Analysis on exercise behavior and its influencing factors among patients with hypertension in Beijing by Health belief Model

目的：研究高血压患者运动锻炼现状及影响因素，为今后实施健康促进干预和政策制定提供参考。方法对北京市顺义区879例已确诊原发性高血压患者进行问卷调查和体格检查，问卷基于健康信念模式设计，信效度良好。结果879例高血压患者每日运动锻炼量 M （Q）为3.8（0.0，10.0）千步当量。Kruskal-Walls秩和检验，文化程度（P ＜0.01）、家庭月收入（P ＜0.05）及高血压控制好坏（P ＜0.01）对日均千步当量存在影响。χ2检验，达到六千步／一万步比例从高到低依次为高中／中专／技校（45.8％／33.1％）、初中（40.8％／27.8％）、大专／大学及以上（35.3％／19.6％）、小学及以下（31.7％／20.2％），差异均有统计学意义（P ＜0.05）；高血压控制好的患者（45.4％／33.9％）比例高于控制不好的患者（36.5％／23.1％），差异均有统计学意义（P ＜0.05）。健康信念模式各因素平均得分：感知到运动对健康的影响（22.5±3.4）分，客观障碍（11.1±4.9）分，主观障碍（6.5±3.4）分，自我效能（12.2±3.6）分，提示因素（12.2±3.7）分。多重回归分析，以日均千步当量为因变量，自我效能感、客观障碍和主观障碍的偏回归系数分别为0.493、－0.284、－0.312。结论目前高血压患者的运动锻炼量严重不足，可以通过采取一些措施来提高其自我效能，减少其主观和客观障碍，以促进高血压患者的运动。Objective To explore the determinants of exercise behavior among the hypertensive patients in Bei-jing,so as to provide reference for policy-making and health promotion in the future.Methods The study enrolleda total of 879 hypertensives from Beijing Shunyi District.A questionnaire survey and blood pressure measurement were conducted.The self-designed questionnaire based on Health Belief Model (HBM) had good validity and reliability.Results Median a-mount of exercise was 3.8 thousand-step equivalent among 879 hypertensives,with quartile of (0.0,10.0).Kruskal-Wal-lis Test,the three influential factors on average daily thousand-step were education-degree (P <0.01),family income (P<0.05)and blood pressure under control or not (P <0.01).Chi-square test,the proportion of the people achieving six thousand steps/ten thousand steps:high school/secondary technical school (45.8%/33.1%) >junior high school (40.8%/27.8%) >junior college /university and above (35.3%/19.6%) >primary school and below (31.7%/20.2%),the differences were statistically significant (P <0.05);people whose blood pressure under control (45.4%/33.9%) >thoseout of control (36.5%/23.1%),the difference had statistical significance (P <0.05).Average score of each factor of HBM was:perceived the effects of exercise on the health (22.5 ±3.4),objective barriers (11.1 ± 4.9),subjective barriers (6.5 ±3.4),self-efficacy (12.2 ±3.6)and cues (12.2 ±3.7).Multiple regression analy-sis,with average daily thousand-step as the dependent variable,the partial regression coefficient of self-efficacy,objective barriers and subjective barriers was 0.493, -0.284 and -0.312,respectively.Conclusion Health promotion strategies of targeted interventions should be taken to improve the situation that physical activities are generally lacking among hyperten-sive,especially by improving their self-efficacy and reducing their objective barriers and subjective barriers.北京市自然科学基金资助项目中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)5414-4183