Qingqing Wang,1 Xiao Xin,2 Xianhua Li1,3 

1School of Nursing, Shanghai Jiao Tong University, School of Nursing, Shanghai, People’s Republic of China; 2Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University, School of Nursing, Shanghai, People’s Republic of China; 3Outpatient Department, Ruijin Hospital, Shanghai Jiao Tong University, School of Nursing, Shanghai, People’s Republic of China

Correspondence: Xianhua Li, Outpatient Department, Ruijin Hospital, Shanghai Jiao Tong University, School of Nursing, Shanghai, People’s Republic of China, Tel/Fax +8617775437057, Email elina2005@126.com

Purpose: Hypertension constitutes a significant global health issue, requiring active patient participation in self-management and health-related behaviors. Patient activation is defined as the knowledge, skills, and confidence in the management of their health. Prior studies have primarily employed total-score methods, potentially overlooking the variability in patient engagement. This study employs Latent Profile Analysis (LPA) to identify distinct patient activation profiles and investigate key predictors influencing activation levels in individuals with hypertension.
Patients and Methods: A convenience sampling method was employed to select 301 patients with essential hypertension from an outpatient clinic in a tertiary care hospital located in Shanghai for a cross-sectional study. A general demographic questionnaire, the Patient Activation Measure (PAM), the General Self-Efficacy Scale (GSES), the Health Literacy Scale for patients with chronic diseases (HLSCP), and the Hypertension Adherence Scale (TASHP) were utilized. Latent profile analysis was employed to investigate the latent profiles of patient activation, while univariate analysis and binomial logistic regression were used to identify significant predictors of patient activation types, based on factors found significant in univariate analysis.
Results: The research revealed two distinct latent profiles of patient activation in individuals with essential hypertension: High Cognition-Proactive Action Type (33.9%) and Passive Cognition-Low Skills Type (66.1%). The logistic regression analysis indicated that monthly income (OR=1.725, p< 0.05), self-efficacy (OR=1.162, p< 0.01), and health literacy (OR=1.027, p< 0.05) are significant predictors of patient activation.
Conclusion: Patients with essential hypertension exhibit diverse activation levels, with a majority (66.1%) demonstrating low skills and passive cognition, indicating the need for targeted interventions. Increased income, health literacy and self-efficacy facilitate activation. Interventions must improve self-efficacy and refine health education to enhance patient engagement and self-management.

Keywords: essential hypertension, patient activation, patient participation, latent profile analysis, health literacy, self-efficacy