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Interview to study the determinants of hypertension in older adults in Taiwan: a population based cross-sectional survey

以訪談調查研究台灣老人高血壓之影響因子:一族群代表性之橫斷研究

摘要


本研究的目的在探討以受訪者問卷自陳方式來瞭解台灣中老年人的高血壓症與社會、經濟、體位指標及生活習性等因素間的關聯性。本研究之原始資料來自「1999年台灣地區中老年身心社會生活狀況長期追蹤調查」。該調查以橫斷方式對4440位53歲以上的中老年人進行在家訪談。研究發現有31.1%的台灣中老年男性自答有高血壓,女性則有38%。資料經羅吉斯迴歸分析顯示女性、年齡大及肥胖者患高血壓的可能性較高;而多攝取豆類食品者患高血壓的機率則較低。是否有吸菸、飲酒或運動等行為則與高血壓無關。本研究也發現,吸菸者及常飲酒者有低報患有高血壓的情形。本研究亦分析經實際血壓測定的樣本子群的資料,以驗證自陳高血壓的準確性,發現只有60%有高血壓的患者自答有高血壓。此結果顯示,自陳式調查低估了台灣中老年人高血壓的盛行率。自陳式調查大致可以偵測出高血壓與年齡、性別、肥胖及一些飲食因素之關聯性,但不能偵測出高血壓與吸菸、飲酒、運動或教育程度之關聯性。因此引用自陳的方式判別有無高血壓的資料時,必需格外謹慎。要減少臨床檢查與自陳方法間估計高血壓罹患率之差異,或許可以採用一個能對臨床診斷結果及受訪者之記憶力加以驗證及對照的問卷來補強。儘管有這些缺點,自陳式調查在社區健康研究方面仍佔有重要的角色。此工具在判別、衡量及追蹤台灣中老年人高血壓的致病因子等方面具重要的任務。

關鍵字

高血壓 面談式調查 自答 病歷 身體質量指數 食物 豆類 台灣 效度

並列摘要


The aim of the study was to assess the association of socioeconomic, anthropometric and lifestyle factors with self-reported hypertension in older adults in Taiwan. The data were part of the ”1999 Survey of Health and Living Status of the Elderly in Taiwan”. The survey was conducted in-home, face-to-face, by interviews of 4440 men and women, 53 years or older, in a population-based cross-sectional study. The prevalence of self-reported hypertension was 31.1% for men and 38.0% for women. A logistic regression model showed a higher probability of self-reported hypertension for female gender, older age, and greater BMI, and lower probability for increased consumption of leguminous foods. No association was observed with cigarette smoking, alcohol consumption or physical activity. Current cigarette smokers and alcohol-drinkers underreported their hypertension status. Compared to the medically measured hypertension of a sub-sample study of the same cohort, only about 60% of medically-substantiated hypertensive patients self-reported their hypertensive status, indicating that the interview survey underestimated the prevalence of hypertension in this Taiwanese elderly population. The interview survey appears to identify associations of hypertension with age, gender, BMI and some food patterns, but does not recognize the likely associations with the candidate risk factors of physical inactivity, cigarette smoking, alcohol consumption and limited education, at least in this Taiwanese population. Thus caution must be applied where interview alone categorises individual older Taiwanese as hypertensive or not. A survey which has validation or cross-checking questions about the medical diagnosis of hypertension and the likelihood of its memory and appreciation by the patient (such as method, definition, communication with patient, recall and follow-up, lifestyle advice or pharmaco-therapy, presence of cognitive impairment) may clarify the significance of the discrepancy between self-reporting and medical record. In turn, this would allow a more robust evaluation of blood pressure determinants in such populations. Nevertheless, there is a role for community-based surveys that utilise selfreporting in the identification, prioritization and surveillance of putative contributors to hypertension; this is the case where, as in the Taiwanese elderly, it assumes major importance in the burden of disease and premature mortality.

被引用紀錄


LIAO, Y. C., CHEN, L. L., WANG, H. C., LIN, J. S., LIN, T. K., & LIN, S. C. A. (2021). The Association Between Traditional Chinese Medicine Body Constitution Deviation and Essential Hypertension: A Case-Control Study. The Journal of Nursing Research, 29(4), 1-9. https://doi.org/10.1097%2fjnr.0000000000000442
王郁雯(2009)。"自報高血壓"對隨後罹患慢性疾病及死亡風險之長期預測功能〔碩士論文,亞洲大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0118-1511201215455831

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