Mental Health Status Among Urban And Rural Elderly Hypertensives-A Comparative Research In Shandong Province

BackgroundWith the increasing aging degrees,China has become the country with the largest population of the elderly in the world.Actively coping with the aging of the population has become a long-term strategic task of the country.The health of the elderly has attracted more and more attention from the society.Hypertension is the most common chronic non-communicable disease in the elderly and is one of the major risk factors for cardiovascular diseases.Mental health diseases such as depression and anxiety are not only risk factors for hypertension,but also have adverse effects on the disease development and prognosis of hypertension.China is a typical urban-rural dual society.There are significant differences between urban and rural areas in terms of economic level,living environment,medical and health status,population aging development speed,hypertension prevalence rate,and there are also significant differences in the causes of psychological problems of elderly residents in urban and rural areas.Therefore,the comparative study on mental health status between urban and rural areas has important guiding significance for the implementation of mental health intervention in different regions.ObjectiveTaking the elderly with hypertension aged 60 and above in Shandong province as the research object,the psychological health status of elderly hypertensive patients was investigated by questionnaire.This paper analyzes the differences in the mental health status of the elderly hypertensive patients in urban and rural areas,compares the similarities and differences in the influencing factors of the mental health status,and propose some measures for improving the mental health status of the elderly hypertensive patients in urban and rural areas.MethodsThe data is from the National Natural Science Foundation of China(71673169).Using stratified cluster random sampling method,3124 elderly hypertensive patients aged 60 years and above in Shandong Province were selected.The mental health status of the elderly was measured with K10 scale,the survey data were entered into Epi Data,a database was established,and SPSS24.0 was used for statistical analysis.Single factor analysis uses rank sum test,two samples use Wilcoxon Z test,and multiple samples use Kruskal-Wallis H test.Multivariate analysis of elderly hypertensive patients in urban and rural areas was respectively performed using ordinal logistic regression analysis.ResultsThere are significant differences in the mental health status of elderly hypertensive patients between urban and rural areas.In the urban areas,the K10 average score is 15.10,and the proportions of poor mental health status are 4.5%.The average K10 score in rural areas is 16.24,and the percentages of poor mental health are 7.8%.The mental health status of elderly hypertensive patients in urban areas is obviously better than that of elderly hypertensive patients in rural areas.The influencing factors of the mental health status of the elderly hypertensive patients in the city are gender,monthly self-paid medical expenses,self-rated health status,whether ADL is damaged,personality,life pressure,whether they have encountered major setbacks or unexpected misfortune.The influencing factors of mental health of elderly hypertensive patients in rural areas are personality,age,whether they live alone,self-rating economic status,whether they owe money,whether they eat regularly,self-rating health status,whether ADL is damaged,self-sensing blood pressure control effect,medication compliance,personality,trust,life pressure,whether they have encountered major setbacks or unexpected misfortune.ConclusionThe mental health status of elderly hypertensive patients in urban areas is obviously better than that of elderly hypertensive patients in rural areas.The study found that in urban areas,the mental health status of elderly patients who are female,have higher monthly self-paid medical expenses,poor self-rated health,impaired ADL,introverted personality,high life pressure,and have experienced major setbacks or accidents is poor.In rural areas,female,aged 60-69 years old,living alone,self-rated poor economy,debts,irregular meals,self-rated poor health,impaired ADL,poor self-perceived blood pressure control,non-compliance with medication,introverted personality,low degree of trust,high life pressure,major setbacks or unexpected misfortune of elderly patients with poor mental health.In order to improve the mental health of elderly hypertensives,we should strengthen the construction of community support system,focusing on the mental health of vulnerable elderly hypertensives.We should improve the social security system for the elderly and medical services,and implement a free policy for essential drugs.We should create a harmonious family environment and create a social atmosphere of respecting.