| 摘要: | 背景及目的：研究女性停經後罹患高血壓風險增加的論文很多。但是，探討影響病患定期服用治療藥物因子之相關研究則不多。因此，本研究針對中老年女性患者對高血壓的認知、焦慮程度與飲食行為量表得分等相關性進行研究。 實驗設計：橫斷式問卷調查研究。 研究對象與方法：以台灣地區經醫師診斷患有高血壓的中老年女性，排除年齡小於45歲的患者或心智健康狀況不佳者，以方便取樣法進行面對面訪談。問卷內容包括：基本資料、生活型態、健康狀況 、高血壓認知與態度問卷、貝克焦慮量表以及荷蘭飲食行為量表等。資料收集後以描述性統計、皮爾森卡方、費雪精確、單因子變異數分析、線性複迴歸以及多變項羅吉斯迴歸等進行分析可能的影響因子。 結果：本研究於2020年10月至2021年2月期間，共發出500份問卷（有效完成率96.0%）。受訪者平均年齡為63.7歲、身體質量指數為24.8 kg/m2、子女數以2人居多（87.1%）、教育程度以高中職最多（38.5%）、39.6%有固定職業、宗教信仰以道教者居多（36.5%）、66.5%居住在南部地區以及59.6%的患者偶爾喝茶飲習慣。受訪者中有86%沒有規律的月經週期、發現高血壓已超過三年以上的有44.2%、48.1%因身體不適而發現患有高血壓、44.8%的患者有定期服用高血壓藥物、36.5%為遺傳性高血壓、69.8%為偶爾量血壓習慣。有定期服用高血壓藥物的患者中，超過50%不知道服用藥物種類、大多是每三個月回診者、69.8%有其他慢性病以及17.7%的患者有服用中藥。另外，有定期服用高血壓藥物者在高血壓認知與態度問卷的基礎面向總分較高（P=0.001）、貝克焦慮量表總分較高（P=0.008）和荷蘭飲食行為量表總分較高（P=0.019），其中限制性飲食面向總分則較低（P=0.012）。研究也發現影響患者焦慮的相關因子有：年齡、職業、發現高血壓時是否有症狀？是否有慢性疾病？以及是否使用輔助療法等。另外，教育程度、發現高血壓時是否有症狀？以及發現高血壓時的收縮壓等，都是影響患者使用中醫治療高血壓的獨立因子。而有頭暈、呼吸困難、背部疼痛及疲憊/虛弱等症狀者，亦較會使用中醫。 結論：影響中老年女性是否定期服用治療高血壓藥物的相關因子很多，沒有定期服用藥物者較重視飲食行為，重視飲食行為者焦慮程度相對較低。本研究結果可提供醫療單位重視服用治療高血壓患者的衛教，也提供患者重視控制飲食行為，以達到減少因高血壓引起的症狀之不適。
Background: There are many papers studying the increased risk of hypertension in women after menopause. However, there were few related studies on the factor that affect patients' regular use of antihypertensive medications. Therefore, this study aimed to explore the correlation between the knowledges and attitudes hypertension, anxiety level and eating behavior scale score among middle-aged and elderly female patients. Experimental Design A: cross-sectional survey. Subjects/ Methods: In Taiwan, middle-aged and elderly women who perceived have been diagnosed with hypertension by physician, exclusive with those younger than 45 years old or those with poor mental health, use convenient sampling method to conduct face-to-face interviews. The questionnaire included basic information, lifestyle, health status, hypertension cognitive questionnaire, Baker Anxiety Inventory and dietary behavior scale. After data collection, descriptive statistics, Pearson's Chi-square test, Fisher's exact test, one-way ANOVA, multiple regression analysis and multivariate logistic regression were used to analyze possible influencing factors. Results/Conclusion/Contribution This study were sent out 500 questionnaires between October 2020 and February 2021, (effective completion rate of 96%). The average of the respondents is 63.7 years old, the BMI is 24.8kg/m2, the family size is the majority of 2 (87.1%), the highest level of education is high school (38.5%), 39.6% have a permanent occupation, and their religious belief is mostly Taoism (36.5%), 66.5% of the respondents live in the southern region and 84.6% are vegetarian occasionally or daily. 86% of the respondents had irregular menstrual cycles, 44.2% found that hypertension has been more than three years, 48.1% of the patients were found to have hypertension due to physical discomfort, 44.8% of people regularly take hypertension medications, 36.5% of patients have hereditary hypertension, and 69.8% of patients take occasional blood pressure. More than 50% of patients who took hypertension medications but did not know the type of medication, the majority returned every three months, 69.8% had other chronic diseases and 17.7% took traditional Chinese medicine. In addition, those who took hypertension medications had higher total scores on the basis of Hypertension Cognitive Questionnaires (P=0.001), higher total score on the Anxiety Scale (P=0.008), Dietary Behavior Scale (P=0.019) and the total score of Restrictive Diet is lower (0.012). The study also found that the relevant factors that affect patients' anxiety are: age, occupation, whether there are symptoms when hypertension is found? Are there any chronic diseases? And whether to use adjuvant therapy, etc. Also, education level, were there any symptoms when hypertension was detected? As well as the systolic blood pressure when hypertension is found, they are all independent factors that affect patients' use of traditional Chinese medicine to treat hypertension. Those with symptoms such as dizziness, difficulty breathing, back pain, fatigue and weakness are also more likely to use Traditional Chinese medicine. Conclusions: There are many related factors that affect whether middle-aged and elderly women take medicines for the treatment of hypertension regularly. Those who do not take drugs pay more attention to dietary behavior and relatively less anxious. The results of this study can provide health education for medical units to take care of patients with hypertension, and also provide patients with attention to control their dietary behavior, which can also reduce the discomfort of symptoms caused by hypertension. |
