| ObjectiveA cross-sectional survey was conducted to understand the current situation of selfmanagement behaviours and factors influencing the self-management behaviours of elderly empty nesters with hypertension and diabetes in Lanzhou city,so as to provide a reference basis for future interventions by community health care workers in self-management behaviours of patients with chronic diseases;a semi-structured interview was conducted to understand the problems of patients with low levels of self-management behaviours in the process of disease self-management,and to provide corresponding countermeasures and suggestions.MethodsThis study adopts a mixed research approach,consisting of both quantitative and qualitative research.1.Quantitative study: using a cross-sectional study method,290 elderly empty nesters with hypertension combined with diabetes were selected from four communities in Lanzhou City between May 2022 and December 2022 using a multi-stage random sampling method to conduct a cross-sectional survey using the General Conditions Questionnaire,the Hypertension Self-Management Behaviour Scale and the Diabetes Self-Management Behaviour Scale as research tools to understand the patients’ self-management behaviour A cross-sectional survey was conducted using the General Conditions Questionnaire,the Hypertension Self-Management Behaviour Scale and the Diabetes Self-Management Behaviour Scale as instruments to understand the current status of patients’ self-management behaviour and the factors influencing it.The data were entered using Epi Data 3.1 software and statistically analysed using SPSS 24.0 software.Count data were statistically described using frequencies and percentages,while measurement data were statistically described using mean ± standard deviation,median and interquartile spacing.t-test,one-way ANOVA and multiple linear regression were used to analyse the influencing factors.2.Qualitative study: Using a phenomenological research method,12 cases of elderly empty-nesters with hypertension combined with diabetes mellitus in the Lanzhou community whose self-management behaviour was at a low level in the quantitative study were selected for face-to-face semi-structured interviews between January 2023 and February 2023 using a purposive sampling method,and the interview data were analysed according to Colaizzi’s 7-step content analysis method to refine themes and understand the patients’ difficulties in the process of disease self-management.Results1.Quantitative study results(1)The total score of hypertension self-management behavior of elderly empty nesters with hypertension and diabetes in Lanzhou city was(99.80±7.00),of which the medication management dimension was(13.44±2.89),condition monitoring dimension was(9.56±1.39),diet management dimension was(31.37±2.86),exercise management dimension was(7.64±2.96),rest and activity management dimension was(16.03±1.78),and emotional management dimension was(21.76±1.92),Standardised scores for each dimension of hypertension self-management behaviour in descending order: management of medication,rest and activity management,dietary management,Emotional management,exercise management and disease monitoring.The standardised scores for each dimension of hypertension self-management behaviour are listed in descending order: medication management,rest and activity management,diet management,mood management,exercise management and condition monitoring.(2)The total score of diabetes self-management behaviour of elderly empty nesters with hypertension and diabetes in Lanzhou city was(77.01±4.26),which was generally at a low level.The exercise management dimension scored(12.78±2.23),the diet management dimension scored(17.28±1.48),the medication management dimension scored(11.57±1.18),the blood glucose monitoring dimension scored(6.48±1.41),the foot care dimension scored(17.16±1.16)and the management of high and low blood glucose dimension scored(11.74±1.35).The standardised diabetes self-management behaviour scores in descending order were as follows: medication management,foot care,exercise management,high and low blood glucose management,diet management and blood glucose monitoring.(3)The results of univariate analysis showed that age,residence status,education level,monthly per capita household income,medical payment method,hypertension classification,duration of hypertension,and hypertension complications were statistically significant(P<0.05)in the score of hypertension self-management behavior among elderly empty nesters with hypertension combined with diabetes in Lanzhou city community.age,residence status,education level,monthly per capita household income,medical There was a statistically significant difference between age,residence status,education level,monthly per capita household income,mode of payment,diabetes treatment options,duration of diabetes,and complications of diabetes in the score of diabetes self-management behavior(P <0.05).(4)The results of multiple linear regression analysis showed that the differences in age,residence status,education level,medical payment method,hypertension classification,and duration of hypertension were statistically significant(P <0.05)in the scores of hypertension self-management behavior among elderly empty nesters with hypertension combined with diabetes mellitus in Lanzhou community.age,residence status,education level,medical payment method,diabetes treatment options,and duration of diabetes mellitus were statistically significant in the scores of diabetes The differences in self-management behaviour scores were statistically significant(P <0.05).To further understand the current status of patients’ self-management behaviour and the factors influencing it.2.Qualitative study resultsA total of 12 cases of elderly empty nesters with hypertension combined with diabetes mellitus in Lanzhou community were interviewed in this study.Among them,4 cases were male and 8 cases were female,with an average age of(73.75±4.10)years.The results of the thematic analysis mainly included 3 themes and 7 sub-themes.Theme 1 was the lack of selfmanagement ability,with the sub-themes being:(1)the existence of cognitive bias in disease monitoring;(2)the difficulty in obtaining effective disease knowledge;and(3)the difficulty in changing bad behavioural habits.Theme 2 is a lack of motivation for self-management,with sub-themes of:(1)the presence of complications;(2)the presence of poor psychological status.Theme 3 is limited opportunities for self-management,with the sub-themes being:(1)physical limitations to self-management opportunities;(2)weaknesses in social support.Conclusion1.In this study,the scores of hypertension self-management behaviours of elderly empty nesters with hypertension and diabetes in the Lanzhou community were generally moderate and the scores of diabetes self-management behaviours were generally poor.2.In this study,self-management behaviour of hypertension and diabetes was better in patients who were younger,more educated,lived with their spouses,had employee health insurance,and had a longer duration of illness.Self-management behaviour of hypertension and diabetes was better in patients with grade 2 hypertension and better in patients with a combination of oral hypoglycemic drugs and insulin injections.3.The lack of self-management skills,insufficient motivation and limited opportunities for self-management among elderly empty-nesters with hypertension combined with diabetes in the Lanzhou community should be taken into account by community health care workers. |
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