RT Journal Article
SR Electronic
T1 Self-management and blood pressure control in China: a community-based multicentre cross-sectional study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e025819
DO 10.1136/bmjopen-2018-025819
VO 9
IS 3
A1 Zhan Qu
A1 Monica Parry
A1 Fang Liu
A1 Xiulin Wen
A1 Jieqiong Li
A1 Yanan Zhang
A1 Duolao Wang
A1 Xiaomei Li
YR 2019
UL http://bmjopen.bmj.com/content/9/3/e025819.abstract
AB 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.