利用健康公平框架探索影响两个学术卫生系统有效高血压管理的患者层面因素
Justin Kramer1,2, David J Johnson1, Karen Wolf1
1Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Medical care research and review : MCRR
|December 1, 2025
概括
健康影响的社会决定因素高血压管理. 患者资源,健康素养和心理健康显著影响结果,需要个性化,公平的护理策略.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
- 心血管疾病研究研究
背景情况:
- 健康的社会决定因素 (SDOH) 是健康差异的关键驱动因素,特别是在诸如高血压等心血管结果方面.
- 了解患者层面的因素对于有效的高血压管理和减少结果差异至关重要.
研究的目的:
- 通过健康公平框架评估影响高血压管理的患者层面因素.
- 在不同临床绩效水平和地理环境中探索这些因素的差异.
主要方法:
- 定性研究涉及29名医疗保健提供者和25名高血压患者的采访.
- 在北卡罗来纳州和堪萨斯州的14个诊所 (初级保健和心脏病学) 中利用了主题分析和开放编码.
- 包括按绩效分类的诊所:高,中,低绩效.
主要成果:
- 五个患者级别的主题出现了:患者资源,健康素养,生活方式,意向性和以患者为中心的护理.
- 医疗素养是一个关键的障碍,表现不佳的诊所的提供者更频繁地引用识字挑战,并将农村与理解能力下降联系起来.
- 精神健康 (焦虑,抑郁) 被确定为影响高血压管理和治疗动机.
结论:
- 根据健康公平原则制定个性化高血压管理策略至关重要.
- 解决患者资源,健康素养和心理健康问题对于改善高血压结果至关重要.
- 医疗保健系统必须认识到并减轻SDOH对高血压护理的影响.
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