中国全科医学2026，Vol.29Issue(13)：1660-1665,1681,7.DOI:10.12114/j.issn.1007-9572.2024.0688
高血压患者8年就医行为轨迹及影响因素分析
Analysis of the 8-year Trajectories and Influencing Factors of Medical-help-seeking Behavior of Hypertensive Patients
摘要
Abstract
Background Hypertension has become a major health issue,impacting both health and quality of life.Due to its long course of illness,multiple and complex complications,and lack of a cure or correcting deviation,patients require lengthy and continuous support and medical management.Understanding the long-term journey and influencing factors of medical-help-seeking behaviour in hypertensive patients is crucial for developing targeted and patient-centred prevention and control strategies.Objective The study aimed to identify and analyze the long-term trajectories of medical-help-seeking behaviour among hypertensive patients who were managed by community health centres of Putuo District in Shanghai City.Using trajectory modeling to determine key behavioral patterns and the influencing factors,the study will inform hypertension prevention and treatment policies.Methods Continuous clinical records of 8 922 hypertensive patients were retrieved from Resident Electronic Health Record System of Putuo District in Shanghai from 2014 to 2021.The data include histories,encounters,diagnostic,management and follow-up information.The Group-Based Trajectory Model(GBTM)was applied to analyze the patterns of the medical-help-seeking behaviour change,simulate behavioural transitions,and identify the best fitting model.Analysis of variance and chi square test were employed to examine patient characteristics across diflerent behavioural trajectories.The persistently irregular medical-help-seeking behaviour'group served as the reference group for comparing influencing factors among medical-help-seeking behaviour trajectory groups.Results A total of 444 126 outpatient records were retrieved.The GBTM analysis revealed flve distinct medicalhelp-seeking behaviour trajectories:sustained regular(39.84%),regular with a slow decline(25.36%),U-shaped(11.43%),regular with slow increase(11.86%),and persistently irregular(14.86%).Statistical diverences were observed between these groups,including gender,age,illness duration,diabetes history,transient ischemic attack(TIA)history,and family history of high blood pressure,regular exercise habits(P<0.05).Female patients and those aged 75 years or older were more likely to transition from irregular to regular medical-help-seeking behaviour.Patients with diabetes or a history of TIA were less likely to follow irregular medical-help-seeking behaviour.Longer duration of hypertensive history and a family history were associated with a less favorable shift in behaviour.Conclusion Less than 40%of hypertensive patients consistently follow a regular medical-help-seeking behaviour.However,appropriate management strategies can promote regular medical-help-seeking behaviour,particularly in females,patients aged 75 years or above,and those with diabetes or a history of TIA.Further research is suggested identifying factors that can encourage medical help-behavioral changes in other medicalhelp-seeking behaviour trajectory groups.关键词
高血压/就医行为/行为轨迹/规律就医/行为转变/影响因素分析Key words
Hypertension/Medical-help-seeking behavioural/Behavioral trajectories/Regular medical-care-seeking/Behavioral change/Root cause analysis分类
医药卫生引用本文复制引用
吴春香,田婕,郭毅,邓波,于杰,蔡宁,沈莉..高血压患者8年就医行为轨迹及影响因素分析[J].中国全科医学,2026,29(13):1660-1665,1681,7.基金项目
上海市普陀区卫生健康系统科技创新项目(ptkwws202226) （ptkwws202226）
