在中国农村,高血压患者的治疗依从性仍然是一个挑战.尽管早期关于患者依从性的研究已经证实了信任医生的重要性,信任的二维结构对坚持的相对贡献和影响尚未探讨。因此,这项研究检查了患者对初级保健医生(PCPs)的信任和能力对药物依从性的影响,饮食管理,和身体活动。数据来自2017年2月至2018年5月中国54个基层医疗机构(村级)的2,533名患者。使用中文版的WakeForest医师信任量表和高血压患者的治疗依从性量表对参与者进行评估。其他信息包括地区,性别,年龄,和自我评估的健康状况。多元线性回归和结构方程模型的结果证实,患者对PCPs的信任与患者对药物的依从性呈正相关,饮食管理,和身体活动。患者对PCPs能力的信任与坚持饮食管理和体力活动呈负相关。我们得出的结论是,旨在提高PCP仁慈度的干预措施具有最大的潜力,可以提高患者对高血压治疗的依从性。在国家倡导改善PCP诊断和治疗技术的政策下,培养医生的沟通技巧可能很重要,医学伦理学,和其他仁慈的品质,以提高患者对药物和非药物治疗的依从性。
In rural China, treatment adherence of patients with hypertension remains a challenge. Although early research on patient adherence has confirmed the importance of trust in doctors, the relative contribution and influence of the two-dimensional structure of trust on adherence has not been explored. Thus, this
study examined the effects of patient trust in primary care physicians\' (PCPs) benevolence and ability on medication adherence, dietary management, and physical activity. The data were derived from 2,533 patients at 54 primary health institutions in China (village level) from February 2017 to May 2018. Participants were assessed using the Chinese version of the Wake Forest Physician Trust Scale and the Therapeutic Adherence Subscale for Hypertensive Patients. Other information included region, gender, age, and self-rated health status. The results of multiple linear regression and structural equation modeling confirmed that patient trust in PCPs\' benevolence was positively correlated with patient adherence to medication, diet management, and physical activity. Patient trust in PCPs\' ability was negatively correlated with adherence to dietary management and physical activity. We concluded that interventions aimed at increasing PCP benevolence have the greatest potential to improve patient adherence to hypertension treatment. Under the country\'s policy of advocating to improve PCPs\' diagnoses and treatment technology, it may be important to cultivate doctors\' communication skills, medical ethics, and other benevolent qualities to improve patients\' adherence with drug and Non-drug treatments.