Study On Health Related Quality Of Life And Its Influencing Factors Of Middle-aged And Elderly Patients With Hypertension In Rural Areas

ObjectivesThe purpose of this study was to explore the effects of sociodemographic characteristics,lifestyle and health status on health-related quality of life of middleaged and elderly patients with hypertension in rural areas.Furthermore,the mechanism between the influencing factors and health-related quality of life was analyzed in order to provide a reference for the health management of middle-aged and elderly patients with hypertension in rural China.MethodsIn this study,cluster random sampling method was used to select hypertension patients aged 45 and above from 4 towns in Xuan ’en County,Enshi City,Hubei Province.A total of 507 valid questionnaires were collected.A self-made questionnaire was used to investigate the basic demographic characteristics,lifestyle and health status of the subjects.The 12-item Short Form Health Survey(SF-12)was used to evaluate the health-related quality of life of middle-aged and elderly patients with hypertension.After that,the collected cross-sectional data were statistically analyzed.One-way ANOVA and multiple linear regression analysis were used to identify the factors influencing the health-related quality of life of middle-aged and elderly patients with hypertension in rural areas.At the same time,structural equation models were used to explore the interaction pathways among socioeconomic status,lifestyle,health status and health-related quality of life.The Bootstrap method was used to test the mediating effect of the influencing factors.The statistical software SPSS22.0 and AMOS22.0were used for all data analysis.Results(1)Current status of health-related quality of life among middle-aged and elderly hypertensive patients in rural areas.The survey found that the quality of life of middleaged and elderly hypertensive patients in Xuan’en County is poor.In this study,the average scores of physical component summary(PCS)of 507 hypertensive patients was 33.55±8.17,and the average scores of mental health summary(MCS)was46.29±7.38.(2)Multi-factor analysis of health-related quality of life among middle-aged and elderly hypertensive patients in rural areas.The results of multiple linear regression showed that in the field of physical health,age,marital status,smoking status,weekly exercise frequency,years of diagnosis of hypertension,number of other diseases,and sleep quality were the influencing factors of PCS score(P<0.05);in the field of mental health,education level,smoking status,tea drinking status,food saltiness,BMI,number of other diseases,and sleep quality are the influencing factors of MCS score(P<0.05).(3)Path analysis of various factors affecting health-related quality of life among middle-aged and elderly hypertensive patients in rural areas.The structural equation model has a good fitting effect,where χ2/df is 1.823,GFI is 0.958,AGFI is 0.942,CFI is 0.937,NFI is 0.872,and RMSEA is 0.040.All indicators meet the standard requirements.Health status has a significant direct effect on health-related quality of life,with an effect size of-0.621(P<0.001),indicating that middle-aged and elderly hypertensive patients with poor health status have worse quality of life.Lifestyle not only has a direct effect on the health-related quality of life of patients with hypertension,but also has an indirect effect on them through their health status.The effect values are-0.317 and-0.389 respectively(P<0.001).ConclusionsThis study found that the physical and mental health of middle-aged and elderly hypertensive patients in rural areas is poor,and it is urgent to develop effective measures to improve their health-related quality of life.There are certain health inequities among different groups of middle-aged and elderly hypertensive patients in rural areas.We should focus on vulnerable groups such as the elderly,unpartnered,and low-income groups to promote their health equity.In addition,a good lifestyle is conducive to the health and quality of life of middle-aged and elderly hypertensive patients in rural areas.We should pay attention to rural health care services,strengthen the health management of middle-aged and elderly hypertensive patients,and improve the patients’ unhealthy lifestyles through appropriate health education.