Analysis Of The Current Situation And Factors Influencing Quality Of Life Of Young And Middle-Aged Patients With Primary Hypertension In Shenyang Community

Objective: To investigate the current situation of quality of life of young and middle-aged primary hypertension patients in communities of Shenyang city,and to analyze as well as explore the influencing factors that affect the quality of life of young and middle-aged primary hypertensive patients in urban areas.According to the results of the study,some suggestions are provided for further improving and strengthening the management of chronic diseases by grass-roots general practitioners and improving the quality of life of young and middle-aged primary hypertension patients,to help them reduce the burden of disease,promote physical-psychological-social health,and accelerate the realization of the "Healthy China 2030 Plan Outline".Methods: In this study,from November 2021 to June 2022,four community health service centers(Changbai,Beishi,Taiyuan Street and Danan)were randomly selected from all community health service centers in Shenyang using a random sampling method.From the health records of primary hypertension patients aged 18-64 who visited these four community health service centers in the past six months,1012 patients who met the inclusion and exclusion criteria were screened and randomly selected as study participants.Basic information(sociodemographic data,socio-economic situation,lifestyle risk factors and clinical health information)was collected through questionnaires and EQ-5D-5L scale was used to evaluate the quality of life.The reliability and validity of EQ-5D scale were analyzed.The basic situation of patients and the distribution of problems in each dimension of quality of life were statistically described.The factors influencing the overall quality of life of patients were analyzed by t-test and analysis of variance for single-factor analysis,and multivariate regression was used for multivariate analysis.Multivariate logistic regression analysis was performed for the influencing factors of each dimension in the EQ-5D.Results:(1)The effective sample size for this included study was 1012,and the Cronbach’sα coefficient value of the EQ-5D-5L scale used was 0.867 and the KMO value was 0.836.(2)Young and middle-aged patients with primary hypertension in Shenyang were ranked by the percentage of those having difficulties in five dimensions: pain/discomfort,anxiety/depression,mobility,usual activities,and self-care.(3)The EQ-5D-5L scale took values ranging from-0.34 to 1.00 by converting health utility values,and the mean EQ-5D index score was 0.90±0.12;the mean VAS score was 82.47±10.33.(4)EQ-5D total score through univariate analysis of the results of different demographic basic information of patients showed that age,gender,BMI classification,marriage,occupation,education,monthly income,medical insurance,family relationship and social activities were statistically significant(P<0.05).Univariate analysis of health status of different patients showed that smoking,drinking,exercise,sleep,hypertension grade,years of illness,whether blood pressure was controlled below 140/90 mmHg and whether salt intake was controlled were statistically significant(P<0.05).(5)Tobit regression analysis showed that age,occupation,education level,monthly income,participation in social activities,exercise,years of illness and blood pressure under 140/90 mmHg(P<0.05)were the main factors affecting the quality of life of young and middle-aged primary hypertension patients.(6)The results of the multifactorial logistic regression analysis indicated that age,occupation,education,monthly income,family relationship,social activity,alcohol consumption and years of illness were the main influencing factors for the mobility dimension;marriage and gender were the main influencing factors for the self-care dimension;age,occupation,monthly income,social activity,years of illness and whether blood pressure was controlled below 140/90 mmHg were the main influencing factors for the usual activity dimension.Marriage,education,monthly income,health insurance status,social activity,smoking status,exercise status,years of illness,hypertension classification,and whether blood pressure was controlled below 140/90 mmHg were the main influencing factors for the pain/discomfort dimension;age,occupation,monthly income,years of illness,and hypertension classification were the main influencing factors for the anxiety/depression dimension.Conclusions: The overall quality of life of young and middle-aged patients with primary hypertension in the Shenyang community is relatively slightly lower and still needs to be improved.From the entries of each dimension of EQ-5D,the two dimensions of pain/discomfort and anxiety/depression responded to the most problems and were the main health problems of middle-aged and young patients.Age,occupation,education level,monthly income,participation in social activities,exercise,years of illness and whether blood pressure was controlled below 140/90 mmHg were the main factors affecting the quality of life of patients.Therefore,the government should strengthen the construction of health service system and pay attention to the disadvantaged groups among urban young and middle-aged patients with primary hypertension;while primary general practitioners should also strengthen the health management of urban young and middle-aged hypertensive patients and promote them to develop a healthy lifestyle.