Medical and social factors and quality of life in patients with arterial hypertension: the role of the nurse

Abstract

The paper examines the role of medical and social factors, general well-being, and quality of life in patients with hypertension. The role of the nurse of the therapeutic department in the preventive training of patients is emphasized to form a healthy lifestyle and reduce the pathogenic impact of negative social factors.Objective – substantiation of the main measures for prevention of hypertension and improvement of quality of life by studying medico-social and social factors of patients' quality of life with arterial hypertension by nurses.Material and methods. The survey (by questionnaire) involved 120 patients with arterial hypertension consulted at the Municipal Institution "Polyclinic №1" in Chernivtsi, including: men – 43.3%, women – 56.7% aged from 23 to 79 years. With the help of the questionnaires, medical and social, sociological factors of influence, general well-being and quality of life were studied. The research was conducted according to all ethical rules, in particular, in compliance with the principles of voluntariness, confidentiality, research integrity. The results of the study were processed by conventional statistical methods using computer packages STATISTICA 10 and presented by the appropriate number of observations, percentages, and the exact value of p.Results. I and II degree AH prevailed among the examined individuals, and burdened heredity was found in 62.5% (75 people). Insufficient amount of vegetables and fruits, fish in the diet and salt intake of more than 5 g per day (60%) was found. The vast majority of respondents had a secondary special, less of respondents – higher education. Social status survey: 71.62% were employed, most worked full time. According to the survey, 22.09% of people noted excellent working conditions, 38.37% – good, satisfactory – 25.58%, and 13.96% poor working conditions. It was found that the percentage of patients (60.47%), among whom there are excellent and good sanitary and working conditions, exceeds the percentage of respondents with satisfactory and poor working conditions (39.53%). The majority of respondents (53.49%) indicated satisfactory and poor psychological working conditions, which slightly exceeded the number of employees with excellent and good working conditions (46.51%). The advantage of assessing excellent and good material and technical working conditions over excellent and good psychological conditions (60.47% vs. 46.51%) was revealed. The financial condition of the majority of respondents was assessed as average (42.5%). The level of QOL fluctuated from very high to extremely low. Factors that led to a decrease in the level of QOL are the following: the indicator of "health" (1.44), "social status" (1.48), "job satisfaction" (1.59), "social activity" (1.62). Social factors such as financial difficulties, additional work to increase income were reported as negative during the last 6 months by every second patient; deterioration of mutual understanding, deterioration of relations: husband / wife, children, parents, friends, the threat of unemployment for relatives – every third respondent.Conclusions 1. 120 Patients with hypertension have a burdened heredity (62,5%), insufficient consumption of the recommended amount of vegetables and fruits (25,83%), fish in the diet (12,5%), and excessive salt consumption (60%); the predominance of people is with secondary special education and workers (71,62%) with excellent and good sanitation and satisfactory and poor psychological working conditions (39,53%), with an average financial situation (42,5%) and fluctuations in the level of QOL from very high to extremely low. 2. Hypertension worsens the QOL of patients, which is manifested by a decrease in both physical and psychological states. 3. The ability of patients to adequately perceive their disease and form attitudes toward treatment and prevention depends on the level of education. 4. Social support, training and diagnosis of hypertension are significant predictors of commitment to prevention and treatment. 5. Education of patients with hypertension on the principles of a healthy lifestyle by nurses, assistance in reducing the pathogenic impact of negative social factors, the constant promotion of medical knowledge will contribute to the formation of a responsible attitude to maintaining their own health, prevent complications, improve the QOL and social adaptation.