| Abstract | Cilj istraživanja:Utvrditi stupanj i prediktore suradljivosti pacijenatau liječenju arterijske hipertenzije. Utvrditi odnos suradljivosti u farmakološkom i nefarmakološkom liječenju hipertenzije. Odrediti model suradljivosti hipertoničara primjenjiv u radu obiteljskih liječnika.Ispitanici i metode:Pacijenti s nekompliciranom hipertenzijom iz Rijeke, 131 žena i 169 muškaraca prosječne dobi od 53,5±8,4 godine . Suradljivost je utvrđena samoprocjenom ispitanika. Analizirani prediktori suradljivosti: antropometrijske i biološke varijable, lijekovi, laboratorijski nalazi, temeljne dimezije osobnosti, percepcija stresa, hipertenzije i infarkta, te socijalne varijable. Primijenjene su statističke metode: faktorska analiza, regresijska analiza, Pearsonov koeficijent korelacije, uz Kolmogorov-Smirnovljev, χ2, Mann-Whitneyev i t-test. Statistička značajnost odredjena jena razini vjerojatnostimanjoj od 5% ( p<0,05). Rezultati: 45% hipertenzivnih žena i 65% muškaracamotivirano je za medikamentozno liječenje, 65% muškaraca i 56% žena posjeduje znanje o primjeni antihipertenziva.57% žena i 55% muškaraca prihvaća prehranu, vježbanje, samomjerenje tlaka i posjete obiteljskom liječniku.39% žena i 32% muškaraca prihvaća ustezanje od pušenja,kave ialkohola. Muškarci su motiviraniji za medikamentozno liječenje, ali manje prihvaćaju ustezanje od pušenja, kave i alkohola.Regresijska analiza-prediktori suradljivosti: Pozitivni prediktori motivacije za uzimanje antihipertenzivasu:srednji arterijski tlak, monoterapija, diuretici, GUP, kreatinin u krvi, ekstraverzija,fiziološke smetnje, potencija hipertenzije,zadovoljstvo obiteljskim odnosima i odnosom sobiteljskim liječnikom, negativni:3-4 antihipertenziva, neuroticizam, percepcija stresa, negativne misli i emocije. Pozitivni prediktori znanja o uzimanju antihipertenzivasu:srednji arterijski tlak, multimorbiditet, 1-2 antihipertenziva, sveukupni lijekovi, GUP, LDL-kolesterol, GGT,ekstraverzija, percepcija Vstresa,potencija hipertenzije i infarkta,zadovoljstvo obiteljskim životom i odnosom s liječnikom, a negativni:blokatori kalcijskih kanala, beta blokatori, percepcija kontrole stresa i evaluacija hipertenzije . Pozitivni prediktori prehrane, vježbanja, samomjerenja tlaka i posjeta liječniku su:1-2 antihipertenziva, HDL-kolesterol, ureja, TIBC, bilirubin, ekstraverzija, socijalna poželjnost, percepcija stresa, potencija hipertenzije i infarkta, te zadovoljstvo životom, a negativni:biološki indeks bolesti, indeks tjelesne mase , odnos struk/bokovi, srednji arterijski tlak, 3-4 antihipertenziva, sveukupni lijekovi, SE eritrocita, kreatinin u krvi, UIBC, ALT, neuroticizam, psihoticizam,percepcija stresa; negativne misli i emocije,evaluacija hipertenzije iinfarkta.Pozitivni prediktori ustezanja od pušenja,kave i alkoholasu :1-2antihipertenziva; HDL-kolesterol, ureja, TIBC, bilirubin, ekstraverzija. socijalna poželjnost,percepcija stresa, potencija hipertenzije i infarkta i zadovoljstvo životom, a negativni: odnos struk/bokovi; tlak pulsa, multimorbiditet, 4 antihipertenziva, beta blokatori,ukupni i LDL-kolesterol, trigliceridi, UIBC,GGT, negativne misli i emocije, evaluacija infarkta, razvedenost inezaposlenost . Suradljivosti u medikamentoznom liječenjunisko su, iako statistički značajno povezane međusobno i s aktivnim načinom života. Ustezanje od pušenja, kave i alkoholaneznatno je povezano s prehranom, vježbanjem, samomjerenjem tlaka i posjetima liječniku. Zaključak: Suradljivost pacijenata u liječenju arterijske hipertenzije je nezadovoljavajuća. Poznavanje prediktora različitih vidova suradljivostiomogućava obiteljskom liječniku indidualiziranu intervenciju u poboljšanju suradljivosti hipertoničara. |
| Abstract (english) | Objectives :To determine the degree and predictors of patients ́ compliance in the treatment of arterial hypertension. To determine the relationship between compliance to drug treatment of hypertension and the recommended lifestyle. To determine the hypertensive patients ́ compliance model applicable in the work of family physicians. Patients and Methods: Patients with uncomplicated hypertension from Rijeka, 131 women and 169 men, mean age 53.5 ± 8.4 years. Compliance was determined by self-assessment . Analyzed predictors of compliance: anthropometric and biological variables, antihypertensives, laboratory tests, personality dimensions, perception of stress, hypertension and myocardial infarction and social variables. Applied statistical methods: factor analysis, regression analysis, Pearson ̇s correlation coefficient, and Kolmogorov-Smirnov, χ2, Mann-Whitney and t-test. Statistical significance was set at probability of less than 5% (p<0.05). Results:45% of hypertensive women and 65% of men were motivated for medication, 65% men and 56% of women have knowledge about drug treatment of hypertension. 57% women and 55% of men accepted the diet, exercise, blood pressure self-measurement and visits to a family doctor. 39%women and 32% of men accepted the withdrawal from smoking, coffee and alcohol. Mene were more motivated for medication, but less accepted the withdrawal from smoking, coffee and alcohol. Regression analysis: Positive predictors of motivation for taking antihypertensiveswere :mean arterial pressure, monotherapy, diuretics, plasma glucose, creatinine, extraversion, physiological disturbances, potency of hypertension, satisfaction with family relations and relationship with the family doctor, and negative: 3-4 antihypertensives, neuroticism, perceived stress and negative thoughts and emotions. Positive predictors of knowledge about taking antihypertensiveswere :mean arterial pressure, multimorbidity, 1-2 antihypertensives, all drugs, plasma glucose, LDL-cholesterol, GGT, VIIextraversion, perceived stress, potency of hypertension and myocardial infarction , satisfaction with family life and relationship with the doctor, and negative: calcium channel blockers, beta blockers, perception of stress control, potency and evaluation of hypertension. Positive predictors of the diet, exercise, blood pressure self-measurements and visiting family doctorwere:1-2 antihypertensive drugs, HDL-cholesterol, urea, TIBC, bilirubin, extraversion, social desirability, perceived stress, potency of hypertension and myocardial infarction and life satisfaction, and negative : a biological index of disease, body mass index, the waist / hips ratio, mean arterial pressure, 3-4 antihypertensive drugs, all drugs, sedimentation of erythrocytes, creatinine, UIBC, ALT, neuroticism, psychoticism, perceived stress, negative thoughts and emotions, evaluation of hypertension and myocardial infarction. Positive predictors of the withrawal from smoking,coffee and alcoholwere:1-2 antihypertensives, HDL-cholesterol, urea, TIBC, bilirubin, extraversion, social desirability, perceived stress, potency of hypertension and myocardial infarction and life satisfaction, and negative: the waist / hips ratio, pulse pressure, multimorbidity, 4 antihypertensives, beta blockers, total and LDL-cholesterol, triglycerides, UIBC, GGT, negative thoughts and emotions , evaluation of myocardial infarction, being divorced and unemployed. Compliance dimensions of drug treatmentwere slightlyand significantly related to each other and to the active lifestyle. Withdrawal from smoking, coffee and alcoholwere barely and significantly associated with diet, exercise, blood pressure self-measurements and visits to a family doctor.Conclusion:Compliance of patients in the treatment of arterial hypertension is unsatisfactory. Knowing predictors of various compliance forms allows a family doctor to indidualize the intervention in improving hypertensive patients ́ compliance. |
