The Effect of Health Literacy, Self-management Behavior, Self-efficacy and Social Support on the Health-related Quality of Life of Kazakh Hypertension Patients in a Low-income Rural Area of China: a structural Equation Model

Abstract

Background Considering the High Blood Pressure-Health Literacy (HBP-HL) has not been included in the study of Health-Related Quality of Life (HRQoL). The synergistic effects and the potential mechanism HBP-HL, self-management behavior, medication adherence, self-efficacy, social support on HRQoL remain unclear. This study aimed to introduce the conception of HBP-HL, and develop a structural equation model to identify the factors influencing of the HRQoL among Kazakh hypertensive patients. Methods A cross-sectional investigation study was conducted to collect data. Patients with hypertension were recruited through random cluster sampling in Kazakh settlements in Urumqi County, Xinjiang. The one-on-one household interviews were conducted by Kazakh investigators. The questionnaires regarding HBP-HL, HRQoL, self-management behavior, medication adherence, self-efficacy, and social support were collected. In addition, the results of physical examination were also included. A structural equation model was used to assess the association between the measured factors and HRQoL. Results 516 Kazakh patients were recruited, and 94.4% of them had a relatively low HBP-HL score. The mean standardized scores of HRQoL, self-management, medication adherence were poor; they were 63.5, 66.2, and 64.4, respectively. But 96.1% and 98.3% of the participants had high levels of self-efficacy and social support. The structural equation model of the HRQoL had a good overall fit (χ2/df = 2.078, AGFI = 0.944, GFI = 0.968, CFI = 0.947, IFI = 0.949, RMSEA = 0.046). The model indicated that the HBP-HL has the highest correlation with HRQoL, following with self-management behavior, social support, and self-efficacy. Conclusions Evidence from this study demonstrates that low HBP-HL is a major influenced factor of HRQoL among Kazakh hypertensive patients. Future programs should consider HBP-HL as the breakthrough point when designing targeting intervention strategies for Kazakh hypertension patients. Firstly, researchers should give a priority to evaluate patient’s HBP-HL before intervention. Next, tailored interventions are implemented for patients, and and ultimately it will contribute to control blood pressure and improve patients’ HRQoL.

Influence of chronic illness resources on self‐management and the mediating effect of patient activation among patients with coronary heart disease

“…In this study, the level of utilization of resources is unsatisfactory, and the score (2.36 ± 0.39) is less than 3 which is the intermediate point. In Table 2, the score of healthcare team is the highest in all subdomains, which is consistent with previous study (Wang & Zhang, 2020). Support from medical staff is an important resource who will give direct guidance to patients with chronic diseases during their hospitalization (Cao et al, 2018).…”