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Lopes S, Diniz F, Mesquita Bastos J, Oliveira J, Polónia J, Alves AJ, Ribeiro F, Figueiredo D. "What do we think?": a qualitative exploratory study of acceptability and experiences of individuals with resistant hypertension after completing a physical exercise program (the EnRICH trial). Disabil Rehabil 2024; 46:2662-2669. [PMID: 37424233 DOI: 10.1080/09638288.2023.2229237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Aerobic exercise training programs decrease blood pressure in individuals with resistant hypertension. However, participants' experiences regarding exercise training participation are unknown and often undervalued. Therefore, participant's experiences and program acceptability of the exercise arm of the EnRicH trial, a randomized clinical trial investigating the effect of a 12-week aerobic exercise training program in individuals with resistant hypertension were analysed. METHODS An exploratory qualitative study was conducted with twenty individuals with resistant hypertension (11 males, mean age 58.9 ± 8.9 years), after the exercise program. Four focus group interviews were performed to explore participants' perspectives. The interviews were digitally audio-recorded, transcribed verbatim, and subjected to thematic analysis. RESULTS Five themes emerged from the data analyses: 1) main impacts of participating in the exercise program; 2) facilitators of adherence; 3) perceived barriers; 4) perception of the program structure; and 5) global satisfaction with the program. Positive physical and emotional changes were reported, associated with reduced perceived stress and irritability, and decreased blood pressure. Adherence to the exercise program was facilitated by personalized supervision and feedback, the personal commitment to attend the training sessions, and different schedule options. Lack of motivation, peer support, physical health limitations, and difficulty in conciliating schedules were identified as barriers to the maintenance of exercise training after the program. CONCLUSION The qualitative analysis demonstrates the acceptability of the program. Peer and health professional's support, commitment to health professionals, and boosting individual-perceived advantages are key-points to promote participants adherence.
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Affiliation(s)
- Susana Lopes
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
- Physiotherapy Department, Polytechnic of Coimbra, ESTeSC Coimbra Health School, Coimbra, Portugal
- Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Filipa Diniz
- Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
- Education and Psychology Department, University of Aveiro, Aveiro, Portugal
| | - José Mesquita Bastos
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
- Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Jorge Polónia
- Faculty of Medicine, University of Porto, Porto, Portugal
- Hypertension and Cardiovascular Risk Unit, Unidade Local de Saúde Matosinhos, Matosinhos, Portugal
| | - Alberto Jorge Alves
- Research Center in Sports Sciences, Health and Human Development, CIDESD, University of Maia, Maia, Portugal
- OncoMove, Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Fernando Ribeiro
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- Centre for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Sarfika R, Sulistiawati, Afriyanti E, Saifudin IMMY. Self-care behavior among adult patients with hypertension in Padang, West Sumatra, Indonesia: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:595-602. [PMID: 38130680 PMCID: PMC10731429 DOI: 10.33546/bnj.2915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/25/2023] [Accepted: 10/26/2023] [Indexed: 12/23/2023] Open
Abstract
Background Self-care behavior is crucial in preventing chronic diseases, such as hypertension, which has become highly prevalent in Indonesia. Hypertension, often referred to as the "silent killer" due to its asymptomatic nature, can easily go unnoticed. Neglecting its treatment can lead to severe complications, including heart disease, heart failure, and stroke. Despite adults with hypertension feeling well, embracing self-care behavior, including making healthy lifestyle choices, disease management, and enhancing life quality, remains essential. Objective This study aimed to describe the self-care behavior of adult patients with hypertension in Indonesia. Methods A cross-sectional study design was employed, involving 270 participants selected through consecutive sampling. Data were collected between 15 March and 4 April 2023, using the Hypertension Blood Pressure Self Care Profile (HBP-SCP) questionnaire in six public healthcare centers in Padang City, West Sumatra, Indonesia. The data were analyzed using descriptive analysis, Mann-Whitney, and Kruskal-Wallis tests. Results The self-care behavior among adult patients with hypertension was at a moderate level (Mean = 49.78, SD = 6.64), and it had significant differences according to ethnicity (p = 0.041), marital status (p = 0.017), and body mass index (p = 0.008). Conclusion The findings highlight the influence of diverse ethnic backgrounds, various marital statuses, and differing body mass index levels, which may lead to distinct approaches to managing hypertension. These results offer valuable insights for nurses and other healthcare professionals to develop comprehensive strategies to enhance self-care among adult patients with hypertension.
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Affiliation(s)
- Rika Sarfika
- Mental Health and Community Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | - Sulistiawati
- Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | - Esi Afriyanti
- Medical and Surgical Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
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Wee SYM, Salim H, Mawardi M, Koh YLE, Ali H, Shariff Ghazali S, Lee PY, Ching SM, Shamsuddin NH, Tan NC. Comparing and determining factors associated with hypertension self-care profiles of patients in two multi-ethnic Asian countries: cross-sectional studies between two study populations. BMJ Open 2021; 11:e044192. [PMID: 34127489 PMCID: PMC8204178 DOI: 10.1136/bmjopen-2020-044192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To compare the sociodemography, disease characteristics and hypertension self-care profiles and to determine the factors influencing Hypertension Self-Care Profiles (HTN-SCP) in two populations in primary care settings from Singapore and Malaysia. DESIGN Cross-sectional, cross national. SETTING Multi-centre, primary care clinics Malaysia and Singapore. PARTICIPANTS 1123 adults with hypertension enrolled and analysed. PRIMARY AND SECONDARY OUTCOME MEASURES Comparison between sociodemography, disease characteristics and the mean scores of HTN-SCP domains (behaviour, motivation and self-efficacy) and the factors influencing hypertension self-care. RESULTS 1123 adults with hypertension attending primary care clinics in Malaysia and Singapore were involved. The participants' mean age was 63.6 years (SD 9.7) in Singapore and 60.4 (SD 9.1) in Malaysia. Most of the participants in Singapore had tertiary education (22.3%) compared with Malaysia (13.0%), p<0.001. A higher proportion of participants from Singapore had controlled blood pressure (74.6%) compared with Malaysia (33.8%), p<0.001. The mean total score of HTN-SCP was significantly higher among Singapore participants compared with Malaysia participants 190 (SD 28) versus 184 (SD 23) (p<0.001). Similarly, the mean score for motivation domain 67 (SD 10) versus 65 (SD 9), followed by self-efficacy score 65 (SD 11) versus 62 (SD 9) and behaviour score (58 SD 9 vs 56 SD 9) were higher among Singapore participants. In both countries, the factors which influenced higher HTN-SCP mean scores across all domains were being Indian and had tertiary education. CONCLUSIONS The study population in Singapore had a higher HTN-SCP mean score compared with Malaysia. The common factors influencing higher HTN-SCP mean scores at both study sites were ethnicity and level of education. Future intervention to improve self-care among people with hypertension may need to be tailored to their behaviour, motivation and self-efficacy levels.
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Affiliation(s)
- Sabrina Yi-Mei Wee
- SingHealth Polyclinics, Singapore
- Family Medicine Academic Clinical Programme, SingHealth Duke-NUS, Singapore
| | - Hani Salim
- Department of Family Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Maliza Mawardi
- Department of Family Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Hanifatiyah Ali
- Department of Family Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Universiti Putra Malaysia, Serdang, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia
| | - Ping Yein Lee
- UM eHealth Unit, University of Malaya, Kuala Lumpur, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore
- Family Medicine Academic Clinical Programme, SingHealth Duke-NUS, Singapore
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Effects of Self-Efficacy, Depression, and Anger on Health-Promoting Behaviors of Korean Elderly Women with Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176296. [PMID: 32872450 PMCID: PMC7504112 DOI: 10.3390/ijerph17176296] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/25/2022]
Abstract
The prevalence of hypertension among women in Korea aged 65 years or older is 61.7%. Past research has emphasized the importance of health-promoting behaviors in hypertension management for the elderly. The purpose of this cross-sectional study was to identify the effects of self-efficacy, depression, trait anger, and anger expression on the health-promoting behaviors of elderly women with hypertension. Self-report questionnaires were completed by 208 women aged 65 and older (age range: 65 to 85) diagnosed with hypertension by physicians and living in the communities of G city and N city of Gyeonggi-do in South Korea. A hierarchical regression analysis revealed that exercise (β = 0.36, p < 0.001) had the most significant effect on health-promoting behaviors, followed by depression (β = −0.31, p < 0.001), trait anger (β = 0.21, p = 0.002), anger control (β = 0.20, p < 0.001), religion (β = 0.18, p = 0.001), and self-efficacy (β = 0.18, p = 0.003). Trait anger and anger control were identified to have a more significant effect on health-promoting behaviors than self-efficacy. Thus, health-promoting behaviors were influenced by exercise, depression, anger, religion, and self-efficacy. It is necessary to implement a nursing intervention strategy which pays attention to these factors to improve health-promoting behaviors of Korean community-dwelling elderly women.
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Shim JS, Heo JE, Kim HC. Factors associated with dietary adherence to the guidelines for prevention and treatment of hypertension among Korean adults with and without hypertension. Clin Hypertens 2020; 26:5. [PMID: 32190348 PMCID: PMC7073010 DOI: 10.1186/s40885-020-00138-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/07/2020] [Indexed: 01/11/2023] Open
Abstract
Background Although dietary modification is strongly recommended for prevention and treatment of hypertension, little is known about which factors are associated with adherence to dietary guidelines. We investigated knowledge and attitude, perceived benefits of, barriers to, and self-efficacy of dietary therapy, and identified the factors associated with dietary adherence among adults with and without hypertension. Methods We collected information on the knowledge/attitudes and perceived benefits of dietary therapy, as well as barriers to and self-efficacy regarding dietary adherence from 497 middle-aged (34–69 years) adults who participated in the follow-up examination of the Cardiovascular and Metabolic Diseases Etiology Center (CMERC) cohort study during December 2018 and February 2019. Results Among people without hypertension, 95.5% (343/359) and 95.8% (344/359) answered that they would limit sodium intake and consume health diet, respectively, if diagnosed hypertension. However, among people with hypertension, only 79.7% (110/138) and 77.5% (107/138) reported they were limiting dietary sodium intake and having healthy diet, respectively. Frequency of diet management was not different between normotensive (34.0%) and hypertensive (35.5%) groups. Compared to normotensives, hypertensive people were more likely to have lower dietary adherence score, think they need to change their diet, think dietary change impossible, and report lower self-efficacy for following diet guidelines. Dietary management was significantly associated with cardiometabolic risk factors (OR: 1.63) and dietary education (OR: 2.19) among normotensives, while it was associated only with awareness that lifestyle modification is necessary regardless of antihypertensive medication (OR: 6.29) among hypertensive people. Good dietary adherence had significant associations with perceived barriers (OR: 0.71), self-efficacy (OR: 3.71), and dietary education (OR: 1.98) among normotensives; and with perceived barriers (OR: 0.54), self-efficacy (OR: 4.06), and dietary management (OR: 4.16) among hypertensive people. Conclusions Many Koreans have relatively low adherence to dietary guidelines for hypertension prevention and treatment. Knowledge, dietary practices, and factors affecting dietary adherence were different between adults with and without hypertension. A targeted approach will be needed to improve blood pressure control of the Korean population.
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Moore AP, Rivas CA, Stanton-Fay S, Harding S, Goff LM. Designing the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) self-management and support programme for UK African and Caribbean communities: a culturally tailored, complex intervention under-pinned by behaviour change theory. BMC Public Health 2019; 19:1146. [PMID: 31429735 PMCID: PMC6702734 DOI: 10.1186/s12889-019-7411-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 07/31/2019] [Indexed: 01/02/2023] Open
Abstract
Background UK African and Caribbean (AfC) communities are disproportionately burdened by type 2 diabetes (T2D). Promoting healthy eating and physical activity through structured education is the cornerstone of T2D care, however cultural barriers may limit engagement in these communities. In addition, changes in lifestyle behaviour are shaped by normative influences within social groups and contextual factors need to be understood to facilitate healthful behaviour change. The Behaviour Change Wheel (BCW) and associated COM-B framework offer intervention designers a systematic approach to developing interventions. The aim of this study was to apply the BCW in the design of a culturally sensitive self-management support programme for T2D in UK AfC communities. Methods An intervention development study was conducted. Focus groups were held with 41 AfC patients with T2D to understand healthful weight-management, diet and physical activity behaviours. The COM-B framework and BCW were used to evaluate the qualitative data, identify appropriate behaviour change techniques and specify the intervention components. Results Participants were motivated to avoid diabetes-related consequences although did not always understand the negative impact of their current health behaviours on long-term diabetes outcomes. Barriers to healthful behaviour included gaps in knowledge related to diet, physical activity and weight management guidance. In addition, motivation and social opportunity barriers included an acceptance of larger body sizes, rejection of body mass index for weight guidance and cultural identity being strongly linked to consumption of traditional starches. There was a lack of social opportunity to perform moderate to vigorous physical activity, although walking and dance were culturally acceptable. The resulting Healthy Eating & Active Lifestyles for Diabetes (HEAL-D) intervention uses social support, social comparison, credible sources and demonstration as key behaviour change techniques. Conclusion Use of COM-B and the BCW highlighted the need for an intervention to address motivational and social opportunity barriers to engaging in healthful behaviours, as well as addressing key gaps in knowledge. This framework facilitated the linkage of theoretical behaviour constructs with evidence-based behaviour change techniques, which will enable us to evaluate operationalisation of our chosen BCTs and their impact on behaviour change in a future feasibility study. Electronic supplementary material The online version of this article (10.1186/s12889-019-7411-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amanda P Moore
- King's College London, Departments of Diabetes & Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, Room 3.87 Franklin-Wilkins Building, Stamford Street, London, SE1 9NH, England
| | - Carol A Rivas
- Institute of Education, University College London, 18 Woburn Square, London, WC1H ONR, England
| | - Stephanie Stanton-Fay
- Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, Alexandra House, 17-19 Queens Square, WC1N 3AZ, London, England
| | - Seeromanie Harding
- King's College London, Departments of Diabetes & Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, Room 3.87 Franklin-Wilkins Building, Stamford Street, London, SE1 9NH, England
| | - Louise M Goff
- King's College London, Departments of Diabetes & Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, Room 3.87 Franklin-Wilkins Building, Stamford Street, London, SE1 9NH, England.
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Asgari MR, Bouraghi H, Mohammadpour A, Haghighat M, Ghadiri R. The role of psychosocial determinants in predicting adherence to treatment in patient with hypertension. Interv Med Appl Sci 2019; 11:8-16. [PMID: 32148898 PMCID: PMC7044565 DOI: 10.1556/1646.10.2018.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Non-adherence in patients with hypertension directly exacerbates clinical outcomes. The purpose of the present research is to study the recognition of the relationships between the perceived social support and self-efficacy and the satisfaction of health care agents and the interaction of the patient with therapeutic personnel and access to health care and the behaviors of adherence to treatment in the patients who suffer hypertension. MATERIALS AND METHODS This descriptive cross-sectional correlation study recruited 250 patients from a specialized hypertension clinic in Semnan, who completed the following questionnaires: Multidimensional Scale of Perceived Social Support, self-efficacy, adherence to treatment, access to and satisfaction with health care, and the patient's interaction with treatment personnel. RESULTS An overall statistical description of the sample consists of 89 (35.6%) men and 161 (64.4%) women (SD = 10.41, range = 51.98). Regression coefficient of previous variables (three steps) shows that self-efficacy share, consent form civil services, and job could demonstrate with 99% certainty in the changes of treatment conformity in a meaningful way. CONCLUSIONS High self-efficacy, satisfaction with health care, and a favorable job have a high direct effect on adherence to treatment in patients with hypertension and controlling hypertension. Social support and education do not have a significant impact on adherence to treatment.
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Affiliation(s)
- Mohammad Reza Asgari
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Hamid Bouraghi
- Department of Health Information Technology, School of Paramedical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Mohammadpour
- Department of Health Information Technology, School of Paramedical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mina Haghighat
- Unit of Psychology Consultation, Semnan University, Semnan, Iran
| | - Raheleh Ghadiri
- Jahadieh Health Center, Semnan University of Medical Sciences, Semnan, Iran
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Bouma AJ, van Wilgen P, Lemmink KAPM, Stewart R, Dijkstra A, Diercks RL. Barrier-belief lifestyle counseling in primary care: A randomized controlled trial of efficacy. PATIENT EDUCATION AND COUNSELING 2018; 101:2134-2144. [PMID: 30072044 DOI: 10.1016/j.pec.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 07/14/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Intervening on barrier beliefs (BBs) may inhibit the role of barriers as mediating factors in lifestyle behavior. The aim of this study was to analyze the effects of a barrier-belief counseling intervention (BBCI) on physical activity (PA) and healthy food intake. METHODS An RCT was conducted in a primary care setting among adults (aged 18-70), with two interventions: a BBCI (n = 123) and a standardized lifestyle group intervention (SLI) (n = 122). A non-treated hanging control group (n = 36) received no intervention. Outcomes on PA (accelerometer and SQUASH) and fruit and vegetable intake (self-report) were measured with follow-ups at 6, 12 and 18 months, and analyzed using multiple regression. RESULTS The BBCI was more effective on PA compared with the SLI (p < .01): in the short term all PA outcomes improved (p < .05), in the long term moderate-to-vigorous PA outcomes improved (p < .05), all with small effect sizes. No differences between interventions were found on fruit and vegetable intake. None of the outcomes in the control group changed over time. CONCLUSIONS BBCI in primary care improves PA compared with SLI. PRACTICE IMPLICATIONS The customized BB approach seems promising for implementation in healthcare practice to stimulate PA.
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Affiliation(s)
- Adrie J Bouma
- Hanze University of Applied Sciences Groningen, Institute of Sports Studies, Zernikeplein 17, 9766 AS Groningen, The Netherlands.
| | - Paul van Wilgen
- Transcare, Transdisciplinary Pain Management Centre, Barkmolenstraat 196, 9723 DM Groningen, The Netherlands.
| | - Koen A P M Lemmink
- Center for Human Movement Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Roy Stewart
- Faculty of Medical Sciences, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Arie Dijkstra
- Faculty of Behavioral and Society Sciences, Grote Kruisstraat 2/1, 9712 TS, University of Groningen, Groningen, The Netherlands.
| | - Ron L Diercks
- Department of Sports Medicine and Orthopedic Surgery, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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Giena VP, Thongpat S, Nitirat P. Predictors of health-promoting behaviour among older adults with hypertension in Indonesia. Int J Nurs Sci 2018; 5:201-205. [PMID: 31406825 PMCID: PMC6626242 DOI: 10.1016/j.ijnss.2018.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/07/2018] [Accepted: 04/02/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study aimed to determine the predictors of health-promoting behaviour among older adults with hypertension in Bengkulu City, Bengkulu, Indonesia. METHODS A cross-sectional study was conducted in 333 older adults with hypertension, who were selected using multistage sampling method. Data were obtained by face-to-face interview with structured questionnaires. The questionnaires used in this study included the Health-Promoting Lifestyle Profile II (HPLP II), Hypertension Knowledge-Level Scale (HK-LS), Self-Rated Abilities for Health Practices Scale (SRAHP), Barriers to Health-promoting Behaviour Scales (BAS), Benefits to Health-Promoting Behaviour Scales (BES), Multidimensional Scale of Perceived Social Support (MSPSS) and Situational Influences Questionnaire (SIQ). Data were analysed by using multiple linear regressions. RESULTS The mean and standard deviation (Mean ± SD) of each questionnaire were as follows: HPLP II, 2.55 ± 0.19; HK-LS, 11.83 ± 3.00; SRAHP, 2.00 ± 5.87; BAS, 27.89 ± 2.70; BES, 34.29 ± 2.29; MSPSS, 60.35 ± 8.12; and SIQ, 47.71 ± 6.66. According to the multiple linear regression model, 36.9% of the variation in health-promoting behaviour among older adults with hypertension can be explained by six variables, namely, education, knowledge, self-efficacy, perceived barriers, social support and situational influences (adjusted R 2 = 0.369). CONCLUSIONS High and good-quality education will increase the level of health-promoting behaviour, whereas barriers, such as expense and time requirement, can decrease it. Situational influences and support from family and friends can also influence the older adult's attempts to change their health behaviour. Increased self-efficacy will clearly result in improved health-promoting behaviour of older adults with hypertension.
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Ma C. An investigation of factors influencing self-care behaviors in young and middle-aged adults with hypertension based on a health belief model. Heart Lung 2018; 47:136-141. [PMID: 29395265 DOI: 10.1016/j.hrtlng.2017.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To explore whether five variables of the health belief model were factors influencing self-care behaviors in young and middle-aged adults with hypertension. BACKGROUND The self-care behaviors of young and middle-aged adults with hypertension are suboptimal in China, and the factors associated with self-care behaviors have rarely been studied in the population. METHODS A questionnaire survey was adopted in the study. 382 eligible participants were recruited from two tertiary teaching hospitals using the convenience sampling. RESULTS The predictors of self-care behaviors in young and middle-aged adults with hypertension included age, complications related to hypertension, perceived susceptibility, severity, benefits, barriers and self-efficacy. Five aspects of health beliefs model accounted for 47.0% of total variance. CONCLUSIONS The perceived susceptibility, severity, benefits, barriers, and self-efficacy were key factors affecting self-care behaviors in young and middle-aged adults with hypertension. A health education program targeting improving health beliefs for the population should be developed.
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Affiliation(s)
- Chunhua Ma
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China.
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Loeb DF, Leister E, Ludman E, Binswanger IA, Crane L, Dickinson M, Kline DM, deGruy FV, Nease D, Bayliss EA. Factors associated with physician self-efficacy in mental illness management and team-based care. Gen Hosp Psychiatry 2018; 50:111-118. [PMID: 29156252 PMCID: PMC5842160 DOI: 10.1016/j.genhosppsych.2017.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Danielle F. Loeb
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, USA;
| | - Erin Leister
- Department of Biostatistics & Informatics, Colorado School of Public Health, The Adult and Child Center for Outcomes Research and Delivery Science, Aurora, USA.
| | | | - Ingrid A. Binswanger
- Institute for Health Research, Kaiser Permanente Colorado, Denver, USA; Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, USA
| | - Lori Crane
- The Adult and Child Center for Outcomes Research and Delivery Science, Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, USA.
| | - Miriam Dickinson
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, USA; Department of Family Medicine, University of Colorado, Aurora, USA.
| | - Danielle M. Kline
- Division of General Internal Medicine, Department of Internal Medicine, University of Colorado School of Medicine, Aurora, USA;
| | | | - Donald Nease
- Department of Family Medicine, University of Colorado, Aurora, USA.
| | - Elizabeth A. Bayliss
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA; Department of Family Medicine, University of Colorado, Aurora, CO, USA;
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Borhaninejad V, Shati M, Bhalla D, Iranpour A, Fadayevatan R. A Population-Based Survey to Determine Association of Perceived Social Support and Self-Efficacy With Self-Care Among Elderly With Diabetes Mellitus (Kerman City, Iran). Int J Aging Hum Dev 2017; 85:504-517. [PMID: 28114826 DOI: 10.1177/0091415016689474] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This survey examined association between social support and self-efficacy with self-care in elderly with diabetes. A total of 374 subjects were identified in Kerman city, Iran who responded to questionnaires on self-care, social support, and self-efficacy. Data were analyzed by using SPSS. Along with customary descriptive statistics, we also determined group difference for self-care, and Pearson correlation, and prediction value of various variables by using hierarchical multiple regression. And 67.37% of subjects were classified as poor adherence to self-care; 55.9% patients reportedly had good foot care habits, while 68.4% patients were not taking adequate physical activity. There was a significant correlation between self-care with social support and self-efficacy. Independent variables accounted for 44.3% of the variance in self-care. Diabetes care programs should aim to implement (a) weekly free-of-cost mass physical activity programs, (b) mass education adapted for gender- and age-based needs, and
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Affiliation(s)
- Vahidreza Borhaninejad
- 1 Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Shati
- 2 Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Abedin Iranpour
- 4 Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Iran
| | - Reza Fadayevatan
- 1 Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Borhaninejad V, Iranpour A, Shati M, Tahami AN, Yousefzadeh G, Fadayevatan R. Predictors of Self-care among the Elderly with Diabetes Type 2: Using Social Cognitive Theory. Diabetes Metab Syndr 2017; 11:163-166. [PMID: 27594115 DOI: 10.1016/j.dsx.2016.08.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 08/22/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Diabetes is one of the most common chronic diseases among the elderly and is also a very serious health problem. Adopting theory-based self-care behaviors is an effective means in managing such diseases. This study aimed to determine the predictors of diabetes self-care in the elderly in Kerman based on a social cognitive theory. MATERIAL AND METHODS In this cross-sectional study, 384 elderly diabetic patients who had referred to health screening centers in Kerman were chosen via cluster sampling. To collect information about self-care and its predictors, Toobert Glasgow's diabetes self-efficacy scale as well as a questionnaire was used which was based on social cognitive theory constructs. The validity and reliability of the questionnaire was confirmed. The data were analyzed using Pearson correlation and linear regression analysis in SPSS software 17. FINDINGS Among the subjects, 67.37% (252) had poor self-care ability; 29.14% (109) had average ability, and 3.40% (13) enjoyed a proper level of self- care ability. There was a significant relationship between the constructs of the social cognitive theory (knowledge, self- efficacy, social support, outcome expectations, outcome expectancy and self-regulation) and the self-care score. Furthermore, the mentioned constructs could predict 0.47% of the variance of the self-care behaviors. CONCLUSION self-care behaviors in this study were poor. Therefore, it is necessary to develop an educational intervention based on cognitive theory constructs with the goal of properly managing diabetes in the elderly patients.
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Affiliation(s)
- Vahidreza Borhaninejad
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abedin Iranpour
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Shati
- Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ahmad Naghibzadeh Tahami
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamrezan Yousefzadeh
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Fadayevatan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Daniali SS, Darani FM, Eslami AA, Mazaheri M. Relationship between Self-efficacy and Physical Activity, Medication Adherence in Chronic Disease Patients. Adv Biomed Res 2017; 6:63. [PMID: 28603704 PMCID: PMC5458405 DOI: 10.4103/2277-9175.190997] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The global epidemic of unhealthy lifestyle causes to increase chronic disease. It has been proven that psychological factors such as self-efficacy are responsible to success in the process of lifestyle change. Low self-efficacy is usually related to low level of physical activity and medication adherence. Objective of the study was to investigate the effects of self-efficacy, other physical symptoms on physical activity and medication adherence in patients with chronic illness in public health centers. MATERIALS AND METHODS A cross-sectional study was conducted on 483 patients with chronic diseases attended to governmental health care centers in Isfahan. Participants were chosen by systematic random sampling. Inclusion criteria were having a chronic illness at least 6-month ago while prescription of medication and willing to take part in the survey. The parts of Stanford Self-management Questionnaire were used. Data were analyzed by SPSS 18 software using the descriptive and analytic statistics. P < 0.05 was considered significant. RESULTS Mean age of participants was 54.8 (7.22) years. The half of participants had low self-efficacy and 87.2% had low physical activity. Nearly 80% of patients had a good medication adherence. There was a significant relationship between self-efficacy and physical activity (P = 0.336, β = 1.01, P < 0.001). CONCLUSION Although chronic disease patients had a good medication adherence, other self-care behaviors such as physical activity has been neglected. It is seemed that concentration on psychological factors such as self-efficacy should be considered as a proximal factor to improve self-care.
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Affiliation(s)
- Seyde Shahrbanoo Daniali
- Department of Health, Student Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firooze Mostafavi Darani
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Ali Eslami
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Mazaheri
- Department of Traditional Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Mansyur CL, Rustveld LO, Nash SG, Jibaja-Weiss ML. Hispanic Acculturation and Gender Differences in Support and Self-Efficacy for Managing Diabetes. DIABETES EDUCATOR 2016; 42:315-24. [DOI: 10.1177/0145721716640905] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this study was to determine whether perceived support, social norms, and their association with self-efficacy varied by gender and language-based acculturation in Hispanic men and women with uncontrolled type 2 diabetes mellitus (T2DM). Methods A cross-sectional, secondary analysis of baseline survey data from a randomized control trial. Participants were 248 Hispanic patients from 4 community health centers who participated in a culturally targeted intervention for diabetes management. Quantitative statistical methods were used, including chi-square analyses, one-way ANOVA, and multiple regression. Results Gender and language both moderated the relationship between social factors and self-efficacy. Regardless of language, better perceived support was associated with improved self-efficacy in women but not men. Dietary norms were associated with self-efficacy in English-speaking men and women, while physical activity norms were associated with self-efficacy for Spanish-speaking women only. Conclusions This study builds on previous research by exploring the extent to which the social context of diabetes self-management may vary in its effects depending on gender and acculturation. The findings revealed potentially important differences based on both gender and language, suggesting that interventions must be designed with these differences in mind. Diabetes-specific support from family members, especially spouses, may be especially important for Hispanic women. For both men and women, it may be effective to find creative ways of involving the family in creating healthier social norms and expectations.
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Affiliation(s)
- Carol L. Mansyur
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia (Dr Mansyur)
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas (Dr Rustveld, Dr Nash)
- School of Allied Health Sciences, Baylor College of Medicine, Houston, Texas (Dr Jibaja-Weiss)
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas (Dr Jibaja-Weiss)
| | - Luis O. Rustveld
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia (Dr Mansyur)
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas (Dr Rustveld, Dr Nash)
- School of Allied Health Sciences, Baylor College of Medicine, Houston, Texas (Dr Jibaja-Weiss)
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas (Dr Jibaja-Weiss)
| | - Susan G. Nash
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia (Dr Mansyur)
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas (Dr Rustveld, Dr Nash)
- School of Allied Health Sciences, Baylor College of Medicine, Houston, Texas (Dr Jibaja-Weiss)
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas (Dr Jibaja-Weiss)
| | - Maria L. Jibaja-Weiss
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia (Dr Mansyur)
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas (Dr Rustveld, Dr Nash)
- School of Allied Health Sciences, Baylor College of Medicine, Houston, Texas (Dr Jibaja-Weiss)
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas (Dr Jibaja-Weiss)
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de Oliveira MR, da Silva VM, Guedes NG, de Oliveira Lopes MV. Clinical Validation of the “Sedentary Lifestyle” Nursing Diagnosis in Secondary School Students. J Sch Nurs 2015; 32:186-94. [DOI: 10.1177/1059840515588956] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study clinically validated the nursing diagnosis of “sedentary lifestyle” (SL) among 564 Brazilian adolescents. Measures of diagnostic accuracy were calculated for defining characteristics, and Mantel–Haenszel analysis was used to identify related factors. The measures of diagnostic accuracy showed that the following defining characteristics were statistically significant: “average daily physical activity less than recommended for gender and age,” “preference for activity low in physical activity,” “nonengagement in leisure time physical activities,” and “diminished respiratory capacity.” An SL showed statistically significant associations with the following related factors: insufficient motivation for physical activity; insufficient interest in physical activity; insufficient resources for physical activity; insufficient social support for physical activity; attitudes, beliefs, and health habits that hinder physical activity; and insufficient confidence for practicing physical exercises. The study highlighted the four defining characteristics and six related factors for making decisions related to SL among adolescents.
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Gånedahl H, Zsaludek Viklund P, Carlén K, Kylberg E, Ekberg J. Work-site wellness programmes in Sweden: a cross-sectional study of physical activity, self-efficacy, and health. Public Health 2015; 129:525-30. [PMID: 25749670 DOI: 10.1016/j.puhe.2015.01.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 01/19/2015] [Accepted: 01/21/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED In Sweden, a work-site wellness programme implies reimbursing some of the expenses for health-promoting activities. Although work-site wellness programmes are readily available in Sweden, a large number of employees elect not to participate. OBJECTIVES The aim of this study was to investigate the association of physical activity, self-reported general health assessment and self-efficacy with participation in a work-site wellness programme. STUDY DESIGN A cross-sectional study design was used. METHODS An online questionnaire was distributed to employees of a manufacturing company with 2500 employees in southwest Sweden. RESULTS Those who took advantage of the work-site wellness programme assessed their general health as better and had higher assessment of physical activity. The study showed that being enlisted also implies a higher level of physical activity and general health; however, the effect sizes of these correlations were small. Self-efficacy, i.e. perceived behavioural control, was not associated with participation in the work-site wellness programme. However, self-efficacy was correlated with both general health assessment and physical activity. A regression analysis to determine explanatory contributions to the general health assessment score showed no significant contribution from participation in a work-site wellness programme, but was instead explained by perceived behavioural control and physical activity. CONCLUSIONS Given the small effect size of the difference in physical activity between participators and non-participators in the work-site wellness programme, it is probable that only a small proportion of participators changed their health-promoting activities as a result of the work-site wellness programme.
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Affiliation(s)
- H Gånedahl
- Unit of Public Health, Department of Health and Education, University of Skövde, Skövde, Sweden
| | - P Zsaludek Viklund
- Unit of Public Health, Department of Health and Education, University of Skövde, Skövde, Sweden
| | - K Carlén
- Unit of Public Health, Department of Health and Education, University of Skövde, Skövde, Sweden
| | - E Kylberg
- Unit of Public Health, Department of Health and Education, University of Skövde, Skövde, Sweden
| | - J Ekberg
- Unit for Health Analysis, Centre for Healthcare Development, County Council of Östergötland, Linköping, Sweden; Unit of Community Medicine, Department of Medicine and Health, Linköping University, Linköping, Sweden.
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Bouma AJ, van Wilgen P, Dijkstra A. The barrier-belief approach in the counseling of physical activity. PATIENT EDUCATION AND COUNSELING 2015; 98:129-136. [PMID: 25455791 DOI: 10.1016/j.pec.2014.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 09/26/2014] [Accepted: 10/06/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To understand inactivity and relapse from PA, and to develop theory-based behavior change strategies to stimulate and support maintenance of PA. METHODS We conducted a literature search to explore barriers to PA. Social cognitive theories and empirical evidence were evaluated and guided the process developing a theoretical framework and counseling strategies. RESULTS A theoretical framework is presented to understand why people do not engage in PA and often relapse once they started PA. A distinction is made between three related types of BBs. In PA counseling these three beliefs are addressed using four different BB behavior change strategies. CONCLUSION BB counseling aims to develop an individual pattern of PA for the long term that is adapted to the (often limited) motivation of the client, thereby preventing the occurrence of BBs. The client will learn to cope with factors that may inhibit PA in the future. PRACTICE IMPLICATIONS The BBs approach composes a way of counseling around the central construct of barrier-beliefs to stimulate engagement in PA independently, in the long term.
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Affiliation(s)
- Adrie J Bouma
- Hanze University of Applied Sciences Groningen, Institute of Sports Studies, Groningen, The Netherlands.
| | - Paul van Wilgen
- Transcare, Transdisciplinairy Painmanagement Center, Groningen, The Netherlands; Pain in Motion Study Group, Department of Physiotherapy and Rehabilitation Sciences, Faculty of Physical Education & Physiotherapy, Free University of Brussels, Brussels, Belgium.
| | - Arie Dijkstra
- Department of Psychology, Faculty of Behavioral- and Social Sciences, Grote Kruisstraat 2/1, 9712 TS, University of Groningen, Groningen, The Netherlands.
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Kang Y, Yang IS, Kim N. Correlates of health behaviors in patients with coronary artery disease. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 4:45-55. [PMID: 25030792 DOI: 10.1016/s1976-1317(10)60005-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 02/17/2010] [Accepted: 03/09/2010] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To investigate the effect of cardiac knowledge and cardiac self-efficacy on health behaviors after controlling for influences from associating factors of health behaviors in patients with coronary artery diseases (CADs). METHODS A descriptive correlational and cross-sectional design was used. Subjects with CADs were recruited from outpatient clinics of three academic medical centers. The cardiac knowledge, cardiac self-efficacy, and health behaviors were measured by Coronary Heart Disease Awareness and Knowledge Questionnaire, Cardiac Self-Efficacy Scale, and Health-Promoting Lifestyle Profile II respectively. The data collected were statistically analyzed by descriptive statistics, t test, Kruskal-Wallis test, analysis of variance, Pearson's correlation analysis, and the hierarchical multiple regression analysis. RESULTS A total of 157 subjects were recruited for this study. The mean age of subjects was 59.38 ± 10.04 years, and three-fourths (75.2%) were male. Subjects showed relatively low cardiac knowledge, moderately high cardiac self-efficacy, and moderate level of health behaviors. The overall model significantly explained 48% of variance in health behaviors (F = 14.52, p < .001). Among predictors, age, education, smoking status, experience of receiving patient education, and cardiac self-efficacy significantly affected health behaviors, and cardiac self-efficacy had the greatest effect on health behaviors (β= .39). However, cardiac knowledge had no statistically significant influence on health behaviors after controlling for the other factors. CONCLUSION The findings suggested that cardiac self-efficacy was shown to be the most influencing factor on health behaviors but cardiac knowledge had no influence on health behaviors. The nursing interventions tailored on the patient characteristics should be developed in order to improve the health behaviors of patients with CADs.
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Affiliation(s)
- Younhee Kang
- Associate Professor, Division of Nursing Science, College of Health Sciences, Ewha Womans University, Seoul, Korea
| | - In-Suk Yang
- Docotoral Student, Division of Nursing Science, College of Health Sciences, Ewha Womans University, Seoul, Korea
| | - Narae Kim
- Master's Student, Division of Nursing Science, College of Health Sciences, Ewha Womans University, Seoul, Korea
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The association of family social support, depression, anxiety and self-efficacy with specific hypertension self-care behaviours in Chinese local community. J Hum Hypertens 2014; 29:198-203. [PMID: 25008000 DOI: 10.1038/jhh.2014.58] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 05/23/2014] [Accepted: 05/29/2014] [Indexed: 11/09/2022]
Abstract
This study aimed to test the role of family social support, depression, anxiety and self-efficacy on specific self-care behaviours. In a local community health center, 318 patients with hypertension completed a questionnaire assessing self-care, family social support, depression, anxiety and self-efficacy in 2012. Each self-care behaviour was separately analyzed with logistic regression models. The mean score of perceived family social support for hypertension treatment was 20.91 (maximum=60). Adult children were identified as the primary support source. Approximately 22.3% and 15.4% of participants reported symptoms of anxiety and depression, respectively. Participants had moderately positive levels of confidence performing self-care (42.1±13.3 out of 60). After adjusting for demographic and health variables, a 10-unit increase in family social support increased the odds ratio (OR) of taking medication by 1.39 (95% confidence interval (CI) 1.03-1.87) and increased the OR for measuring blood pressure (BP) regularly by 1.33 (95% CI 1.02-1.74). Depression and anxiety were not associated with any self-care behaviours. A10-unit increase in self-efficacy increased the adjusted OR for performing physical exercise to 1.25 (95% CI 1.04-1.49). In conclusion, family social support was positively associated with medication adherence and regular BP measurement. Strategies to improve family social support should be developed for hypertension control, yet further prospective studies are needed to understand the effects of family social support, depression, anxiety and self-efficacy on self-care behaviours.
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Allahverdipour H, Asgharijafarabadi M, Heshmati R, Hashemiparast M. Functional status, anxiety, cardiac self-efficacy, and health beliefs of patients with coronary heart disease. Health Promot Perspect 2013; 3:217-29. [PMID: 24688971 DOI: 10.5681/hpp.2013.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 12/19/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Beliefs and emotions could effect on functional status, quality of life, and mortality amongst patients who are suffering coronary heart disease (CHD). Current study examined the role of anxiety: trait/ state, self-efficacy, health beliefs, and functional status among patient with history of CHD. METHOD In this correlational study, 105 hospitalized and outpatients patients suffering CHD in Tehran Heart Center Hospital participated by using convenience sampling method in 2012. Cardiac self-efficacy, Seattle Angina, and research-designed health beliefs questionnaires were used to gather data. RESULTS The functional status in CHD patients showed significant relationships with gender, job, and type of medical insurance of the participants (All ps<0.05). In addition , perceived vulnerability to face again cardiac attack in the future, per-ceived severity of next cardiac attack, anxiety, state anxiety and trait anxiety (All ps<0.05) had significant and negative relationships with functional status. Con-versely, the cardiac self-efficacy had a positive and significant relationship (P<0.001) with functional status. CONCLUSION Psychological factors have important role in functional status and quality of life of patients who suffering CHD. Therefore, it is necessary to emphasize on supportive and complementary programs to promote Cardiac Reha-bilita-tion Programs.
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Affiliation(s)
- Hamid Allahverdipour
- Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, 14711, Iran
| | | | - Rasoul Heshmati
- Department of Health Psychology, Tehran University, Tehran, 84449, Iran
| | - Mina Hashemiparast
- Department of Health Education, Tehran University of Medical Sciences, Tehran, Iran
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Yang SO, Jeong GH, Kim SJ, Lee SH. Correlates of self-care behaviors among low-income elderly women with hypertension in South Korea. J Obstet Gynecol Neonatal Nurs 2013; 43:97-106. [PMID: 24354464 DOI: 10.1111/1552-6909.12265] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To identify correlates of self-care behaviors among elderly, low-income Korean women with hypertension. RESEARCH DESIGN A secondary analysis of data from a community-based intervention trial for hypertension control. SETTING Three community health posts in the Gangwon province, South Korea. PARTICIPANTS Two hundred thirty-four (234) low-income elderly women (age 60-93) who had previously participated in a community-based intervention trial for hypertension control. METHODS The researchers collected data that included patient background characteristics, hypertension self-care behavior, self-efficacy of hypertension control, general knowledge of hypertension, and social support. The data were analyzed using descriptive and inferential statistics, including hierarchical regression analysis. RESULTS The model explained 41.1% of the total variance in hypertension self-care behavior scores. Among elderly, low-income Korean women, the significant factors of their hypertension self-care behavior included: (a) self-efficacy of hypertension control (β = .62), (b) social support (β = .16), and (c) age (β = -.14). Hierarchical regression analysis showed that elderly Korean women that had higher self-efficacy of hypertension control, higher social support, and were younger were more likely to have higher hypertension self-care behavior scores. CONCLUSIONS The results highlight the need for interventions that focus on improving an individual's self-efficacy and social support to enhance hypertension self-care. The findings of this study can help nurses better understand hypertension self-care behavior in elderly, low-income Korean women.
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Khan BV, Merchant N, Rahman ST, Ahmad M, Parrott JM, Umar K, Johnson J, Ferdinand KC. Changes in Central Aortic Pressure, Endothelial Function and Biomarkers in Hypertensive African-Americans with the Cardiometabolic Syndrome: Comparison of Amlodipine/Olmesartan versus Hydrochlorothiazide/Losartan. Cardiorenal Med 2013; 3:221-31. [PMID: 24474950 PMCID: PMC3901604 DOI: 10.1159/000355136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 08/14/2013] [Indexed: 01/22/2023] Open
Abstract
Sixty-six self-identified African-American subjects with stage 1 and 2 hypertension and characteristics of the cardiometabolic syndrome were treated with amlodipine/olmesartan (A/O) versus losartan/hydrochlorothiazide (L/H) for 20 weeks in an open-label, active comparator fashion. Subjects not meeting a blood pressure (BP) value of <125/75 mm Hg on either regimen at week 14 were placed on additional or alternative therapy. After 20 weeks of therapy, systolic BP was reduced by 34.6 ± 4.2 mm Hg in the A/O group and by 27.0 ± 4.1 mm Hg in the L/H group (p = 0.012 A/O vs. L/H). Diastolic BP was reduced by 16.9 ± 2.0 mm Hg in the A/O group and by 12.3 ± 2.0 mm Hg in the L/H group (p = 0.022 A/O vs. L/H). There was a substantial increase in endothelial function of 44 and 103% in the L/H and A/O groups, respectively (p < 0.005 A/O vs. L/H). Central aorta augmentation pressure was significantly reduced by 42% with the A/O treatment, and a smaller, significant reduction of 28% was observed with the L/H treatment (p = 0.034 A/O vs. L/H). There was a reduction in sIL-6 levels of 20 and 33%, a reduction in serum leptin levels of 22 and 40%, and an increase in serum adiponectin of 19 and 46% in the L/H and A/O groups, respectively (p < 0.005 A/O vs. L/H for each biomarker). Treatment with A/O after 14 weeks reduced pulse wave velocity by 22% (p = 0.011 time comparison), whereas L/H treatment had no significant effect. Our findings suggest that, in addition to effective BP reduction, A/O differentially regulates markers of inflammation and obesity, thereby potentially providing greater vascular protection.
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Affiliation(s)
- Bobby V. Khan
- Atlanta Vascular Research Foundation, Atlanta, Ga., USA
| | | | | | - Mushtaq Ahmad
- Morehouse University School of Medicine, Atlanta, Ga., USA
| | | | - Kanwal Umar
- Atlanta Vascular Research Foundation, Atlanta, Ga., USA
| | - Julie Johnson
- Atlanta Vascular Research Foundation, Atlanta, Ga., USA
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The Influence of Health Information Orientation, Attitude of Internet Health Information, and e-Health Literacy on Personal Health Behaviors. ACTA ACUST UNITED AC 2013. [DOI: 10.15814/jpr.2013.17.3.379] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Breitkopf CR, Dawson L, Grady JJ, Breitkopf DM, Nelson-Becker C, Snyder RR. Intervention to improve follow-up for abnormal Papanicolaou tests: a randomized clinical trial. Health Psychol 2013; 33:307-316. [PMID: 23730719 DOI: 10.1037/a0032722] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the effect of a theory-based, culturally targeted intervention on adherence to follow-up among low-income and minority women who experience an abnormal Pap test. METHOD 5,049 women were enrolled and underwent Pap testing. Of these, 378 had an abnormal result and 341 (90%) were randomized to one of three groups to receive their results: Intervention (I): culturally targeted behavioral and normative beliefs + knowledge/skills + salience + environmental constraints/barriers counseling; Active Control (AC): nontargeted behavioral and normative beliefs + knowledge/skills + salience + environmental constraints/barriers counseling; or Standard Care Only (SCO). The primary outcome was attendance at the initial follow-up appointment. Secondary outcomes included delay in care, completion of care at 18 months, state anxiety (STAI Y-6), depressive symptoms (CES-D), and distress (CDDQ). Anxiety was assessed at enrollment, notification of results, and 7-14 days later with the CDDQ and CES-D. RESULTS 299 women were included in intent-to-treat analyses. Adherence rates were 60% (I), 54% (AC), and 58% (SCO), p = .73. Completion rates were 39% (I) and 35% in the AC and SCO groups, p = .77. Delay in care (in days) was (M ± SD): 58 ± 75 (I), 69 ± 72 (AC), and 54 ± 75 (SCO), p = .75. Adherence was associated with higher anxiety at notification, p < .01 and delay < 90 days (vs. 90+) was associated with greater perceived personal responsibility, p < .05. Women not completing their care (vs. those who did) had higher CES-D scores at enrollment, p < .05. CONCLUSIONS A theory-based, culturally targeted message was not more effective than a nontargeted message or standard care in improving behavior.
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Affiliation(s)
| | - Lauren Dawson
- Department of Obstetrics & Gynecology, University of Texas Medical Branch
| | - James J Grady
- Department of Biostatistics, University of Connecticut Health Center
| | | | | | - Russell R Snyder
- Department of Obstetrics & Gynecology, University of Texas Medical Branch
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Guedes NG, Lopes MVDO, Cavalcante TF, Moreira RP, Araujo TLD. Revisão do diagnóstico de enfermagem Estilo de Vida Sedentário em pessoas com hipertensão arterial: análise conceitual. Rev Esc Enferm USP 2013; 47:742-9. [DOI: 10.1590/s0080-623420130000300031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo tem por finalidade revisar os componentes do diagnóstico de enfermagem Estilo de vida sedentário (EVS) propostos pela NANDA-I em indivíduos com hipertensão arterial. A revisão foi desenvolvida a partir da análise de conceito, com o auxílio do método da Revisão Integrativa da Literatura a partir de 43 artigos pesquisados em cinco bases de dados (LILACS, CINAHL, PUBMED, SCOPUS E COCHRANE). Foram utilizadas as seguintes combinações de descritores e equivalentes nas línguas inglesa e espanhola: Estilo de vida sedentário and Hipertensão e Sedentarismo and Hipertensão. O processo de revisão conduziu aos seguintes resultados: modificação da definição do EVS, de nomeações de alguns indicadores clínicos e acréscimo de outros. Considera-se que o estudo subsidiou uma direção para a eficiência diagnóstica de indicadores clínicos do EVS, contribuindo para o refinamento e o aprimoramento desse diagnóstico e seus componentes.
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The association between self-efficacy and hypertension self-care activities among African American adults. J Community Health 2012; 37:15-24. [PMID: 21547409 DOI: 10.1007/s10900-011-9410-6] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Chronic disease management requires the individual to perform varying forms of self-care behaviors. Self-efficacy, a widely used psychosocial concept, is associated with the ability to manage chronic disease. In this study, we examine the association between self-efficacy to manage hypertension and six clinically prescribed hypertension self-care behaviors. We interviewed 190 African Americans with hypertension who resided in the greater metropolitan Charlotte area about their self-efficacy and their hypertension self-care activities. Logistic regression for correlated observations was used to model the relationship between self-efficacy and adherence to hypertension self-care behaviors. Since the hypertension self-care behavior outcomes were not rare occurrences, an odds ratio correction method was used to provide a more reliable measure of the prevalence ratio (PR). Over half (59%) of participants reported having good self-efficacy to manage their hypertension. Good self-efficacy was statistically significantly associated with increased prevalence of adherence to medication (PR = 1.23, 95% CI: 1.08, 1.32), eating a low-salt diet (PR = 1.64, 95% CI: 1.07-2.20), engaging in physical activity (PR = 1.27, 95% CI: 1.08-1.39), not smoking (PR = 1.10, 95% CI: 1.01-1.15), and practicing weight management techniques (PR = 1.63, 95% CI: 1.30-1.87). Hypertension self-efficacy is strongly associated with adherence to five of six prescribed self-care activities among African Americans with hypertension. Ensuring that African Americans feel confident that hypertension is a manageable condition and that they are knowledgeable about appropriate self-care behaviors are important factors in improving hypertension self-care and blood pressure control. Health practitioners should assess individuals' self-care activities and direct them toward practical techniques to help boost their confidence in managing their blood pressure.
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Self-efficacy and barriers to multiple behavior change in low-income African Americans with hypertension. J Behav Med 2012; 36:75-85. [PMID: 22322910 DOI: 10.1007/s10865-012-9403-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 01/30/2012] [Indexed: 10/14/2022]
Abstract
Behavioral risk factors are among the preventable causes of health disparities, yet long-term change remains elusive. Many interventions are designed to increase self-efficacy, but little is known about the effect on long-term behavior change in older, low-income African Americans, especially when facing more problematic barriers. A cohort of 185 low-income African-Americans with hypertension reported barriers they encountered while undergoing a multiple behavior change trial from 2002 to 2006. The purpose of the present study was to explore the relationships between self-efficacy, barriers, and multiple behavior change over time. Higher self-efficacy seemed to be partially helpful for smoking reduction and increasing physical activity, but not for following a low-sodium diet. Addiction was indirectly associated with less reduction in smoking through lower self-efficacy. Otherwise, different barriers were associated with behavior change than were associated with self-efficacy: being "too busy" directly interfered with physical activity and "traditions" with low-sodium diet; however, they were neither the most frequently reported barriers, nor associated with lower self-efficacy. This suggests that an emphasis on self-efficacy alone may be insufficient for overcoming the most salient barriers encountered by older African Americans. Additionally, the most common perceived barriers may not necessarily be relevant to long-term behavioral outcomes.
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Song Y, Song HJ, Han HR, Park SY, Nam S, Kim MT. Unmet needs for social support and effects on diabetes self-care activities in Korean Americans with type 2 diabetes. DIABETES EDUCATOR 2012; 38:77-85. [PMID: 22222514 DOI: 10.1177/0145721711432456] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study was (1) to characterize the primary sources of social support and the extent of unmet needs for support (defined as the gap between social support needs and the receipt of social support) in a sample of Korean Americans (KAs) with type 2 diabetes and (2) to examine the effect of unmet needs for support on their self-care activities. METHODS Baseline data obtained from a community-based intervention trial were used for this study of 83 middle-aged KAs with type 2 diabetes. Study design and data analysis were guided by social cognitive theory. The key variables were dictated the order of the variables in multivariate regression analysis. RESULTS Our findings indicated that for diabetic KAs, the primary source of social support differed according to gender. Unmet needs for support were significantly associated with self-care activities, but the amount of support needs and of social support received were not. Multivariate analysis also confirmed that unmet needs for social support are a significant strong predictor of inadequate type 2 diabetes self-care activities, after controlling for other covariates. The hierarchical regression model explained about 30% of total variance in self-care activities. CONCLUSIONS The findings highlight the importance of considering unmet needs for social support when addressing self-care activities in type 2 diabetes patients. Future interventions should focus on filling gaps in social support and tailoring approaches according to key determinants, such as gender or education level, to improve self-care activities in the context of type 2 diabetes care.
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Affiliation(s)
| | - Hee-Jung Song
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
| | - Hae-Ra Han
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
| | - So-Youn Park
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
| | - Soohyun Nam
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
| | - Miyong T Kim
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
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Abstract
OBJECTIVES Self-efficacy is an important factor influencing diabetes self-management behaviours. Previous studies have examined self-efficacy as a general measure in diabetes care for all self-care treatment recommendations together. This current study was designed to examine if low self-efficacy in each of the measured self-care treatment recommendations is related to decreased adherence for each specific recommendation. METHODS The self-efficacy was measured in 119 patients for four different treatment recommendations: blood glucose self-monitoring, exercise, diet and oral medication intake and correlated with The Resistance to Treatment Questionnaire. RESULTS Significant and positive Pearson's correlations were found between the frequency of adherence to treatment recommendations and the self-efficacy regarding different recommendations. The correlation between self-efficacy and diet and physical activity was 0.5 and 0.67, respectively. The higher the resistance to treatment score, the less confident the patient is in his or her ability to adhere with treatment recommendations. This pattern was not present in adherence to medication intake. CONCLUSIONS Self-efficacy impacts adherence to treatment and therefore plays a role in the clinical outcome. The practical implication is that assessment of self-efficacy in people with diabetes may be a first step in the development of individually tailored interventions.
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Affiliation(s)
- M Mishali
- Department of Psychology, Tel Aviv University, Tel Aviv, Israel
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Longmire-Avital B, Golub SA, Parsons JT. Self-reevaluation as a critical component in sustained viral load change for HIV+ adults with alcohol problems. Ann Behav Med 2011; 40:176-83. [PMID: 20668976 DOI: 10.1007/s12160-010-9194-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Self-reevaluation is one of the ten processes of change in the transtheoretical model and involves cognitive reappraisal of how behavior change is part of one's identity. Although self-reevaluation is a critical motivator for individuals in the contemplation stage of change, few studies have examined its impact on disease progression associated with sustained behavior change. This study investigated the contribution of self-reevaluation on sustained viral load improvement among 143 participants in a randomized controlled trial testing an eight-session intervention (Project Positive Living through Understanding and Support) designed to improve treatment adherence among HIV+ adults with alcohol problems. Participants' self-reevaluation scores at 3 months emerged as significant and independent predictors of sustained improvement in viral load at 6 months, over and above self-reported HAART dose adherence (p < 0.05). Results underscore the role of self-reevaluation as a critical factor in behavioral interventions and highlight its role in sustained change necessary to slow disease progression.
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Effects of nebivolol in obese African Americans with hypertension (NOAAH): markers of inflammation and obesity in response to exercise-induced stress. J Hum Hypertens 2010; 25:196-202. [DOI: 10.1038/jhh.2010.39] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Merchant N, Searles CD, Pandian A, Rahman ST, Ferdinand KC, Umpierrez GE, Khan BV. Nebivolol in high-risk, obese African Americans with stage 1 hypertension: effects on blood pressure, vascular compliance, and endothelial function. J Clin Hypertens (Greenwich) 2010; 11:720-5. [PMID: 20021529 DOI: 10.1111/j.1751-7176.2009.00198.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The authors sought to determine whether nebivolol treatment results in changes in blood pressure (BP), nitric oxide bioavailability, and vascular function in obese African Americans with recently diagnosed stage 1 hypertension. Forty-three obese, hypertensive African Americans (mean BP: systolic, 148.8+/-14.3 mm Hg; diastolic, 90.4+/-8.2 mm Hg) were treated with nebivolol (5-10 mg/d) for 8 weeks. Primary outcomes were change in systolic and diastolic BP and efficacy in reaching normotensive BP. Mean systolic BP decreased by 9.2+/-14 mm Hg (P<.005) and diastolic BP decreased 6.8+/-9 mm Hg (P<.005) with 8 weeks of therapy. Significant improvements were seen in arterial compliance with nebivolol treatment as measured by aortic augmentation index (P<.005) and time to wave reflection (P=.013). Nebivolol treatment improved endothelial function as measured by flow-mediated dilation (P<.005). Levels of erythrocyte cellular superoxide dismutase increased with nebivolol, indirectly suggesting increased bioavailability of nitric oxide (P<.005). Monotherapy with nebivolol in obese, hypertensive African Americans results in significant systolic and diastolic BP reduction by mechanisms that include improved vascular function and compliance.
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Affiliation(s)
- Nadya Merchant
- Department of Cardiology, Emory University, 69 Jesse Hill Drive SE, Atlanta, GA30303, USA
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Lee JE, Han HR, Song H, Kim J, Kim KB, Ryu JP, Kim MT. Correlates of self-care behaviors for managing hypertension among Korean Americans: a questionnaire survey. Int J Nurs Stud 2009; 47:411-7. [PMID: 19863959 DOI: 10.1016/j.ijnurstu.2009.09.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 09/21/2009] [Accepted: 09/26/2009] [Indexed: 12/19/2022]
Abstract
BACKGROUND While self-care behaviors have been documented as one of the main determinant of hypertension control, studies investigating correlates of self-care behaviors have been rare regarding hypertension among minority population. OBJECTIVES The purpose of this study was to examine factors associated with self-care behaviors for hypertension using a community sample of Korean Americans. DESIGN A descriptive cross-sectional design. SETTINGS Community setting in the Baltimore-Washington metropolitan area. PARTICIPANTS The sample included 445 middle-aged (40-64 years of age) Korean Americans with hypertension (systolic BP > or = 140 and/or diastolic BP > or = 90 mmHg; or taking antihypertensive medication). METHODS Guided by Social Cognitive Theory, a variety of personal (age, gender, marital status, employment status, years in U.S., duration of hypertension, hypertension knowledge, hypertension belief, and hypertension control self-efficacy) and environmental (social support) factors were examined in relation to hypertension self-care behaviors, including medication-taking, exercise, diet, and weight control. RESULTS The model explained 18.0% of the total variance in self-care scores. Hierarchical multiple regression revealed that personal factors contributed significantly to the explanatory model, whereas social support did not add much. Examination of individual regression coefficients showed that Korean Americans who were older, who had longer duration of hypertension, and who had higher hypertension control self-efficacy were more likely to have higher self-care scores. CONCLUSIONS Hypertension control self-efficacy emerged as the most significant contributing factor to hypertension self-care. Future intervention programs should focus on improving hypertension control self-efficacy as a modifiable personal factor.
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Affiliation(s)
- Jong-Eun Lee
- The Johns Hopkins University, School of Nursing, Baltimore, MD 21205-2110, United States
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Daley LK, Fish AF, Frid DJ, Mitchell GL. Stage-specific education/counseling intervention in women with elevated blood pressure. ACTA ACUST UNITED AC 2009; 24:45-52. [PMID: 19523157 DOI: 10.1111/j.1751-7117.2009.00031.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Many women with elevated blood pressure who seek exercise opportunities require a flexible program with systematic follow-up. The study framework included motivational readiness (exercise stage of change) from the Transtheoretical Model and self-efficacy theory. This pilot study, which used a one-group repeated measures design, tested the feasibility of a stage-specific education/counseling intervention aimed at improving exercise outcomes in women with elevated blood pressure. Forty women completed a 2.5-hour session including prescription for moderate-vigorous exercise on their own, practice on equipment, maintenance of an exercise diary, and contracting; three follow-up calls (Weeks 1, 2, 3); a visit (Week 4); and a final call (Week 5). After the intervention, 85% of women moved to or remained in the action or maintenance stages of change, the highest levels of readiness; none relapsed. Exercise self-efficacy and benefits increased and barriers decreased (P<.05); 70% of participants increased exercise performance. The intervention was feasible. Further testing is warranted using larger samples and including a control group.
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Affiliation(s)
- Linda K Daley
- The Ohio State University College of Nursing, Columbus, OH 43210, USA.
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DuRant EM, Leslie NS, Critch EA. Managing polycystic ovary syndrome: a cognitive behavioral strategy. Nurs Womens Health 2009; 13:292-300. [PMID: 19686552 DOI: 10.1111/j.1751-486x.2009.01439.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Finset A, Gerin W. How can we promote medication adherence and lifestyle changes in hypertensive patients? PATIENT EDUCATION AND COUNSELING 2008; 72:1-2. [PMID: 18538724 DOI: 10.1016/j.pec.2008.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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