,35.2%(74/210) patients was in preparation stage,1.4%(3/210) was in action stage,37.6%(79/210) patients was in maintenance stage. 4. The stage of change is positively correlated with drug compliance and its fourdimensions.(r=0.878,0.696,0.779,0.694,0.766, P values were＜0.01).5. The influence factors of stage of change in CPAT were sex, education level, courseof disease, income, disease knowledge, symptom or not.6. Apply the intervention based on the transtheoretical theory to hypertension patientsin community.(1) After the intervention, the intervention group’s systolic blood pressure anddiastolic blood pressure decreased than before. The difference between the two groupswas significant (P＜0.05).(2) After the intervention, the intervention group’s hypertension knowledge hadincreased than before. the difference between the two groups was significant (P＜0.05).(3) After the intervention, the score of drug compliance, stage of change wassignificant between the two groups.(P＜0.05).Conclutions1. The CPAT in community should be improved.2. The influence factors of stage of change in CPAT were sex, education level, courseof disease, income, disease knowledge, symptom or not.3. The intervention programme based on the transtheoretical theory can significantlyenhance the patients’stage of change, drug compliance, hypertension knowledge,decrease the systolic blood pressure.