Survey and analysis of the current status and needs of health management for hypertension among empty-nest elderly / 中华健康管理学杂志

ABSTRACT

Objective:To survey and analyze the current status and needs of health management for hypertension in empty-nest elderly.Methods:In this cross-sectional study, 677 cases of empty-nest elderly with hypertension who underwent health checkups at the Health Management Center of Sichuan Provincial People′s Hospital from March 1st to June 30th, 2022 were selected consecutively by convenience sampling method to conduct a questionnaire survey. The questionnaires included general demographic information, and the current status and needs of health management for hypertension. A total of 677 questionnaires were distributed, and all the questionnaires were recalled, of which 675 (99.7%) were valid. According to the Classification and Definition of Blood Pressure Levels in the Guidelines for Primary Care of Hypertension (2019) the elderly with mean systolic blood pressure controlled between 90 and 139 mmHg (1 mmHg=0.133 kPa) and mean diastolic blood pressure controlled between 60 and 89 mmHg were set as normal blood pressure group (257 cases), and the ones with mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥90 mmHg were set as abnormal blood pressure group (418 cases). The current management status and needs of hypertension between the two groups was compared, and the χ2 test and multi-factor logistic regression were used to analyze the factors influencing the health management level of hypertension among empty-nest elderly. Results:Most of the empty-nest elderly had their blood pressure monitored once a week (40.30%), most of them had their blood pressure reviewed in outpatient setting for no more than one time per year (40.89%), their blood pressure was mainly controlled by medication (48.30%), more than half of them took medication very regularly (51.84%), and the proportion of the elderly with abnormal blood pressure was much higher than that of those with normal blood pressure (61.93% vs 38.07%). Compared with living with or nearby their children, empty-nest elderly preferred to live alone or with their spouses (63.11% vs 15.85% and 21.04%), and the proportion of those who wanted to be taken care of by their children was much lower than those who wanted to be taken care of by the community and mutual care among the elderly (7.70% vs 58.07% and 34.22%); and the people they wanted to talk to were mainly their children (53.19%). In terms of community services, the needs for medical services in empty-nest elderly was higher than the needs for old-age security and cultural entertainment (43.11% vs 36.15% and 20.74%), and the needs for community medical services was focused on blood pressure measurement (89.04%). The proportions of education level of college and above, high household income, regular medication taking, daily blood pressure monitoring, and desire for frequent child care were significantly lower in the abnormal blood pressure group than those in the normal blood pressure group (34.91% vs 58.35%, 5.17% vs 24.16%, 34.89% vs 63.72%, 28.47% vs 44.75%, and 3.35% vs 10.12%), and the proportion without medical insurance was significantly higher than that in the normotensive group (8.13% vs 3.11%) (all P<0.05). The presence of medical insurance (employee medical insurance, OR=1.986, 95% CI 1.130-3.492; resident medical insurance, OR=1.291, 95% CI 1.044-1.598) was positively associated with the health management level of hypertension among empty-nest elderly, while low frequency of blood pressure monitoring (once a week, OR=0.243, 95% CI 0.101-0.583;≤once a month, OR=0.210, 95% CI 0.067-0.661) and irregular medication taking (occasionally forget, OR=0.430, 95% CI 0.186-0.996; often forget, OR=0.361, 95% CI 0.147-0.886) were negatively associated with the health management level of hypertension among empty-nest elderly (all P<0.05). Conclusions:The health management level of hypertension in empty-nest elderly needs to be improved. Community care, medical services and communication with children are the main needs in the empty-nest elderly. The type of medical insurance, frequency of blood pressure monitoring and medication-taking status are correlated with the hypertension management level in empty-nest elderly.