| Objective: To investigate the current status of type A behavior and medication adherence of elderly hypertensive patients in the community and to explore the effect of health education based on behavior change wheel on medication adherence of elderly hypertensive patients with type A behavior in the community.Methods: 1.This study is divided into two parts: cross-sectional investigation and quasi-experimental research.From January 2022 to July 2022,384 elderly patients with hypertension who participated in the management of chronic diseases in a community health service center were selected as the survey subjects.The survey was conducted using the General Data Questionnaire,the Type A Behavior Type Questionnaire,and the 8-item Morisky Medication Adherence Scale in the Chinese edition to understand the detection rate of Type A behavior and the level of medication adherence with antihypertensive drugs in the survey population.2.According to the inclusion exclusion criteria,110 elderly patients with hypertension in the community who met the criteria were selected and randomly divided into observation group and control group,with 55 people each.The control group was given routine hypertension health education in the community,and the observation group was given health education based on BCW theory on the basis of the control group,and the blood pressure and medication adherence scores of the two groups were compared at weeks 4,8 and 12 after the intervention before the intervention.SPSS 25.0 was used for data analysis,and the frequency and composition ratio were used for the counting data.The measurement data are described by mean ± standard deviation((?)±s);The statistical analysis methods include two-independent sample t-test,one-way ANOVA,binary logistic regression analysis,χ2 test,repeated measure ANOVA,and P<0.05 is statistically significant.Results: 1.384 elderly patients with hypertension were included in this study,with a mean age of(72.44±6.12)years,191 cases(49.7%)with good compliance and 193 cases(50.3%)with poor compliance.186 elderly patients with type A behavior hypertension,of which 110 cases had poor compliance and 76 cases had good compliance;198 elderly patients with non-type A behavior hypertension,of which 83 cases had poor compliance and 76 cases had good compliance.Among them,83 cases had poor medication adherence and 115 cases had good medication adherence.Binary logistic regression analysis showed that age,per capita monthly income,education level,and type A behavior were all important factors influencing medication adherence in elderly hypertensive patients in the community(P < 0.05).2.The differences in systolic and diastolic blood pressure between the two groups before and after the intervention were statistically significant(P < 0.05),and the differences in time main effects were statistically significant(P < 0.001),and there was an interaction between the intervention and time factors(P < 0.001).The systolic and diastolic blood pressure of patients in the intervention group were lower than those in the control group at weeks 8 and 12 after the intervention,and the difference was statistically significant(P < 0.05);the decrease in systolic and diastolic blood pressure of patients in the intervention group was greater than that in the control group at 12 weeks after the intervention.3.The difference between groups of patients with medication adherence scores before and after intervention was statistically significant(P<0.05),the difference in time main effect was statistically significant(P<0.001),and there was an interaction between intervention factors and time factors(P<0.001).At weeks 8 and 12 after the intervention,the observation group had higher drug adherence scores than those in the control group,and the difference was statistically significant(P<0.05),and the increase in medication adherence scores in the observation group was higher than that in the control group 12 weeks after the intervention.Conclusion(s): 1.The medication adherence of elderly hypertensive patients with type A behavior in the community is poor,and the level of medication adherence of elderly hypertensive patients in the community needs to be improved.Different age,education level,per capita monthly income,and type A behavior were factors influencing medication adherence among community elderly hypertensive patients.2.Health education based on behavior change wheel can improve the medication adherence level of elderly hypertension patients with type A behavior in the community,and health education based on behavior change wheel can help improve the blood pressure of patients. |
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