Abstract
Purpose
Hypertension is considered a major public health issue worldwide because of its high frequency and concomitant risk of cardiovascular disease (CVD). Chronic-disease self-management has been proven to be cost-effective, but influencing factors and pathways remain complex and unclear. The purpose of this study was to integrate factors associated with hypertension self-management to provide a theoretical reference for community hypertension management.
Methods
A total of 268 community-dwelling hypertensive patients were enrolled in a cross-sectional study conducted from July to September in 2017. A questionnaire on demographic–disease characteristics, disease knowledge, social support, self-efficacy, and self-management was completed by patients. Structural equation modeling was performed to verify multiple factors in self-management based on the self-efficacy theory.
Results
The final model showed a good fit to sample data, ie, younger patients with lower CVD risk, shorter disease course, and less disease knowledge and social support predicted less self-efficacy, less hypertension self-management, and less controlled hypertension. Furthermore, social support was negatively correlated with age, CVD risk, and disease course and positively with disease knowledge.
Conclusion
Medication adherence is the lowest dimension in self-management, and self-efficacy is vital to consider in the development of self-management interventions. Self-management education and mutual-help groups may be potential solutions with the power of technology. Younger patients with lower CVD risk and shorter disease course are vulnerable and need more attention.
Acknowledgments
We thank the community physicians who supported our study and residents for their enthusiastic participation.
Author contributions
AHL, WWD, TL, QYS, and MHY were responsible for conceptualization, WWD for methodology, software, validation, and formal analysis, WWD and TL for investigation, QYS and MHY for resources, WWD and TL for data management, WWD for original draft preparation, WWD, TL, AHL, QYS, and MHY for writing, review, and editing, WWD for visualization, AHL and QYS for supervision, WWD, TL, and MHY for project administration, and WWD and AHL for funding acquisition. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.