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研究生:阮杜氏銀莊
論文名稱:MEDICAL KNOWLEDGE, ATTITUDES AND ADHERENCE OF OUTPATIENTS DIAGNOSED WITH HYPERTENSION AT THONG NHAT GENERAL HOSPITAL
論文名稱(外文):MEDICAL KNOWLEDGE, ATTITUDES AND ADHERENCE OF OUTPATIENTS DIAGNOSED WITH HYPERTENSION AT THONG NHAT GENERAL HOSPITAL
指導教授:周煌智周煌智引用關係
指導教授(外文):Huang-Chih Chou
學位類別:碩士
校院名稱:美和科技大學
系所名稱:健康照護研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:英文
論文頁數:105
中文關鍵詞:高血壓知識態度服藥依從性
外文關鍵詞:Hypertensionknowledgeattitudemedication compliance
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Background: Hypertension affects about 1.5 billion persons worldwide. Compliance to appropriate medical therapy for hypertension can result in controlled blood pressure and reduction in adverse outcomes.
Objective: To determine the relationship between knowledge, attitudes and medication compliance in patients diagnosed with hypertension. Method: A cross-sectional, descriptive study was conducted with 292 hypertensive patients (61% female, mean age: 62.61 ± 11.89). The researcher used a questionnaire with total of 37 questions. Difference is statistically significant when p <0.05, together with the 95% confidence interval.
Results: The rate of good knowledge of medication usage in outpatients diagnosed with hypertension was 66.4%; the rate of positive attitudes was 91.4% and 71.6% of patients with medication compliance. There were significant differences between knowledge about medication use with age, Marital status, education level, occupation, income, health insurance (p<0.05). There were interrelation between patient’s attitude to hypertensive use and other information such as occupation and medical insurance. There were interrelation between patient’s adherence to hypertensive use and occupation. There was tight relation between patient’s attitude and adherence to antihypertensive use. The group of patient adherent to drug use, there is relation between patient’s information and attitude to antihypertensive taking (p<0.05). Conclusion: Patients who had positive attitudes toward medication use, who were ≥ 50 years of age reported high medication compliance.

Background: Hypertension affects about 1.5 billion persons worldwide. Compliance to appropriate medical therapy for hypertension can result in controlled blood pressure and reduction in adverse outcomes.
Objective: To determine the relationship between knowledge, attitudes and medication compliance in patients diagnosed with hypertension. Method: A cross-sectional, descriptive study was conducted with 292 hypertensive patients (61% female, mean age: 62.61 ± 11.89). The researcher used a questionnaire with total of 37 questions. Difference is statistically significant when p <0.05, together with the 95% confidence interval.
Results: The rate of good knowledge of medication usage in outpatients diagnosed with hypertension was 66.4%; the rate of positive attitudes was 91.4% and 71.6% of patients with medication compliance. There were significant differences between knowledge about medication use with age, Marital status, education level, occupation, income, health insurance (p<0.05). There were interrelation between patient’s attitude to hypertensive use and other information such as occupation and medical insurance. There were interrelation between patient’s adherence to hypertensive use and occupation. There was tight relation between patient’s attitude and adherence to antihypertensive use. The group of patient adherent to drug use, there is relation between patient’s information and attitude to antihypertensive taking (p<0.05). Conclusion: Patients who had positive attitudes toward medication use, who were ≥ 50 years of age reported high medication compliance.

Abstract................................................i
Acknowledgement........................................ii
Contents..............................................iii
LIST OF FIGURES.......................................vii
LIST OF TABLES.......................................viii
ABBREVIATIONS...........................................x
Chapter 1. Introduction.................................1
1.1. Statement of this research.........................1
1.2. Significance of this research......................2
1.3. Aim of this research...............................3
1.3.1. General objectives...............................3
1.3.2. Specific objectives..............................3
Chapter 2. Literature review............................4
2.1. Theoretical framework..............................4
2.2. Current status of hypertension in Vietnam and worldwide...............................................6
2.3. Diagnostic criteria for hypertension...............6
2.4. Classification of hypertension ....................7
2.4.1 Isolated systolic hypertension....................7
2.4.2 Isolated systolic hypertension of the young.......7
2.4.3 Isolated diastolic hypertension ..................7
2.4.4 White coat hypertension and white coat effect ....7
2.4.5 Masked hypertension or isolated ambulatory hypertension............................................8
2.4.6 Pseudo hypertension...............................9
2.4.7 Orthostatic hypotension...........................9
2.5 Progression of hypertension .......................10
2.5.1 Hypertension complications.......................10
2.5.2. Prognosis.......................................11
2.6 Hypertension treatment.............................12
2.7. Challenges to medication adherence................14
2.8. Dimensions of patient adherence...................14
2.9. Knowledge, attitudes and compliance...............15
2.10. Patient compliance in hypertension ..............16
2.11. Researches on medication compliance..............17
2.12. Role of nurses in managing and improving compliance of hypertensive patients [12, 37]......................17
2.12.1. Nurses will endeavor to establish therapeutic relationships with clients 17
2.12.2 Nurses will explore clients’ expectations and beliefs regarding their hypertension management........18
2.12.3. Nurses will assess clients’ compliance to the treatment plan at each regular follow-up...............19
2.12.4. Nurses will provide the information needed for clients with hypertension to make choices related to their treatment plan...................................19
2.12.5. Nurses will work with prescribers to simplify clients’ dosing regimens..............................20
2.12.6. Nurses will encourage and remind patients to facilitate adherence...................................20
2.12.7. Nurses will ensure that patients missing appointments receive follow-up calls in order to keep them in care...........................................20
Chapter 3. Research methodology........................22
3.1 Research subjects..................................22
3.1.1 Inclusion criteria...............................22
3.1.2Exclusion criteria................................22
3.2 Research methodology...............................22
3.2.1 Study design.....................................22
3.2.2 Sample size : 292................................22
3.2.3. Sampling methods................................22
3.3 Definitions of research variables..................22
3.3.1 Personal information variables...................22
3.3.2Knowledge variables...............................24
3.3.3 Attitude variables...............................25
3.3.4 Adherence variables..............................25
3.4 Time and place of the research.....................26
3.5 Methods of data collection.........................26
3.6 Data analysis......................................26
3.6.1 Measurement scale of knowledge...................27
3.6.2 Measurement scale of attitudes...................28
3.6.3 Measurement scale of adherence...................29
4.1 Introduction ......................................31
4.2. Demographic characteristics of the study group....31
4.3. Assessment of the scale...........................33
4.3.1. Assessment of knowledge scale about hypertension...........................................33
4.3.2. Assessment of attitude scale about hypertension.35
4.3.3. Assessment of medical adherence scale about hypertension...........................................36
4.3.4. Assessment of interview questionnaire...........38
4.4. Result of good knowledge about drugs used by hypertensive patients..................................39
4.5. Result of right attitudes about drugs used by hypertensive patients..................................41
4.6. Result of drug adherence by hypertensive patients.43
4.7. Common results of knowledge, attitude and drug adherence by hypertensive patients.....................44
4.8. The results of the relationships between drug using knowledge and the personal characteristics of patients with hypertension......................................45
4.9. The results of the relationships between drug using attitudes and the personal characteristics of patients with hypertension......................................47
4.10. The results of the relationships between adherence and the personal characteristics of patients with hypertension...........................................49
4.11. The results of the relationship between adherence and knowledge of patients with hypertension............51
4.12. The results of the relationship between adherence and attitudes of patients with hypertension............52
4.13. The results of the relationships between knowledge, attitudes and adherence of patients with hypertension..52
Table 4.25: the relation between knowledge, attitudes and adherence .............................................53
Chapter 5. Discussion and conclusion...................55
5.1. DISCUSSING STUDYING METHOD........................55
5.1.1. Ethical issue in medicine.......................55
5.1.2. Discussing studying method......................55
5.2. DISSCUSSING RESULTS...............................57
5.2.1. Information of hypertensive patients............57
5.2.2. Patient’s information of antihypertensive taking.................................................58
5.2.3. Patient’s attitude to hypertensive taking......63
5.2.4. Patient’s adherence to antihypertensive using..66
5.2.5. Correlation among patient’s information to drug use, attitude to treatment, and adherence to antihypertensive taking................................68
5.3. LIMITS OF OUR RESEARCH............................71
CONCLUSION AND RECOMMENDATION..........................72
REFERENCES.............................................74
Appendixes.............................................80
Appendixe 1A – English questionnaire..................80
QUESTIONNAIRES.........................................80
Appendixe 1B – Vietnamese questionnaire...............84
Appendix 2A - English Consent..........................88
PATIENT’S INFORMED CONSENT............................89
Appendix 2B - Vietnamese Consent.......................89

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