Research On Influencing Factors Of Compliance Towards National Public Health Service Items

BackgroundWith the deepening of the degree of aging in China,the number of elderly chronic non-communicable diseases is also increasing.Hypertension is a common chronic disease in the elderly,and its management and control has become a problem that cannot be ignored in China because of its large number and great harm.Hypertension disease control in China mainly relies on national basic public health services and hypertension health management services in chronic disease management services.However,the compliance rate and utilization rate of this service need to be improved.How to improve the hypertensive population’s compliance with management services is of great significance for maintaining the health of patients,promoting the implementation of the active aging policy and the establishment of the medical prevention integration mechanism.ObjectiveTo analyze the compliance of hypertensive patients with hypertension management services in national basic public health services,identify the key factors affecting the compliance of hypertensive patients,and put forward strategies and suggestions to improve the compliance of hypertensive patients.MethodsThrough expert consultation and statistical analysis,a scientific,effective and objective questionnaire was constructed to investigate hypertension patients managed by a community health service center in Guangzhou.Chi-square test,logistic regression,structural equation model and other methods were used to analyze the survey data.ResultsThe questionnaire and the cited scale have good reliability and validity.The results of multivariate analysis showed that gender,age,BMI,education level,blood pressure control,types of chronic diseases,self-perceived physical status,satisfaction with the clinic,and positive emotion were related to the good compliance of chronic disease management services in hypertensive patients(P<0.05).The results of structural equation model showed that survival needs(standardized path coefficient 0.09),growth needs(0.237),situational cues(0.164),perceived benefits(0.317),disease characteristics(0.165)and other factors positively affected compliance willingness,and perceived barriers(-0.137)negatively affected compliance willingness.Behavioral intention(standardized path coeficient 0.253),person cue(0.249),scenario cue(0.211),action cue(0.164),disease characteristics(0.123),enabling factors(0.117),perceived benefit(0.202),survival need(0.169),relationship need(0.245),growth need(0.123)0.184)and other factors positively affected compliance behavior,and perceived barriers(-0.288)negatively affected compliance behavior(P<0.05).Conclusions(1)The overall compliance of hypertensive patients in Guangzhou communities to the national essential public health services for hypertension management services is at a medium level and needs to be further improved.(2)There is a certain room for improvement in the transformation of patients’ compliance willingness to compliance behavior;(3)More attention should be paid to the population with risk factors such as gender,age,BMI,education level,and types of chronic diseases to improve their compliance;(4)Positive information feedback is conducive to patients’ long-term compliance;(5)We should make patients aware of their own health needs and other needs from the aspects of needs,obstacles and prompts,reduce the obstacles to service implementation,and increase all kinds of prompts in daily life,so as to improve their compliance intention and compliance behavior.RecommendationsIt is recommended to improve the compliance behavior from the following aspects:(1)establish service social norms and clarify the scope and content of hypertension and chronic disease management in an individual’s lifetime;(2)To optimize the quality of hypertension chronic disease management services and improve the perceived benefit level of patients;(3)reduce all kinds of costs in the service process and reduce the level of perceived barriers of patients;(4)Starting from the living group of patients in the community,developing community patient leaders,family integration and binding,etc.,excavating the potential needs and prompts of individuals;(5)establishing personal information terminals for national basic public health services for patients to increase the content and frequency of individual access to information;(6)Based on the information system,more attention should be paid to the population with risk factors of compliance to promote the occurrence of individual compliance.