Social capital, depressive symptoms, and perceived quality of care among hypertensive patients in primary care
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RESEARCH
Social capital, depressive symptoms, and perceived quality of care among hypertensive patients in primary care Haitao Li1* , Hui Xia2, Shijian Yi1 and Lichang Rao3
Abstract Background: Depression is an important issue in the management of hypertension. However, little attention has been paid to addressing such aspects of psychological health among patients with hypertension. We aimed to estimate the prevalence of depressive symptoms among patients with hypertension in primary care settings and to identify the potential role of social capital in predicting depressive symptoms. The influence of psychological wellbeing on the perceived quality of hypertensive care was also examined. Methods: In Shenzhen, China, an on-site cross-sectional study was conducted from March to September 2017. In total, 1046 respondents completed a face-to-face survey interview. We examined the associations between social capital, depressive symptoms, and perceived quality of care. Results: The results showed that 10.7% of patients with hypertension who attended primary care facilities had depressive symptoms. Two components of social capital—social ties (9.63 vs. 10.67; OR = 1.314, 95% CI 1.165–1.483; P 60 years), gender (male or female), employment status (employed or unemployed), level of education (primary school or lower, middle school, high school or equivalent, or 3-year college or higher), insurance status (covered by local or non-local health insurance schemes or unknown), migration status (locals or migrants based on household registration [hukou]), duration since diagnosis of hypertension, and family history of hypertension (yes, no, or unknown). Statistical analyses
All analyses were conducted using SPSS, Version 20.0. Descriptive statistics were calculated for the following respondent characteristics: gender, age group, employment status, level of education, migration status, insurance status, family history of hypertension, and duration since hypertension diagnosis. The prevalence of depressive symptoms was also calculated. The independent two-sample t-test was used to compare SC and perceived quality of care between the respondents with depressive symptoms and those who did not have depressive symptoms. Multiple logistic regression models were used to test the associations between the different types of SC and depression, and multiple linear regression models were used to test the association between depression and perceived quality of care. The models were adjusted for gender, age group, employment status, level of education, migration status, insurance status, family history of hypertension, and duration since hypertension diagnosis. Odds ratios [ORs] and β coefficients (along with 95% confidence intervals) are reported. All P-values 60
329 (35.1)
Social capital
Gender Male
584 (59.8)
Female
393 (40.2)
Education
72.4 (18.82) 104 (10.7)
Network
2.09 (2.03)
Social ties
10.56 (2.07)
Trust
3.84 (0.65)
Quality of care
Primary school or below
268 (27.9)
Middle school
332 (34
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