Hypertension self-management trajectory patterns and associated factors among Chinese patients with aortic dissection after surgical repair: a longitudinal study.

Min Zeng, Ruiying Wang, Xi Cao
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Abstract

Aims: In patients with aortic dissection (AD) after surgical repair, especially those with hypertension, better management of blood pressure is associated with better health outcomes. The aim of this study is to identify hypertension self-management trajectory patterns and associated factors among Chinese aortic dissection patients after surgical repair to assist in developing tailored behavioural interventions for this population.

Methods and results: 178 patients with aortic dissection who underwent surgical repair were followed for 3 months. Data on hypertension self-management, hypertension knowledge, self-efficacy, and social support were collected before discharge and at 1 and 3 months after discharge. Sociodemographic and clinical data were also collected. A latent class growth model and generalized estimating equations were used to explore hypertension self-management trajectory patterns and factors associated with each pattern. The participants' average age was 57.95 (± 11.27) years. Two hypertension self-management trajectory patterns were identified: 'rapid ascent then suppressed growth' (93.4%) and 'continuously slow ascent' (6.6%). For the 'rapid ascent then suppressed growth' pattern, age, educational background, type of health insurance, family monthly income, self-efficacy, and social support were associated with this pattern (P < 0.05).

Conclusion: Healthcare providers may prioritize hypertension self-management for patients who are younger, have lower educational levels, have resident or employee medical insurance and have a family monthly income between 5001 and 10 000 yuan. Self-efficacy and social support might serve as targets for future intervention to improve hypertension self-management.

Registration: ChiCTR2100050542.

中国主动脉夹层患者手术修复后的高血压自我管理模式及相关因素:一项纵向研究。
目的:对于手术修复后的主动脉夹层(AD)患者,尤其是高血压患者,更好的血压管理与更好的健康状况相关。本研究旨在确定中国主动脉夹层患者手术修复后的高血压自我管理轨迹模式及相关因素,以帮助为这一人群制定有针对性的行为干预措施:对178名接受手术修复的主动脉夹层患者进行了为期3个月的随访。在出院前、出院后 1 个月和 3 个月收集了有关高血压自我管理、高血压知识、自我效能和社会支持的数据。此外,还收集了社会人口学和临床数据。研究采用潜类增长模型和广义估计方程来探索高血压自我管理的轨迹模式以及与每种模式相关的因素。参与者的平均年龄为 57.95 (± 11.27)岁。研究发现了两种高血压自我管理轨迹模式:快速上升然后抑制增长"(93.4%)和 "持续缓慢上升"(6.6%)。对于 "快速上升然后抑制增长 "模式,年龄、教育背景、医疗保险类型、家庭月收入、自我效能感和社会支持与该模式相关(P < 0.05):结论:对于年龄较小、教育程度较低、有居民医保或职工医保、家庭月收入在 5001-10000 元之间的患者,医疗服务提供者可优先考虑对其进行高血压自我管理。自我效能感和社会支持可作为未来改善高血压自我管理的干预目标:注册号:ChiCTR2100050542。
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