| Background and objectives: With the increasing scale of the elderly population,hypertension in China is characterized by increasing prevalence but low control rate,which poses a serious threat to human health.Hypertension has brought great economic burden to patients and their families because of its long course,many kinds of complications,persistence and serious harm.This study investigated the quality of life(QoL)of elderly hypertensive patients in community of Nanjing,to describe the quality of life of elderly hypertensive patients and explore its influencing factors.To provide reference for the research in the field of elderly health,to provide targeted suggestions and strategies for the formulation of community health policy for the elderly,so as to improve the quality of life of the elderly in China.Methods:(1)A cluster random sampling method was used to select the elderly people who have routine physical examination in a community hospital in Nanjing as the research objects to investigate the health status of the research objects.And questionnaire was used to evaluate the quality of life of elderly patients with hypertension and collect the physiological indicators according to physical examination reports.SPSS 19.0 was used to get descriptive statistics,t-test,F-test and multiple linear regression analysis to explore the quality of life of elderly patients with hypertension and its influencing factors;AMOS 23.0 was used to build structural equation model to explore the relationship between factors.(2)The subjects were followed up for baseline period,6th month and 18 th month respectively,and their quality of life was investigated again.A multi-level model was constructed by SPSS 19.0 to explore the relationship between influencing factors and time effect.Results:(1)According to the results,the average scores of physical function,psychological function,social function,hypertension-specific module and quality of life were 69.50±11.69,73.18±16.24,53.63±10.04,66.98±12.41 and 73.90 ±7.30,respectively.(2)Multivariate analysis of influencing factors of quality of life showed that education,diet and the scores of health knowledge are positively correlated with physical function(P<0.05),alcohol consumption and family history of chronic diseases are negatively correlated with physical function(P<0.05);education,diet and blood pressure control are positively correlated with psychological function(P<0.05),age,gender and living alone are negatively correlated with psychology function(P<0.05);education,alcohol and consumption are positively correlated with social function(P<0.05),gender and age are negatively correlated with social function(P<0.05);education and alcohol consumption are positively correlated with hypertension specific module(P<0.05);gender and age are negatively correlated are hypertension specific module(P<0.05);education and diet are positively correlated with total scores of quality of life(P<0.05),age,gender,marital status and alcohol consumption are negatively correlated with total score of quality of life(P<0.05).(3)Structural equation model results showed that the main factors affecting quality of life are demographic characteristics(P<0.001),lifestyle(P<0.001)and health status(P<0.001).Specifically,There are three paths in demographic characteristics to the quality of life with a total effect of-0.838: demographic characteristics ? quality of life(direct effect,-0.901),demographic characteristics ? lifestyle ? quality of life(indirect effect,0.071),demographic characteristics ? lifestyle ? health status ? quality of life(indirect effect,-0.008).There are two paths in lifestyle to quality of life with a total effect of-0.235: lifestyle ? quality of life(direct effect,-0.269),lifestyle ? health status ? quality of life(indirect effect,0.028).Health status has a direct effect on quality of life(direct effect,0.224).(4)Through the multi-level model to evaluate the time effect of influencing factors on the quality of life of elderly patients with hypertension,it can be seen that time,male,lower educational level and lower dietary scores are all risk factors for physical function(P<0.05);no drinking is protect factor for physical function(P<0.05);time,lower educational level,less time for exercise and lower dietary scores are risk factors for psychological function(P<0.05);male,having a spouse and no smoking are all protective factors for psychological function(P<0.05);time,lower educational level,no drinking and lower dietry scores are risk factors for social function(P<0.05);male is the protective factor for social function(P<0.05);time,lower educational level,no drinking and lower dietary scores are risk factors for hypertension specific module(P<0.05);male and having a spouse are protective factors for hypertension specific module(P<0.001);time,lower educational level,lower dietary scores and less time for exercise are risk factors for quality of life(P<0.05);male,having a spouse and no drinking are protective factors for quality of life(P<0.05).Conclusions:(1)The quality of life of elderly hypertensive patients in community is not optimistic,and the scores of physical function,social function and hypertension specific module are low.(2)Gender,age,marriage,educational level,diet,exercise,smoking and alcohol consumption have different effects on all dimensions of quality of life.(3)Demographic characteristics,lifestyle and health status have direct and indirect effects on quality of life.Lifestyle and health status play an intermediary role between demographic characteristics and quality of life,indirectly affecting quality of life.(4)Gender,age,marriage,educational level,diet,exercise,smoking and alcohol consumption have different interaction in different dimensions with time. |
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