Abstract
BackgroundHealth-Related Quality of Life (HRQoL) of hypertensive patients is not only affected by the disease itself but also by some subjective factors. Low health literacy is prevalent among ethnic minorities. Considering the Kazakh-Chinese people have the highest prevalence of hypertension in Xinjiang, and the High Blood Pressure-Health Literacy (HBP-HL) has not been included in the study of HRQoL. The synergistic effects and the potential mechanism HBP-HL, self-management behavior, therapeutic adherence, self-efficacy, social support on HRQoL remain unclear. This study aimed to introduce the HBP-HL, and develop a structural equation model (SEM) to identify the factors influencing of the HRQoL among Kazakh hypertensive patients.MethodsThe data was obtained by questionnaire survey and physical examination in 2015. Patients with hypertension were recruited through random cluster sampling in Kazakh settlements in Xinjiang. Firstly, the blood pressure was measured. Then the one-for-one household interviews were conducted by Kazakh investigators. The questionnaires regarding HBP-HL, HRQoL, self-management behavior, therapeutic adherence, self-efficacy, and social support were used to collect data. Finally, SEM was constructed, and p ≤ 0.05 was taken as significant.ResultsThe data was analysed by SPSS18.0 and AMOS18.0 software. 516 Kazakh hypertension patients were recruited, and 94.4% of them had a relatively low HBP-HL score. The mean standardized scores of HRQoL, self-management, therapeutic adherence were poor; they were 63.5, 66.2, and 64.4, respectively. But 96.1% and 98.3% of the participants had high levels of self-efficacy and social support. The SEM of the HRQoL had a good overall fit (χ2/df = 2.078, AGFI = 0.944, GFI = 0.968, CFI = 0.947, IFI = 0.949, RMSEA = 0.046). The model indicated that the HBP-HL has the highest correlation with HRQoL, following with self-management behavior, social support, and self-efficacy.ConclusionsLow HBP-HL is a major influenced factor of HRQoL among Kazakh hypertensive patients. Future programs should consider HBP-HL as the breakthrough point when designing targeting intervention strategies.
Highlights
Health-Related Quality of Life (HRQoL) of hypertensive patients is affected by the disease itself and by some subjective factors
Future programs should consider High Blood PressureHealth Literacy (HBP-HL) as the breakthrough point when designing targeting intervention strategies
The results of this study indicate that HRQoL, HBP-HL, and self-management behavior of Kazakh hypertension patients in rural areas are suboptimal, but their selfefficacy and social support status are high
Summary
Health-Related Quality of Life (HRQoL) of hypertensive patients is affected by the disease itself and by some subjective factors. Considering the Kazakh-Chinese people have the highest prevalence of hypertension in Xinjiang, and the High Blood PressureHealth Literacy (HBP-HL) has not been included in the study of HRQoL. This study aimed to introduce the HBP-HL, and develop a structural equation model (SEM) to identify the factors influencing of the HRQoL among Kazakh hypertensive patients. In low- and middle- income countries, for example China, Brazil, India and Mexico, the economic burden of cardiovascular disease (CVD) and hypertension contributed together 50% of the total number of economic estimates identified [1]. The Chinese Cardiovascular Disease Report 2018 indicates that about 245 million patients with hypertension in China, which has become a major public health problem. Hypertension has become one of the major public health concerns among Kazakh-Chinese people
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