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自我管理和心理弹性缓和了中国高血压患者症状与健康相关生活质量之间的关系。

Self-management and psychological resilience moderate the relationships between symptoms and health-related quality of life among patients with hypertension in China.

机构信息

School of Nursing, Tianjin Medical University, Qixiangtai Road, Heping District, Tianjin, China.

School of Nursing, Shandong University, Jinan, China.

出版信息

Qual Life Res. 2019 Sep;28(9):2585-2595. doi: 10.1007/s11136-019-02191-z. Epub 2019 May 2.

Abstract

PURPOSE

To examine whether and how self-management and psychological resilience could moderate the relationships between symptoms and health-related quality of life (HRQoL) among hypertensive patients in China.

METHODS

This was a cross-sectional study of 220 participants recruited from January to May, 2018. Demographic and clinical information were obtained from medical records and by patient interview. The Chinese version of 17-item Hypertension-specific Symptom Scale, 21-item Self-Management Scale, and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) as well as Short Form 12 Health Survey (SF-12) were used to collect information in this research. The moderation effects of self-management and psychological resilience were explored using the PROCESS macro for SPSS.

RESULTS

Among all patients, 128 (58.2%) were female, 106 (48.2%) had a bachelor degree or higher, and 133 (60.5%) had moderate to severe Charlson Comorbidity Index. Both self-management and psychological resilience were negatively correlated to symptoms (r = - 0.259, p < 0.001; r = - 0.282, p < 0.001) but positively correlated to physical (r = 0.316, p < 0.001; r = 0.344, p < 0.001) and mental (r = 0.273, p < 0.001; r = 0.309, p < 0.001) HRQoL. After controlling for potential covariates, self-management could moderate the associations between symptoms and physical HRQoL (p = 0.041, ΔR = 0.010), while psychological resilience could moderate the relationships between symptoms and mental HRQoL (p = 0.02, ΔR = 0.010).

CONCLUSIONS

For hypertension patients, HRQoL is dependent on the severity of symptoms, engagement of self-management behaviors, and psychological resilience, which should be carefully considered when to improve patients' HRQoL by health care providers.

摘要

目的

探讨自我管理和心理弹性是否以及如何调节中国高血压患者症状与健康相关生活质量(HRQoL)之间的关系。

方法

这是一项 2018 年 1 月至 5 月期间招募的 220 名参与者的横断面研究。从病历和患者访谈中获取人口统计学和临床信息。使用中文版 17 项高血压特定症状量表、21 项自我管理量表和 10 项 Connor-Davidson 弹性量表(CD-RISC-10)以及 12 项简短健康调查量表(SF-12)收集研究信息。使用 SPSS 的 PROCESS 宏探索自我管理和心理弹性的调节作用。

结果

在所有患者中,128 名(58.2%)为女性,106 名(48.2%)拥有学士学位或更高学历,133 名(60.5%)Charlson 合并症指数为中度至重度。自我管理和心理弹性均与症状呈负相关(r=-0.259,p<0.001;r=-0.282,p<0.001),但与生理(r=0.316,p<0.001;r=0.344,p<0.001)和心理(r=0.273,p<0.001;r=0.309,p<0.001)HRQoL 呈正相关。在控制了潜在的协变量后,自我管理可以调节症状与生理 HRQoL 之间的关系(p=0.041,ΔR=0.010),而心理弹性可以调节症状与心理 HRQoL 之间的关系(p=0.02,ΔR=0.010)。

结论

对于高血压患者,HRQoL 取决于症状的严重程度、自我管理行为的参与和心理弹性,医疗保健提供者在改善患者 HRQoL 时应仔细考虑这些因素。

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