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Self-management and blood pressure control in China: a community-based multicentre cross-sectional study.

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Qu, Zhan, Parry, Monica, Liu, Fang, Wen, Xiulin, Li, Jieqiong, Zhang, Yanan, Wang, Duolao ORCID: https://orcid.org/0000-0003-2788-2464 and Li, Xiaomei (2019) 'Self-management and blood pressure control in China: a community-based multicentre cross-sectional study.'. BMJ Open, Vol 9, Issue 3, e025819.

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Abstract

OBJECTIVES
This study explored the relationship between self-management and blood pressure (BP) control in China.
DESIGN
A cross-sectional study.
SETTING
Eight community health centres from four cities in the Northeast (Shenyang), Northwest (Xi'an), Southwest (Chengdu) and South (Changsha) of China.
PARTICIPANTS
A total of 873 adults with hypertension, including 360 men and 513 women. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg.
OUTCOME MEASUREMENTS
BP control was the primary outcome variable. This was categorised as good control if individuals with hypertension reduced their BP to <140/90 mm Hg, otherwise, it was categorised as poor control. Secondary outcomes included self-management, defined as: (1) context or condition-specific factors or physical/social environments (eg, age, sex, marital status, education, personal income and health insurance) and (2) process or knowledge/beliefs, self-regulation skills/abilities and social facilitation (eg, treatment, diet, exercise and risk factor management). Data were analysed using logistic regression models using SPSS V.20.
RESULTS
A total of 67.1% (n=586) participants had poor BP control. Limited outpatient care benefits in mainly rural residents (OR 2.26, 95% CI 1.06 to 4.81) and longer disease duration (OR 1.03, 95% CI 1.01 to 1.04) were associated with poor BP control. Self-management practices reduced the odds of having poor BP control (OR 0.98, 95% CI 0.97 to 0.99).
CONCLUSIONS
The individual and family self-management theory can serve as an effective theory for understanding the key contexts, processes and outcomes essential for BP control in China. Future research should evaluate the effect of a self-management intervention (eg, self-monitoring, medication adherence, regular and routine doctor visits, and social supports) for BP control in China using a multisite cluster randomised controlled trial. Sex and gender difference, cost and patient-reported outcomes should also be examined.

Item Type: Article
Subjects: WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
WG Cardiovascular System > WG 100 General works
WG Cardiovascular System > WG 20 Research (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1136/bmjopen-2018-025819
Depositing User: Stacy Murtagh
Date Deposited: 26 Mar 2019 11:27
Last Modified: 26 Mar 2019 11:27
URI: https://archive.lstmed.ac.uk/id/eprint/10485

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