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. 2022 Jun 7;12(6):e057495.
doi: 10.1136/bmjopen-2021-057495.

Association among high blood pressure health literacy, social support and health-related quality of life among a community population with hypertension: a community-based cross-sectional study in China

Yujie Wang #  1 , Ting Chen #  1   2 , Wei Gan  1 , Jinyu Yin  1 , Li Song  1 , Huan Qi  1   3 , Qinghua Zhang  4
Affiliations

Association among high blood pressure health literacy, social support and health-related quality of life among a community population with hypertension: a community-based cross-sectional study in China

Yujie Wang et al. BMJ Open. .

Abstract

Objectives: The prevalence of hypertension is increasing worldwide. Hypertensive patients in China have limited high blood pressure health literacy (HBP-HL) and social support (SS), which may have an impact on health-related quality of life (HRQoL) and lead to poorer clinical outcomes. However, the potential mechanism of HBP-HL, SS and HRQoL remains unclear. The aim of this study was to investigate the association among HBP-HL, SS and HRQoL among community patients with hypertension in China.

Design: A community-based cross-sectional survey.

Setting: The community health service center in Huzhou, China.

Participants: 406 community patients with hypertension were investigated from June to October 2019.

Primary outcome measures: HRQoL was assessed using the Quality of Life Instruments for Chronic Diseases-Hypertension V2.0, HBP-HL was assessed with the HBP-Health Literacy Scale into Chines and SS was assessed with the Social Support Rating Scale.

Results: Compared with moderate level of HRQoL and SS, HBP-HL of community hypertensive patients was significantly deficient. Overall, 93 patients (23.2%) lacked HBP-HL, 308 patients (76.8%) had a medium level of HBP-HL, and none of them had sufficient HBP-HL. Correlation analysis showed that HBP-HL, SS and HRQoL were positively correlated (p<0.01). The significant differences in HRQoL and SS were detected in HBP-HL level (p<0.001). In multiple linear regression models, HRQoL was significantly associated with 'Print HL' and 'Medication Label' of HBP-HL (p<0.05) and all three dimensions of SS (p<0.05). In addition, The bootstrap method was used to examine the indirect effect among variables. The results showed that SS played a mediating role between HBP-HL and HRQoL (p<0.001).

Conclusion: There is an association among HBP-HL, SS and HRQoL in community hypertension patients. HBP-HL can directly affect HRQoL, and through SS mediate the HRQoL. Community intervention for hypertension management should consider HBP-HL promotion and social engagement as the breakthrough points to increase the impact on patients' HRQoL.

Keywords: Hypertension; INTERNAL MEDICINE; PUBLIC HEALTH.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Mediation model of SS, HBP-HL and HRQoL (n=401). HBP-HL, high blood pressure-health literacy; HRQoL, health-related quality of life; SS, social support. **P<0.01, ***p<0.001.
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