Cognitive status and influencing factors of hypertension amongst residents in a community in Chengdu
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摘要:
目的 了解成都市某社区居民高血压认知现状,分析其主要影响因素,为社区高血压防控工作提供一定的参考。 方法 于2021年1—3月采用多阶段整群随机抽样从成都市12个辖区中随机抽取某个社区400名18岁以上居民作为调查对象,采用自行设计的调查问卷对其进行面对面访谈和问卷调查,问卷内容包括个人基本信息、高血压相关知识和高血压相关知识获取途径,使用二元logistic回归进行影响因素分析。本次调查共发放问卷400份,回收有效问卷387份,有效回收率为96.75%。 结果 成都市某社区居民高血压相关知识总体知晓率为57.67%,其中基础知识知晓率为54.99%,危险因素知识知晓率为58.36%,并发症知识知晓率为50.71%,预防知识知晓率为66.80%。高血压相关知识总体及格率为50.13%,不同性别、年龄段、受教育程度、职业、月平均收入、婚姻状况、医保类型、家族史的居民高血压相关知识及格率差异有统计学意义(均P<0.05),其中受教育程度、职业、医保类型、家族史是高血压相关知识及格率的主要影响因素(均P<0.05)。亲友近邻(66.93%)、医务人员(51.42%)、广播电视(51.16%)、报纸杂志(44.70%)、互联网络(35.66%)是获取高血压相关知识的主要途径,而社区宣教(24.29%)、健康讲座(14.99%)和专家咨询(11.37%)则明显不足。 结论 成都市某社区居民高血压总体认知水平较差,对高血压相关知识掌握不够全面,社区需进一步加强高血压防控知识的宣传教育。 Abstract:Objective To understand the cognitive status of hypertension amongst residents in a community in Chengdu and analyse its main influencing factors to provide some reference for the prevention and control of hypertension in the community. Methods From January to March 2021, 400 residents over the age of 18 in a community were randomly selected from 12 districts of Chengdu through multistage cluster random sampling. Face-to-face interviews and questionnaires were conducted with self-designed questionnaires, including personal basic information, hypertension-related knowledge, and access to hypertension-related knowledge. Chi-square test was used for intergroup comparison, and the influencing factors were analyzed by binary logistic regression. A total of 400 questionnaires were distributed, and 387 valid questionnaires were recovered, with an effective recovery rate of 96.75%. Results The overall awareness rate of hypertension-related knowledge of residents in a community in Chengdu was 57.67%, including 54.99% of basic knowledge, 58.36% of risk factors, 50.71% of complications, and 66.80% of prevention knowledge. The overall pass rate of hypertension-related knowledge was 50.13%. Significant differences existed in the pass rate of hypertension-related knowledge amongst residents of different gender, age group, education level, occupation, monthly average income, marital status, medical insurance type, and family history (all P < 0.05). Amongst them, education level, occupation, medical insurance type, and family history were the main factors influencing the pass rate of hypertension-related knowledge (all P < 0.05). Relatives, friends and close neighbors (66.93%), medical personnel (51.42%), radio and television (51.16%), newspapers and magazines (44.70%), and Internet (35.66%) were the main ways to obtain hypertension-related knowledge, whereas community publicity and education (24.29%), health lectures (14.99%), and expert consultation (11.37%) were obviously insufficient. Conclusion The overall cognition level of hypertension in the studied community in Chengdu is poor, and the knowledge of hypertension is not sufficiently comprehensive. The publicity and education of hypertension prevention and control knowledge in the community must be further strengthened. -
Key words:
- Community residents /
- Hypertension /
- Cognitive status /
- Influence factor
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表 1 成都市某社区18岁以上居民高血压相关知识知晓率情况
Table 1. Awareness rate of hypertension related knowledge among residents over 18 years old in a community of Chengdu City
问题 男性(194人) 女性(193人) 合计(387人) 知晓人数 知晓率(%) 知晓人数 知晓率(%) 知晓人数 知晓率(%) 基础知识 517 53.30 547 56.68 1 064 54.99 高血压诊断标准中,血压值(高压/低压) 71 36.60 59 30.57 130 33.59 患有高血压病,是否需要服用降压药物 122 62.89 135 69.95 257 66.41 血压控制稳定时,是否有必要继续服药 99 51.03 111 57.51 210 54.26 高血压病患者能否参加锻炼、体育运动 89 45.88 94 48.70 183 47.29 高血压患者是否需要定期测量血压 136 70.10 148 76.68 284 73.39 危险因素知识 754 55.52 827 61.21 1 581 58.36 家族史 110 56.70 128 66.32 238 61.50 超重、肥胖 103 53.09 123 63.73 226 58.40 高盐饮食 121 62.37 140 72.54 261 67.44 缺乏体力活动 113 58.25 113 58.55 226 58.40 精神紧张 93 47.94 94 48.70 187 48.32 过量饮酒 117 60.31 133 68.91 250 64.60 吸烟 97 50.00 96 49.74 193 49.87 并发症知识 378 48.71 407 52.72 785 50.71 脑中风(脑梗死和脑出血) 112 57.73 122 63.21 234 60.47 冠心病和动脉硬化 119 61.34 130 67.36 249 64.34 眼睛损害 83 42.78 83 43.01 166 42.89 肾病 64 32.99 72 37.31 136 35.14 预防知识 489 63.02 545 70.60 1 034 66.80 低盐饮食 123 63.40 135 69.95 258 66.67 加强锻炼、控制体重 128 65.98 143 74.09 271 70.03 戒烟限酒 118 60.82 142 73.58 260 67.18 保持平衡的心态 120 61.86 125 64.77 245 63.31 全部知识 2 138 55.10 2 326 60.26 4 464 57.67 表 2 不同特征居民高血压相关知识及格率比较[人(%)]
Table 2. Passing rate of hypertension related knowledge among residents with different characteristics [persons (%)]
特征 类别 相关知识得分是否及格 χ2值 P值 特征 类别 相关知识得分是否及格 χ2值 P值 不及格 及格 不及格 及格 性别 男性 111(57.51) 83(42.78) 8.396 0.004 月平均收入 2 000元以下 21(10.88) 25(12.89) 12.171 0.016 女性 82(42.49) 111(57.22) 2 000~3 000元 55(28.50) 38(19.59) 年龄 ≤20岁 4(2.07) 3(1.55) 20.003 0.003 3 000~4 000元 63(32.64) 48(24.74) 21~30岁 41(21.24) 63(32.47) 4 000~5 000元 27(13.99) 47(24.23) 31~40岁 46(23.83) 37(19.07) 5 000元以上 27(13.99) 36(18.56) 41~50岁 34(17.62) 50(25.77) 婚姻状况 未婚 18(9.33) 62(31.96) 35.045 < 0.001 51~60岁 38(19.69) 29(14.95) 已婚 154(79.79) 125(64.43) 61~70岁 20(10.36) 11(5.67) 离婚 8(4.15) 4(2.06) ≥71岁 10(5.18) 1(0.52) 丧偶 6(3.11) 2(1.03) 受教育程度 小学及以下 23(11.92) 14(7.22) 52.375 < 0.001 分居 7(3.63) 1(0.52) 初中 78(40.41) 33(17.01) 医保类型 自费 16(8.29) 10(5.15) 72.592 < 0.001 高中/中专 80(41.45) 88(45.36) 商业保险 46(23.83) 6(3.09) 本科/专科 4(2.07) 28(14.43) 新型农村合作医疗 12(6.22) 54(27.84) 本科以上 8(4.15) 31(15.98) 城镇居民医疗保险 60(31.09) 83(42.78) 职业 无业 5(2.59) 11(5.67) 45.524 < 0.001 城镇职工医疗保险 55(28.50) 32(16.49) 职员 71(36.79) 65(33.51) 公费 2(1.04) 8(4.12) 学生 11(5.70) 20(10.31) 其他 2(1.04) 1(0.52) 工农 56(29.02) 29(14.95) 家族史 无 105(54.40) 76(39.18) 32.404 < 0.001 退休 29(15.03) 14(7.22) 有 31(16.06) 82(42.27) 医护 4(2.07) 37(19.07) 不知道 57(29.53) 36(18.56) 其他 17(8.81) 18(9.28) 表 3 变量赋值方法
Table 3. Variable assignment method
变量 赋值方法 性别 男性=1,女性=2 年龄 20岁以下=1, 20~30岁=2,31~40岁=3, 41~50岁=4, 51~60岁=5,61~70岁=6, 71岁及以上=7 受教育程度 小学及以下=1,初中=2,高中/中专=3,本科/专科=4,本科以上=5 职业 无业=(0,0,0,0,0,0),职员=(1,0,0,0,0,0),学生=(0,1,0,0,0,0),工农=(0,0,1,0,0,0),医护=(0,0,0,1,0,0),退休=(0,0,0,0,1,0),其他=(0,0,0,0,0,1) 月平均收入 2 000元以下=1,2 000~3 000元=2,3 000~4 000元=3,4 000~5 000元=4,5 000元以上=5 婚姻状况 未婚=(0,0,0,0),已婚=(1,0,0,0),离婚=(0,1,0,0),丧偶=(0,0,1,0),分居=(0,0,0,1) 医保类型 自费=(0,0,0,0,0,0),商业保险=(1,0,0,0,0,0),新型农村合作医疗=(0,1,0,0,0,0),城镇居民医疗保险=(0,0,1,0,0,0),城镇职工医疗保险=(0,0,0,1,0,0),公费=(0,0,0,0,1,0),其他=(0,0,0,0,0,1) 家族史 无=(0,0),有=(1,0),不知道=(0,1) 表 4 高血压相关知识及格率影响因素的二分类logistic回归分析
Table 4. Binary logistic regression analysis of factors influencing the passing rate of hypertensive knowledge
自变量 类别 B SE Wald χ2 P值 OR值 95% CI 受教育程度(以小学及以下为参照) 初中 0.248 0.630 0.156 0.693 1.282 0.373~4.404 高中/中专 0.698 0.652 1.148 0.284 2.010 0.560~7.213 本科/专科 3.160 1.010 9.787 0.002 23.561 3.255~170.559 本科以上 2.989 0.878 11.599 0.001 19.868 3.557~110.974 职业(以无业为参照) 职员 -2.348 0.989 5.640 0.018 0.096 0.014~0.664 学生 -3.042 1.227 6.146 0.013 0.048 0.004~0.529 工农 -2.213 0.983 5.074 0.024 0.109 0.016~0.750 医护 1.736 1.192 2.123 0.145 5.675 0.549~58.645 退休 -1.123 0.994 1.276 0.259 0.325 0.046~2.282 其他 -2.319 1.038 4.992 0.025 0.098 0.013~0.752 医保类型(以自费为参照) 商业保险 -0.814 0.773 1.111 0.292 0.443 0.097~2.014 新型农村合作医疗 2.767 0.678 16.670 < 0.001 15.904 4.214~60.017 城镇居民医疗保险 1.420 0.631 5.062 0.024 4.138 1.201~14.256 城镇职工医疗保险 0.102 0.697 0.021 0.884 1.107 0.283~4.337 公费医疗 1.668 1.147 2.115 0.146 5.303 0.560~50.220 其他 -0.903 1.494 0.365 0.546 0.405 0.022~7.581 家族史(以无家族史为参照) 有 1.720 0.383 20.212 < 0.001 5.585 2.639~11.823 不知道 -0.306 0.390 0.613 0.434 0.737 0.343~1.583 -
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