Integrating factors associated with hypertensive patients’ self-management using structural equation modeling: A cross-sectional study in Guangdong, China

Abstract

Purpose: Hypertension is considered a major public health issue worldwide because of its high frequency and concomitant risk of cardiovascular disease (CVD). Chronic-disease self-management has been proven to be cost-effective, but influencing factors and pathways remain complex and unclear. The purpose of this study was to integrate factors associated with hypertension self-management to provide a theoretical reference for community hypertension management. Methods: A total of 268 community-dwelling hypertensive patients were enrolled in a cross-sectional study conducted from July to September in 2017. A questionnaire on demographic– disease characteristics, disease knowledge, social support, self-efficacy, and self-management was completed by patients. Structural equation modeling was performed to verify multiple factors in self-management based on the self-efficacy theory. Results: The final model showed a good fit to sample data, ie, younger patients with lower CVD risk, shorter disease course, and less disease knowledge and social support predicted less self-efficacy, less hypertension self-management, and less controlled hypertension. Furthermore, social support was negatively correlated with age, CVD risk, and disease course and positively with disease knowledge. Conclusion: Medication adherence is the lowest dimension in self-management, and self-efficacy is vital to consider in the development of self-management interventions. Self-management education and mutual-help groups may be potential solutions with the power of technology. Younger patients with lower CVD risk and shorter disease course are vulnerable and need more attention.