An Establishment Of Model On The Influencing Factors Of Health-related Quality Of Life Among Hypertension Patients In Urban-rural Fringe Of Huzhou

Research Purpose:1.To explore the status of health-related quality of life,high blood pressure health literacy,self-efficacy,self-management,social support and medication compliance of hypertensive patients in urban-rural fringe of Huzhou;2.To establish a structural equation model of health-related quality of life and its influencing factors for hypertensive patients in urban-rural fringe of Huzhou,and clarify the path relationship between high blood pressure health literacy,self-efficacy and social support and health-related quality of life;3.To test whether the high blood pressure health literacy is a key variable that affects the health-related quality of life of hypertensive patients in urban-rural fringe of Huzhou.Research Methods:1.The literature review method was used to sort out the common influencing factors of the health-related quality of life of patients with hypertension in the community in the past.2.Using a random cluster sampling method,401 permanent residents who were diagnosed with hypertension in multiple communities(villages)in Huzhou,aged ≥ 18 years,were selected as the research objects.3.Using the research method of cross-sectional survey,physical examination and one-to-one questionnaire survey of 401 hypertensive patients in urban-rural fringe were carried out,and SPSS22.0 software was used to conduct descriptive statistics,difference test and multiple linear regression analysis to explore the status of health-related quality of life and its influencing factors of blood pressure patients;4.AMOS 22.0 software was used to establish a structural equation model of the health-related quality of life and its influencing factors of hypertensive patients,and explore the path relationship between influencing factors.Research Results:1.The average score of health-related quality of life for hypertensive patients in urban-rural fringe of Huzhou was(81.42±5.02);the average score of high blood pressure health literacy was(38.94±17.56);the average score of self-efficacy was(7.12±1.19);the average score of self-management was(129.45±16.53);the average score of social support was(35.30±5.93).2.The results of multi-factor analysis of health-related quality of life influencing factors show that age,gender,occupation,income,medical expenses,upper arm systolic blood pressure and comorbidities have significant impacts on patients’ health-related quality of life(P<0.05);3.The path analysis results of the structural equation model show that the total and indirect effects of self-efficacy on the health-related quality of life of hypertensive patients in urban-rural fringe of Huzhou were the largest among all factors,0.481 and 0.144 respectively;followed by self-management,the total effect(0.255);The total and indirect effects of high blood pressure health literacy were 0.228 and 0.080,respectively.Social support was an intermediary factor of high blood pressure health literacy and health-related quality of life.The specific path:self-efficacy → self-management → health-related quality of life,indirect effect(0.565*0.255=0.144);high blood pressure health literacy→social support→health-related quality of life,indirect effect(0.487*0.164=0.080).Research Conclusion:1.The health-related quality of life,self-efficacy,self-management and social support of hypertensive patients in urban-rural fringe of Huzhou were at medium level,and high blood pressure health literacy was obviously insufficient.2.Self-efficacy was the primary influencing factor for the health-related quality of life of hypertensive patients in urban-rural fringe of Huzhou,followed by self-management,high blood pressure health literacy,social support and biological factors(age,neck circumference,upper extremity systolic blood pressure).Self-management was an important mediating factor that mediated the relationship between self-efficacy,age,neck circumference and HRQOL.3.Although high blood pressure health literacy was not the factor that had the greatest impact on health-related quality of life,it had an impact on health-related quality of life through two direct and indirect channels.Social support as a mediating factor mediated the relationship between high blood pressure health literacy and health-related quality of life.4.Hypertension patients with low level of health literacy should be the focus of health education intervention.High blood pressure health literacy can be used as an entry point for health education intervention,and self-efficacy and self-management behavior intervention should become the main content of health education intervention.At the same time,the patient’s social support system should be strengthened to control the patient’s blood pressure level,slow down the disease progression,and improve the patient’s quality of life.