The Level and Influencing Factors of Health Assessment for Hypertensive Patients by Primary Care Physicians

Abstract

Background Primary care physicians play a vital role in the health management of hypertensive patients. Health assessment is an important tool for screening, diagnosis, and risk prediction of hypertension. Risk assessment allows early detection of target organ damage in hypertensive patients and provides a basis for treatment planning. Currently, the national public health service specification has clear requirements for health assessment for hypertensive patients, and such assessments have been carried out in primary health care institutions, but there are few reports on the competence of primary care physicians in health assessment for hypertensive patients. Objective To understand the levels of knowledge, attitude and practice (KAP) about health assessment for hypertensive patients among primary care physicians, and to analyze their influencing factors. Methods From May to June 2022, an online questionnaire survey was conducted among a multistage stratified sample of 420 primary care physicians in northern, central and southern Shanxi Province for collecting information of their baseline demographics, levels of KAP for health assessment for hypertensive patients, and hypertension assessment devices equipped in their medical institutions. Multiple linear regression was used to identify factors associated with primary care physicians' level of health assessment for hypertensive patients. Results A total of 402 cases (95.7%) who returned responsive questionnaires were finally included. The total average score of KAP of the primary care physicians on the health assessment for hypertensive patients was (127.16±18.65) , with an average score of (53.68±8.95) on the knowledge dimension, (28.62±4.09) on the attitude dimension and (44.86±7.53) on the practice dimension. The results of multiple linear regression analysis showed that work unit, the level of highest educational attainment, specialty, participation in standardized training, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, receiving health management-related training, frequency of learning chronic disease knowledge and skills organized by their medical institutions, and weekly hours of independent learning were associated with the knowledge dimension of hypertension health assessment among primary care physicians (P<0.05) . The participation in standardized training, mode of employment, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, frequency of learning chronic disease-related knowledge and management skills organized by their medical institutions, and weekly hours of independent learning were factors influencing primary care physicians' scores on the attitude dimension of hypertension health assessment (P<0.05) . Acquisition of physician qualifications, the participation in standardized training, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, receiving health management-related training, frequency of learning chronic disease-related knowledge and management skills organized by their medical institutions, and weekly hours of independent learning were factors influencing primary care physicians' scores on the behavioral dimension of hypertension health assessment (P<0.05) . In terms of the hypertension assessment equipment equipped in the medical institutions of primary care physicians, except for sphygmomanometer, height and weight measuring instruments and soft rulers for measuring waist circumference with a configuration rate of more than 96.8%, the configuration rates of routine hematology analyzers, routine urine chemistry analyzers, blood biochemistry analyzers, electrocardiogram machines, and chest X-ray (radiography) equipment (35.6%, 35.8%, 26.9%, 42.8%, and 23.1%, respectively) were all less than 45.0%, and the configuration rates of ambulatory blood pressure monitor, cardiac ultrasound machines, vascular color Doppler ultrasound equipment and funduscopic examination equipment were even lower (less than 15.0%) . Conclusion Primary care physicians have a relatively positive attitude toward health assessment for hypertensive patients, and there is still room for improvement in their levels of related knowledge and practical skills. In the future, we can improve primary healthcare services and standards by strengthening the standardized training of professional knowledge and skills of primary care physicians, improving the incentive and assessment system of primary healthcare institutions, and stimulating the awareness of independent learning of primary care physicians.

Keywords

• primary care physicians|hypertension|health assessment|knowledge-attitude-practice|root cause analysis|multiple linear regression