| Objective（1）To explore the health-related Behavior of rural diabetic hypertensive comorbidities and its influencing factors;（2）To explore the utilization of medical services in rural diabetic hypertensive comorbid patients and its influencing factors;（3）To understand the difference of quality of life between rural comorbidity patients and hypertension patients,and develop personalized intervention measures.It provides basis for controlling disease development and improving patients’ quality of life.Methods The hypertension patients in five towns of the capital city were selected as the investigation objects,and the self-designed structured questionnaire was used for the investigation.SPSS 25.0 software was used to analyze the patients with diabetes and hypertension.The contents included :（1）demographic characteristics of the investigation objects;（2）Describe the health-related Behavior by frequency and percentage;（3）Single factor analysis and multiple factor analysis were used to analyze the influencing factors of health-related Behavior;（4）Use frequency and percentage to describe the utilization of medical services;（5）Single factor analysis and multi-factor analysis were used to analyze the influencing factors of medical service utilization;（6）Frequency and percentage were used to describe the quality of life;（7）Health effect and quality of life scores of patients with hypertension and diabetes comorbidities and patients with hypertension alone were compared.（8）Propose health-related behaviour intervention programmesResults（1）A total of 2770 valid samples were obtained in this survey,including 870 diabetic hypertensive comorbid patients and 1900 hypertensive single disease patients.In terms of gender,male and female patients with diabetes and hypertension accounted for 36.9% and 63.1% respectively.The incidence of hypertension alone was 45.4% in males and 54.6% in females.In terms of age,the average age of comorbidities was65.90±8.95,among which 232 patients（26.7%）were <60 years old,335 patients（38.5%）were 60-70 years old,and 303 patients（34.8%）were >70 years old.The mean age of patients with single disease of hypertension was 65.33±10.09,among which 612patients（32.2%）were <60 years old,625 patients（32.9%）were 60-70 years old,and663 patients（34.9%）were >70 years old.（2）In the past month,404,or 46.4 percent,of those with diabetes and hypertension had exercised.There were 140 comorbidity patients who drank alcohol,accounting for 16.1%;The number of those who did not try to drink less was 54（38.6 percent）.There were 100（11.5%）smokers.The number of patients who sometimes tried to smoke less was the largest,45（45.0%）.There were 276 comorbidity patients with emotional problems,accounting for 31.7%.118 of them,accounting for 42.8%,had adopted self-health behaviors to regulate their emotions.The number of patients who ate staple food or vegetables at each meal in the past 24 hours exceeded 40%;The number of patients who eat whole grains and fruits is small,less than 20%;In the past month,457 patients,or 52.5%,had a controlled diet.The patients with light diet,less salt and less fat were more than 50%.The patients who ate more fruits and grains were less than 20%.（3）In terms of exercise,gender（P=0.001）and BMI（P=0.043）were the influencing factors of physical exercise.Education level was the influencing factor of physical exercise（P=0.010）and intentional joint movement（P=0.018）.Patients living alone（OR=1.820）,overweight（OR=1.919）and obese（OR=1.653）were more likely to exercise.Patients who had been reminded by their family members to exercise more（OR=3.054）,deliberately exercise more（OR=2.456）,and intentionally move their joints（OR=2.512）were more likely to do physical exercise.In terms of tobacco and alcohol,males were more likely to drink alcohol（OR=3.380）and smoke（OR=92.135）.Patients with junior middle school OR above education level were more likely to drink than illiterate patients（OR=2.460）.Patients with primary education level（OR=1.077）were more likely to smoke and more likely to reduce smoking（OR=7.920）;Patients with complications were less likely to drink alcohol（OR=0.394）,smoke cigarettes（OR=0.269）,and try to smoke less（OR=0.296）.Patients reminded by family members to drink less and smoke less are more likely to drink（OR=21.667）,smoke（OR=95.653）,and are more likely to try to drink less（OR=2.872）and smoke less（OR=4.773）.Overweight patients（OR=0.376）were less likely to try to reduce alcohol consumption;Older patients were more likely to try to reduce alcohol consumption at many times（OR=1.065 ～ 1.188）.Emotion: Gender is a factor influencing whether there are emotional problems,and male is less likely to have emotional problems than female（OR=0.541）.Among self-regulating emotions,patients with high systolic blood pressure were less likely to self-regulate emotions（OR=0.533）;Patients with hyperglycemia for more than 6 years were more likely to take measures to regulate their own emotions（OR=2.395）.Diet: Older patients were less likely to take measures to control diet（OR= 0.523-0.625）;Patients with high diastolic blood pressure were less likely to control diet than those with diastolic depression（OR=0.653）.Patients with hyperglycemia for more than 6 years（OR=1.492）,family history of hypertension（OR=1.596）,and family reminders to control diet（OR=2.156）were more likely to control diet.（4）In the past year,272 patients,or 31.3 percent,had been hospitalized.Most of them were hospitalized once a year（61.0%）,and most of them（35.7%）were hospitalized 0-9 days a year,mainly in county（city）level hospitals.In the past month,257 patients（29.5%）visited the outpatient department.Among them,64.2% of the patients went to outpatient service once a month,mainly to rural township health centers.（5）Patients aged 60-70 years were more likely to be hospitalized（OR=1.651）;Patients with education level of junior middle school OR above were less likely to be hospitalized（OR=0.599）;Patients with hypertension for more than 10 years（OR=1.638）and complications（OR=3.289）were more likely to be hospitalized.In terms of outpatient visits,patients with hyperglycemia for 2-6 years were more likely to visit outpatient visits than patients with hyperglycemia for ≤2 years（OR=1.633）.Patients with complications were more likely to visit an outpatient clinic than those without complications（OR=1.583）.（6）The mean UI score of comorbidients was0.770±0.256,and 193（22.5%）patients had no difficulty in the evaluation results of the five dimensions.The number of patients with grade 3 or above（moderate or above difficulties）in MO,SC,UA,AD and PD were 223（26.1%）,69（8.0%）,122（14.2%）,278（32.4%）and 118（13.7%）,respectively.（7）There were statistically significant differences in health utility value and scores of MO,SC,UA,AD and PD among different populations（P<0.05）.The health utility value of comorbid patients was lower than that of hypertensive single disease group,and the scores of five dimensions were higher than that of hypertensive single disease group.（8）The intervention direction was: "Pay attention to the characteristic indicators of comorbid patients","pay attention to the status quo of health related behaviors of comorbid patients","pay attention to the influencing factors of health related behaviors".Conclusions（1）Diabetes patients with hypertension are generally older,more women,more overweight and obese,and poorer quality of life.（2）Diabetic patients with hypertension control diet more,but the control behavior is not standard;Relatively few patients took exercise,controlled tobacco and alcohol,and regulated their emotions.Family members remind patients to exercise more,control diet more,remind the control of tobacco and alcohol,regulate emotions relatively less,should strengthen the overall self-health behavior of publicity and education.（3）different demographic factors on the influence of different health care behavior is different,but the family remind can guide the patients to take health-related Behavior,suggesting health work will fully consider different health behavior risk factors,focus on the health behavior of "weak groups",improve family participation and social support.（4）Rural diabetic hypertensive comorbid patients frequently seek help from primary medical institutions,so the medical level of primary medical institutions should be improved to meet the medical needs of rural patients.（5）The utilization of medical services for comorbidities was affected by age,education level,course of disease and other factors.Patients with older age,lower education level,longer course of disease and complications had more utilization of medical services and heavier burden.（6）According to health belief theory and social cognition theory,through telephone,wechat,SMS and other convenient ways,patients’ cognition can be improved by pushing relevant information and knowledge,opening personalized reminder and implementation plan services,involving family and friends,and improving patients’ compliance to implement health-related behaviors. |
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