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Kim JH, Thiruvengadam R. Hypertension in an ageing population: Diagnosis, mechanisms, collateral health risks, treatments, and clinical challenges. Ageing Res Rev 2024; 98:102344. [PMID: 38768716 DOI: 10.1016/j.arr.2024.102344] [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: 07/20/2023] [Revised: 05/07/2024] [Accepted: 05/15/2024] [Indexed: 05/22/2024]
Abstract
Ageing population is considerably increasing worldwide, which is considered to reflect an improved quality of life. However, longevity in the human lifespan has increased the burden of late-life illnesses including cancer, neurodegeneration, and cardiovascular dysfunction. Of these, hypertension is the most common condition with huge health risks, with an increased prevalence among the elderly. In this review, we outline the current guidelines for defining hypertension and examine the detailed mechanisms underlying the relationship between hypertension and ageing-related outcomes, including sodium sensitivity, arterial stiffness, endothelial dysfunction, isolated systolic hypertension, white coat effect, and orthostatic hypertension. As hypertension-related collateral health risk increases among the elderly, the available management strategies are necessary to overcome the clinical treatment challenges faced among elderly population. To improve longevity and reduce adverse health effects, potential approaches producing crucial information into new era of medicine should be considered in the prevention and treatment of hypertension among elderly population. This review provides an overview of mechanisms underlying hypertension and its related collateral health risk in elderly population, along with multiple approaches and management strategies to improve the clinical challenges among elderly population.
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Affiliation(s)
- Jin Hee Kim
- Department of Integrative Bioscience & Biotechnology, Sejong University, Seoul 05006, the Republic of Korea.
| | - Rekha Thiruvengadam
- Department of Integrative Bioscience & Biotechnology, Sejong University, Seoul 05006, the Republic of Korea
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Irwan AM, Potempa K, Abikusno N, Syahrul S. Health Coaching Intervention to Improve Self-Care Management of Hypertension Among Older People in Indonesia: A Randomized Controlled Study Protocol. J Multidiscip Healthc 2024; 17:2799-2808. [PMID: 38881756 PMCID: PMC11178085 DOI: 10.2147/jmdh.s461166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/18/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose One-third of the global population is predicted to be diagnosed with hypertension (HTN) in 2025, with the percentage highest among older people. Without proper self-care management, uncontrolled HTN causes negative health consequences and decreases the quality of life. The previous scoping review identified various challenges that older adults may face in dealing with HTN and that effective approaches should consider each individual's circumstances and attributes. This study aims to investigate the efficacy and sustainable impact of an Indonesian adaptation of an 8-week nurse health coaching intervention on self-care management and self-efficacy among older people with HTN. Patients and Methods The coaching sessions will last for 30 min weekly for 8 weeks. The data will be measured at three points: baseline (initial), 1 week after the eighth health coaching session, and 3 months after concluding the intervention. Discussion This study will be the first health coaching intervention research based on motivational interviewing and cognitive behavioral therapy approach with Indonesian background adjustment. The study result will help develop a guideline for nurses and other health workers providing health coaching for older people in Indonesia and other countries with similar characteristics in terms of sociodemographics or lifestyle. Trial Registration thaiclinicaltrials.org Identifier: TCTR20230410001 (Date of registration: April 9, 2023).
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Affiliation(s)
- Andi Masyitha Irwan
- Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Syahrul Syahrul
- Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia
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Bhattarai S, Wagle D, Shrestha A, Åsvold BO, Skovlund E, Sen A. Role of Perceived Social Support in Adherence to Antihypertensives and Controlled Hypertension: Findings of a Community Survey from Urban Nepal. Patient Prefer Adherence 2024; 18:767-777. [PMID: 38558834 PMCID: PMC10981373 DOI: 10.2147/ppa.s455511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Social support is considered vital for effective management of chronic conditions, but its role in improving adherence to antihypertensive medication and control of hypertension in urban Nepal is unknown. We examined the role of social support in adherence to antihypertensives and controlled blood pressure to inform future interventions for hypertension management. Methods We analyzed cross-sectional data collected at baseline of a cluster randomized trial of hypertension patients (n=1252) in the community between May and November 2022. Multidimensional scale of perceived social support was used to measure social support, adherence to antihypertensives was measured using the Morisky medication adherence scale -8, and individuals with systolic- and diastolic- blood pressure less than 140 and 90 mmHg respectively were considered to have controlled hypertension. Modified Poisson regression models were used to estimate the prevalence ratios and corresponding 95% confidence intervals. Results We found that 914 (73%) individuals received moderate to high social support. Participants receiving high social support had a numerically lower proportion of controlled hypertension (51%) however not statistically significant. The proportion of good adherence to antihypertensives did not differ between the social support categories. There was no association in overall, family, friends, and significant other sub-scales of social support with controlled hypertension and adherence to antihypertensives. Discussion Further studies to understand the quality and mechanisms through which social support contributes to blood pressure control are needed for the health system to include social support in designing and implementing community-based interventions for hypertension management.
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Affiliation(s)
- Sanju Bhattarai
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Institute of Implementation Science and Health, Kathmandu, Nepal
| | - Dikshya Wagle
- Institute of Implementation Science and Health, Kathmandu, Nepal
| | - Archana Shrestha
- Institute of Implementation Science and Health, Kathmandu, Nepal
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Chronic Disease Epidemiology, Center of Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eva Skovlund
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Abhijit Sen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Oral Health Services and Research (Tkmidt), Trondheim, Norway
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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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Assefa B, Zeleke H, Sergo T, Misganaw M, Mekonnen N. Self-care practice and associated factors among hypertensive follow-up patients at East Gojam zone public hospitals, North West Ethiopia, 2021. J Hum Hypertens 2023; 37:854-861. [PMID: 36402827 DOI: 10.1038/s41371-022-00775-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/18/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022]
Abstract
Uncontrolled hypertension leads to cardiovascular complications and organ damage. Self-care practice is crucial for the prevention and management of hypertension by improving quality of life, preventing complications and decreasing health care expenditure. The study aimed to assess self-care practice and its associated factors among hypertensive follow up patients at East Gojjam Zone public hospitals; in Northwest Ethiopia. Quantitative cross-sectional study design and qualitative phenomenological approach were applied. The quantitative result was supported by in-depth interview. Out of 480 patients included in the study, 49% have good self-care practices. Out of the total participants 44.6% have poor in antihypertensive medication adherence, 92.5% have low in diet management, 82.8% were poorly practiced physical activity and 62.5% poor practice to weight management. Participants who cannot read and write (AOR = 3.1, 95% CI: 1.6-5.9), and have no comorbidity (AOR = 0.4, 95% CI: 0.2-0.6), uncontrolled blood pressure status (AOR = 2.1, 95% CI: 1.2-3.6), poor social support status (AOR = 2.5, 95% CI: 1.5-4.3) and unfavorable attitude (AOR = 3.1, 95% CI: 1.9-5.2) are the factors for poor self-care practice. During interview; family meal preparation habits, inadequate information about self-care practice during follow-up time, inconvenient working environment, pressure during social events to share food, negligence, and poor self-efficacy were highly described as challenges for practicing and sustaining self- care. The level of hypertension self-care practices was found to be low. Therefore, hypertension self-care practices should be strengthened throughout their follow-up time, and creating awareness in the community is highly encouraged.
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Affiliation(s)
- Birtukan Assefa
- Department of Pediatric Nursing, College of Health Sciences, Debre-Markos University, Debre-Markos, Ethiopia
| | - Haymanot Zeleke
- Department of Nursing, College of Health Sciences, Debre-Markos University, Debre-Markos, Ethiopia.
| | | | - Mekdes Misganaw
- Department of Nursing, College of Health Sciences, Bahir Dar university, Bahir Dar, Ethiopia
| | - Nakachew Mekonnen
- Department of Public Health, College of Health Sciences, Debre-Markos University, Debre Markos, Ethiopia
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Edmealem A, Geleta E, Mengesha Z, Tegegne B, Ademe S, Liknaw T. Blood pressure self-monitoring practice and associated factors among adult hypertensive patients on follow-up at South Wollo Zone Public Hospitals, Northeast Ethiopia. Open Heart 2023; 10:openhrt-2023-002274. [PMID: 36958769 PMCID: PMC10040000 DOI: 10.1136/openhrt-2023-002274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Hypertension is a silent killer that causes serious health issues in all parts of the world. It is risk factor for cardiovascular disease, stroke and kidney disease. Self-monitoring practice has been identified as an important component of hypertension management. Hence, this study aimed to assess blood pressure (BP) self-monitoring practice and associated factors among adult hypertensive patients on follow-up in South Wollo Zone public hospitals, Northeast Ethiopia. METHODS Hospital-based cross-sectional study was conducted from 1 June 2022 to 30 June 2022, among 336 adult hypertensive patients on follow-up at selected South Wollo Zone public hospitals. Data were collected by using self-administered pretested structured questionnaires; the collected data were entered into Epi-data V.4.6 and then exported to SPSS V.25 software for analysis. Descriptive statistics such as frequency and percentage were used to describe the study participants. Tables and texts were used for data presentation. Binary logistic regression was conducted to test the association between the independent and dependent variables. Adjusted OR (AOR) with 95% CI was estimated to identify the factors associated with BP self-monitoring and the level of significance was declared at p<0.05. RESULTS The proportion (95% CI) of BP self-monitoring practice among hypertensive patients in South Wollo Zone Public Hospitals was 8.93% (95% CI 6.3% to 12.5%). In the multivariable analysis, urban residence (AOR 3.97, 95% CI (1.11 to 14.20)), comorbidity (AOR 4.80, 95% CI (1.23 to 18.69)), regular healthcare professional visit (AOR 4.64, 95% CI (1.02 to 21.14)), advice on the type of devices used for BP self-monitoring (AOR 5.26, 95% CI (1.49 to 18.58)) and knowledge on hypertension self-care (AOR 13.13, 95% CI (4.21 to 40.99)) were positively associated with BP self-monitoring practice. CONCLUSION The proportion of BP self-monitoring practice was low. Living in urban areas, comorbidity, regular healthcare professional visits, advice on the type of devices used for BP self-monitoring, and knowledge of hypertension self-care were positively associated with BP self-monitoring practice.
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Affiliation(s)
- Afework Edmealem
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | - Esmael Geleta
- Department of Nursing, Tropical College of Medicine, Dessie, Ethiopia
| | - Zemen Mengesha
- Department of Nursing, Wollo University, Dessie, Ethiopia
| | | | - Sewunet Ademe
- Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Tiliksew Liknaw
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
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Tebelu DT, Tadesse TA, Getahun MS, Negussie YM, Gurara AM. Hypertension self-care practice and its associated factors in Bale Zone, Southeast Ethiopia: A multi-center cross-sectional study. J Pharm Policy Pract 2023; 16:20. [PMID: 36732868 PMCID: PMC9893557 DOI: 10.1186/s40545-022-00508-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/21/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Hypertension is a serious threat to public health globally owing to its high prevalence and related complications. It is the main risk factor for cardiovascular disease, kidney disease, eye problems, and death. Self-care practices have been emphasized as a major element in reducing and preventing complications from hypertension. Thus, this study aimed to assess hypertension self-care practices and associated factors in Bale Zone, Southeast Ethiopia. METHODS A health facility-based cross-sectional study was conducted at three public hospitals from April 1 to May 31, 2021. Data were entered into Epi-Data version 4.6 and exported to Statistical Package for the Social Sciences (SPSS) version 25.0 for analysis. The study participants were characterized using descriptive statistics. The associations between self-care practice and independent variables were modeled using binary logistic regression analysis. Adjusted odds ratios with a 95% confidence interval were used to estimate the association between self-care practice and independent variables. The statistical significance of the association was declared at p < 0.05. RESULTS This study involved 405 hypertensive patients, with a response rate of 96.7%. The overall level of good self-care practice was 33.1% (95% CI: 28.6, 37.5). The multivariable logistic regression model showed that age under 65 years (AOR = 3.77, 95% CI: 1.60-8.89), good knowledge of hypertension self-care practice (AOR = 6.36, 95% CI: 2.07-19.56), absence of a depression (AOR = 6.08, 95% CI: 1.24-29.73) and good self-efficacy (AOR = 3.33, 95% CI: 1.12-9.87) were independent predictors of good self-care practice. CONCLUSION The level of good hypertension self-care practice in the study area was low. Hence, it is crucial to expand non-communicable disease control programs and implement public health interventions on self-care for hypertension. Moreover, to enhance hypertension self-care practices, patient-centered interventions are essential.
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Zeb H, Younas A, Sundus A, Iqbal M, Ishaq K. Perceived Therapeutic Self-Care Ability of Patients in Surgical Units: A Multisite Survey. Clin Nurs Res 2023; 32:414-422. [PMID: 35209737 DOI: 10.1177/10547738221078901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Assessing patients' therapeutic self-care ability allows nurses to initialize care and implement interventions to enhance their self-care abilities. However, sociocultural beliefs and determinants can affect patients' self-care practices. This study determined perceived therapeutic self-care ability of patients in surgical units in Pakistan. A survey was conducted using a purposive sample 511 patients admitted to surgical units for at least 24 hours. Data were collected using the Urdu version of Therapeutic Self-Care Measure. The mean self-care ability score was 20.05 ± 4.3. Patients felt more prepared to take their medications, but less prepared to respond to any unforeseeable physical changes. Significant difference was found between self-care ability of male (20.68 ± 4.15) and female (19.18 ± 4.27) (p < .001) patients. A weak negative correlation was found between patient age and self-care ability (r = -0.15, p = .001). Self-care ability assessment should be included in routine discharge planning, and nurses should provide more tailored self-care discharge education to surgical patients.
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Affiliation(s)
- Hussan Zeb
- Swat College of Nursing, Swat, Pakistan.,Saidu Group of Teaching Hospital, Swat, Khyber Pakhtunkhwa, Pakistan
| | - Ahtisham Younas
- Swat College of Nursing, Swat, Pakistan.,Memorial University of Newfoundland, Canada
| | - Amara Sundus
- Al Jahra Hospital, Al Jahra, Kuwait.,Foundation University, Islamabad, Pakistan
| | | | - Khurram Ishaq
- Federal General Hospital, Chak Shahzad, Islamabad, Pakistan
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Sahile AT, Nurhussien HA. Level of self-care practices and associated factors among hypertensive patients in Addis Ababa, Ethiopia. BMC Cardiovasc Disord 2023; 23:48. [PMID: 36698084 PMCID: PMC9875385 DOI: 10.1186/s12872-023-03062-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/12/2023] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The study assessed the level of self-care practice and its predictors among hypertensive patients in the health centers of Bole Sub-city, Addis Ababa, Ethiopia. METHODS A multi-Center-based cross-sectional study that employed 370 hypertensive participants at the conveniently selected Health Centers in Bole Sub-City; from August 01-30, 2020. The researchers selected the participants based on a simple random sampling method after applying for a pre-tested interviewer-administered questionnaire and secured for informed consent. All the statistical analyses were SPSS 22.0 software based. The authors used binary logistics regression to identify the presence and strength of association; with its respective 95%CI and p-value less than five percent as a significant level. RESULTS The overall level of good self-care practice among hypertensive patients was 53.0% (95% CI: 47.2-58.8%) whereas 61.4%, 63.8%, 92.7%, 82.7%, and 18% of the study participants were adherent to medication, good weight management, non-smokers, alcohol abstainers and physical activity consecutively. Being illiterate had 2.347 and 2.084 times higher odds of having had good self-care practice compared to secondary school and a diploma or above consecutively. Being a merchant, civil, and retired were associated with good self-care practice than being unemployed. CONCLUSION AND RECOMMENDATION The study reported a lower level of self-care practice in the study settings. Educational level and occupation were factors identified for self-care practice. The authors recommended policymakers, healthcare workers, and researchers work on the identified factors of self-care practice of hypertensive participants in the study settings.
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Affiliation(s)
- Addisu Tadesse Sahile
- grid.442847.90000 0004 4914 9615Department of Public Health, Unity University, Addis Ababa, Ethiopia
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da Silva RC, de Lima NX, Lopes MVDO, da Silva VM, Cavalcante AMRZ. Ineffective health management in people with hypertension: Accuracy study. Int J Nurs Knowl 2023; 34:55-64. [PMID: 35535522 DOI: 10.1111/2047-3095.12370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/03/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension. METHODS This is a cross-sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability. RESULTS Ineffective health management is probably present in 37.5% of people with hypertension. 'Failure to include treatment regimen in daily living' was the clinical indicator with the highest sensitivity value, and 'failure to take action to reduce risk factor' had the highest specificity value. CONCLUSIONS Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario. IMPLICATIONS FOR NURSING PRACTICE This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing.
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Du M, Kong H, Ran L, Ran Y, Bai L, Du Y, Guan H, Dong Y, Zhao Y. Associations among health-promoting lifestyle, self-care agency and health-related quality of life in Bai older adults with hypertension in Yunnan China. BMC Geriatr 2022; 22:942. [PMID: 36476421 PMCID: PMC9730677 DOI: 10.1186/s12877-022-03608-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous Chinese studies focused on the prevalence and influential factors of hypertension; however, little is known about their self-care literacy and quality of life among the Bai older adults with hypertension. The purpose of this research was to explore the associations among health-promoting lifestyle, self-care agency, and health-related quality of life in Bai ethnic older patients with hypertension, as well as the related factors of hypertension self-care abilities. METHODS A total of 472 Bai ethnic hypertension older adults aged 60 and above were enrolled in this study voluntarily from 5 rural communities of the Bai ethnic group. The Exercise of Self-Care Agency Scale (ESCAS) was employed to assess the Self-care ability of hypertension for the subjects, the Health-promoting lifestyle profile II(HPLP-II) was utilized to evaluate the health behavior, and MOS 36-Item Short Form Health Survey (SF-36) was chosen to assess the HRQOL for the studying population. All descriptive analyses, including demographic characteristics, socio-economic status, and clinical characteristics were stratified by Bai hypertensive elderly. Pearson correlation analysis model was used to examine the associations among health-promoting lifestyle, self-care agency, and health-related quality of life in Bai ethnic elderly with hypertension. RESULTS The HPLP-II, ESCA, and of HRQOL levels of the subjects were low, and the mean HPLP and ESCA scores had no significant statistical variance among different age groups. Significant statistical differences were found in Bai elderly subjects in the domain of PF and PH as well as the overall score in SF-36(all P< 0.01), 60-64 year group had the highest score of the above three domains in SF-36 than other age groups. The SF-36 scores were positively associated with HPLP and ESCA levels. CONCLUSION The HPLP-II, ESCA, and of HRQOL levels of the Bai subjects were poor in the Bai ethnic hypertensive elderly. The HRQOL scores of subjects were positively connected with HPLP-II and ESCA abilities. More attention should be paid to lifestyle, healthy behaviors, and self-care abilities improvements to enhance the better HRQOL of Bai minority older adults with hypertension.
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Affiliation(s)
- Mengqi Du
- grid.21729.3f0000000419368729Teacher’s College of Columbia University, New York, NY USA
| | - Hongqian Kong
- Disease Control and Prevention Center, Yunnan Qujing, China
| | - Lingyun Ran
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yuanyuan Ran
- grid.506978.5Hunan University of Finance and Economics, Changsha, China
| | - Leixao Bai
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yongxue Du
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Hongxue Guan
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yong Dong
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Ying Zhao
- Disease Control and Prevention Center, Yunnan Lijiang, China
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Abate TW, Gedamu H, Ayalew E, Genanew A, Ergetie T, Tesfa G. A systematic review and meta-analysis of the Ethiopian cohort of adult hypertensive people's adherence to healthy behaviors. Heliyon 2022; 8:e11555. [DOI: 10.1016/j.heliyon.2022.e11555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 06/25/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022] Open
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Yazie TS, Mengistu WE, Asmare Z, Belete AM, Teshome AA, Yimer YS. Medication regimen complexity and its association with adherence and blood pressure control among hypertensive patients at selected hospitals of South Gondar Zone: A hospital based cross sectional study. PLoS One 2022; 17:e0272717. [PMID: 35980967 PMCID: PMC9387796 DOI: 10.1371/journal.pone.0272717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 07/25/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Despite the availability of effective antihypertensive medications, blood pressure (BP) control is suboptimal. High medication regimen complexity index (MRCI) is known to reduce adherence and may be the reason for poor BP control. However, there is no data in the present study areas. Hence, the aim of this study was to assess MRCI and its association with adherence and BP control among hypertensive patients at selected hospitals of South Gondar Zone. METHODS A hospital based cross sectional study was conducted from December 1, 2020 to February 30, 2021 at selected hospitals of South Gondar Zone. Medication regimen complexity and adherence was evaluated using 65-item validated tool called MRCI (Text removed at time of retraction. See retraction notice for more information.). Multivariable logistic regression analysis was done to determine the association between predictive and outcome variables. RESULTS About 3.3% of participants were classified as having high HTN specific MRCI whereas 34.75% of participants were classified as having high patient level MRCI. (Text removed at time of retraction. See retraction notice for more information.) Being illiterate, and having low HTN MRCI were more likely to have controlled BP in adjusted analyses. On the contrary, (Text removed at time of retraction. See retraction notice for more information.) not having health insurance, and having lower monthly income were less likely to have controlled BP. CONCLUSION A considerable proportion of patients had high MRCI. Having low HTN MRCI was more likely to have controlled BP. Simplification of a complex medication regimen for patients with HTN should be sought by physicians and pharmacists to improve BP control.
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Affiliation(s)
- Taklo Simeneh Yazie
- Department of Pharmacy, Pharmacology and Toxicology Unit, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Workneh Ebabu Mengistu
- School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Zemen Asmare
- School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Abebe Muche Belete
- Department of Medicine, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
| | - Assefa Agegnehu Teshome
- Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Yohannes Shumet Yimer
- Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
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Abdisa L, Balis B, Shiferaw K, Debella A, Bekele H, Girma S, Mechal A, Amare E, Kechine T, Tari K, Nigussie K, Assefa N, Letta S. Self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City administration, Eastern Ethiopia: A multi-center cross-sectional study. Front Public Health 2022; 10:911593. [PMID: 35991019 PMCID: PMC9389041 DOI: 10.3389/fpubh.2022.911593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Hypertension is a silent killer that causes serious health issues in all parts of the world. Hypertension is a risk factor for cardiovascular disease, stroke, and kidney disease. Self-care practices have been identified as an important component of hypertension management. Despite the government's commitment and the interventions of various stakeholders, the burden of hypertension and its sequel remain unabated. A recent study showed that hypertension self-care practices play a vital role in controlling and managing high blood pressure, even though there is poor self-practice among hypertensive patients in Ethiopia. Therefore, this study assessed the level of self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City Administration, Eastern Ethiopia. Methods Hospital-based cross-sectional study was conducted from June 15 to July 15/2021 among 415 adult hypertensive patients on follow-up. The participants were selected using systematic sampling. Hypertension Self-Care Activity Level Effects (H-SCALE) was used to collect data through face-to-face interviews. The SPSS version 24 was used for analysis. Logistic regression analyses were done to determine the association between the outcome and independent variables. For multivariate logistic regression models, variables having a P < 0.25 during bivariate analysis were candidates. The strength of the association was estimated using AOR and 95% CI. The level of statistical significance was declared at a p < 0.05. Results This study revealed that 52% (95% CI, 48.2–58%) had good level of self-care practices. Formal education (AOR = 3.45, 95% CI: 2.1–4.85), good knowledge about hypertension (AOR = 1.5, 95% CI: 1.17–2.1) 1.5, abstain from chewing khat (AOR = 2.01, 95% CI: 1.44–3.94), strong social support (AOR= 1.9, 95% CI: 1.16–3.1), and absence of depression (AOR = 2.03, 95% CI: 1.43–3.92) were statistically associated with a good level of self-care practices. Conclusions This study pointed out that about half of the participants had a good level of self-care practices. Formal education, good knowledge about hypertension, abstaining from khat chewing, good social support, and absence of depression showed associations with a good level of self-care practices. Therefore, public health interventions on hypertension self-care practices, and strengthening non-communicable diseases control programs are vital. Moreover, the provision of targeted education to patients can improve disease knowledge and self-care practices.
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Affiliation(s)
- Lemesa Abdisa
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
- Lemesa Abdisa
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
- *Correspondence: Bikila Balis
| | - Kasiye Shiferaw
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Sagni Girma
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Ayalnesh Mechal
- Department of Nursing, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Eldana Amare
- Department of Nursing, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Temesgen Kechine
- Department of Nursing, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Kajela Tari
- Department of Nursing and Midwifery, College of Medical and Health Science, Dilla University, Dilla, Ethiopia
| | - Kabtamu Nigussie
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Shiferaw Letta
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis. Int J Hypertens 2022; 2022:5962571. [PMID: 35879985 PMCID: PMC9308551 DOI: 10.1155/2022/5962571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/01/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patients in Ethiopia. Thus, this systematic review and meta-analysis was done to determine the pooled estimate self-care adherence. Methods This systematic review and meta-analysis was reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. An intensive search of online databases such as PubMed (MEDLINE), CINHAL, Google Scholar, and advanced Google search was made to access both published and unpublished articles that report self-care adherence among hypertensive patients in Ethiopia. The pooled estimate was done with STATA version 11 metan commands in a 95% confidence interval. The presence of heterogeneity and publication bias were detected by I2 and Egger's test, respectively. A random-effect model was obtained, and subgroup analysis was done for the management of heterogeneity. Result A total of 24 articles with a total of 7224 participants were included in the final systematic review and meta-analysis. The pooled estimate of overall self-care adherence among hypertensive patients was 36.98% (95% CI: 27.13–46.83). In subgroup analysis, the highest overall self-care adherence was observed in the Amhara region at 53% (95% CI: 46.54, 59.47). The pooled estimate of self-care dimensions such as medication adherence, low-salt diet, physical activity, smoking abstinence, alcohol abstinence, and weight management was 62.71%, 65.96%, 47.28%, 92.53%, 67.59%, and 52.54%, respectively. Conclusion The pooled estimate of good self-care adherence among hypertensive patients was low. From the dimensions of self-care, the lowest level was in physical activity and the highest level was in smoking abstinence. Comparing all regions, the lowest level of overall self-care adherence was observed in Addis Ababa, Tigray region, and South Nations and Nationalities of Ethiopia. Screening of adherence to self-care and health education should be provided to every patient during every visit.
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Pahria T, Nugroho C, Yani DI. Factors Influencing Self-Care Behaviors in Hypertension Patients With Complications. Vasc Health Risk Manag 2022; 18:463-471. [PMID: 35818584 PMCID: PMC9270883 DOI: 10.2147/vhrm.s366811] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Tuti Pahria
- Faculty of Nursing, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
| | - Cahyo Nugroho
- Faculty of Nursing, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Nursing Management Team, Majenang Hospital, Majenang, 53257, Indonesia
| | - Desy Indra Yani
- Faculty of Nursing, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Correspondence: Desy Indra Yani, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang KM 21, Jatinangor, 45363, Indonesia, Tel/Fax +62 22-7796647, Email
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Yan LD, Dévieux JG, Pierre JL, Dade E, Sufra R, St Preux S, Tymejczyk O, Nash D, Metz M, Lee MH, Fitzgerald DW, Deschamps M, Pape JW, McNairy ML, Rouzier V. The relationship between perceived stress and support with blood pressure in urban Haiti: A cross-sectional analysis. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000263. [PMID: 35785017 PMCID: PMC9249088 DOI: 10.1371/journal.pgph.0000263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/31/2022] [Indexed: 12/04/2022]
Abstract
Haiti is a low-income country whose population lives under repeated and chronic stress from multiple natural disasters, civil unrest, and extreme poverty. Stress has been associated with cardiovascular (CVD) risk factors including hypertension, and the impact of stress on blood pressure may be moderated by support. The distribution of stress, support, and their association with blood pressure has not been well described in low-income countries. We measured stress and support using validated instruments on cross-sectional enrollment data of a population-based cohort of 2,817 adults living in Port-au-Prince, Haiti between March 2019 and April 2021. Stress was measured using the Perceived Stress Scale, while support was measured using the Multidimensional Scale of Perceived Social Support. Continuous scores were categorized into three groups for stress (low (1-5), moderate (6-10), high (11-16), and five groups for support (low (7-21), low-moderate (22-35), moderate (36-49), moderate-high (50-64), high (65-77)). Linear regression models were used to quantify the associations between: 1) support and stress adjusting for age and sex, and 2) stress and blood pressure adjusting for age and sex. A moderation analysis was conducted to assess if support moderated the relationship between stress and blood pressure. The cohort included 59.7% females and the median age was 40 years (IQR 28-55). The majority had an income <1 US dollar per day. The median stress score was moderate (8 out of 16 points, IQR 6-10), and median support score was moderate to high (61 out of 77 points, IQR 49-71). Stress was higher with older ages (60+ years versus 18-29 years: +0.79 points, 95% CI 0.51 to 1.08) and in females (+0.85 points, 95% CI +0.65 to +1.06). Support was higher in males (+3.29 points, 95% CI 2.19 to 4.39). Support was inversely associated with stress, adjusting for age and sex (-0.04 points per one unit increase in support, 95% CI -0.04 to -0.03). Stress was not associated with systolic or diastolic blood pressure after adjustment for age and sex. Support did not moderate the association between stress and blood pressure. In this urban cohort of Haitian adults living with chronic civil instability and extreme poverty, perceived levels of stress and social support were moderate and high, respectively. Contrary to prior literature, we did not find an association between stress and blood pressure. While support was associated with lower stress, it did not moderate the relationship between stress and blood pressure. Participants reported high levels of support, which may be an underutilized resource in reducing stress, potentially impacting health behaviors and outcomes.
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Affiliation(s)
- Lily D. Yan
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Jessy G. Dévieux
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States of America
| | - Jean Lookens Pierre
- Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Eliezer Dade
- Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Rodney Sufra
- Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Stephano St Preux
- Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Olga Tymejczyk
- City University of New York Institute for Implementation Science in Population Health, New York, NY, United States of America
| | - Denis Nash
- City University of New York Institute for Implementation Science in Population Health, New York, NY, United States of America
| | - Miranda Metz
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Myung Hee Lee
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Dan W. Fitzgerald
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Marie Deschamps
- Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Jean W. Pape
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Margaret L. McNairy
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Vanessa Rouzier
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
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Zareban I, Araban M, Rohani MR, Karimy M, Zamani-Alavijeh F, Babanejad M, Stein LAR. High blood pressure self-care among hypertensive patients in Iran: a theory-driven study. J Hum Hypertens 2022; 36:445-452. [PMID: 33077805 DOI: 10.1038/s41371-020-00429-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/17/2020] [Accepted: 10/05/2020] [Indexed: 11/09/2022]
Abstract
High blood pressure is becoming a universal epidemic for both developed and developing countries; it is one of the main public health problems all over the world. This research was conducted to assess blood pressure self-care among hypertensive patients in Iran. This cross-sectional analytic study was conducted on 527 patients with hypertension recruited from Zarandieh, Iran in 2018. Data were gathered using questionnaires assessing socio-demographic information, social support, health belief model (HBM) constructs (perceived benefits to healthy behavior, barriers to healthy behavior, perceived disease threat, self-efficacy to engage in healthy behavior, and cues to action), and self-care activities to address blood pressure. A stepwise multiple linear regression analysis was used to determine factors associated with self-care behaviors. Overall, 512 patients (215 men and 297 women) participated in this study. Participants who were married, and more educated engaged in more self-care behaviors. At least one-half of the patients (47.6%) demonstrated a moderate level of self-care behaviors with a mean score of self-care equal to 9.32 ± 3.6 (out of 18). All the elements of HBM and social support were significant predictors of self-care behaviors and self-efficacy was the strongest predictor, followed (in descending order) by perceived barriers, social support, perceived disease threat, and perceived benefits. Health education based on HBM, enhanced with attention to social support, may help patient enact healthier behaviors to reduce blood pressure.
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Affiliation(s)
- Iraj Zareban
- Health Promotion Research Center, Zahedan of University Medical Sciences, Zahedan, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Reza Rohani
- Internal Medicine Department, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mahmood Karimy
- Ph.D. of Health Education Promotion, Department of Public Health, Faculty of Health, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Fereshteh Zamani-Alavijeh
- Ph.D. of Health Education Promotion, Department of Public Health, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehran Babanejad
- Ph.D. of Health Education Promotion, Department of Public Health, Faculty of Health, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - L A R Stein
- Department of Social & Behavioral Sciences, Brown University School of Public Health, Providence, RI, USA.,Department of Behavioral Health, Developmental Disabilities & Hospitals, Cranston, RI, USA.,Rhode Island Training School, Department of Children, Youth & Families, Cranston, RI, USA.,Department of Psychology, University of Rhode Island, South Kingstown, RI, USA
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Melaku T, Bayisa B, Fekeremaryam H, Feyissa A, Gutasa A. Self-care practice among adult hypertensive patients at ambulatory clinic of tertiary teaching Hospital in Ethiopia: a cross-sectional study. J Pharm Policy Pract 2022; 15:23. [PMID: 35317847 PMCID: PMC8939157 DOI: 10.1186/s40545-022-00421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, hypertension is a major public health problem and a strong predictor of cardiovascular disease complications. To reduce and prevent complications from hypertension, it is important to adapt self-care behaviors. This study aimed to assess the self-care practices of adult hypertensive patients at a tertiary teaching hospital in Ethiopia. METHODS A health facility-based prospective cross-sectional study was conducted at Jimma Medical Center in Ethiopia between February 2021 and July 2021. Binary and logistic regression was performed to assess the strength of associations between independent and dependent variables. Data entry and analysis were done using Statistical Package for social science (SPSS) software version 22.0. A p-value < 0.05 was considered to declare statistical significance. RESULTS From a total of 422 respondents included to the study, male accounted 55.7% and the mean ± SD age of the respondents was 58.7 ± 9.75 years. About 53.1% of patients had poor self-care practices toward hypertension. Not attending formal education [AOR = 2.15; 95% CI (1.74, 6.39); p ≤ 0.001], uncontrolled blood pressure [AOR = 2.14 95% CI (1.27, 3.61); p = 0.003], chronic disease co-morbidity [AOR = 1.48; 95% CI (0.25, 7.73); p ≤ 0.001], unfavorable attitude toward hypertension[AOR = 3.13; 95% CI (1.95, 7.52); p ≤ 0.001], and poor social support [AOR = 2.75; 95% CI (1.45, 6.43); p ≤ 0.001] were independent predictors of poor self-care practice. CONCLUSION The level of self-care practices for hypertension in the study area was low. In particular, the level of adherence to the DASH diet, exercise, and weight control was very low. Patient-specific targeted interventions are required to improve self-care practices for hypertension.
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Affiliation(s)
- Tsegaye Melaku
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Bodena Bayisa
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Helen Fekeremaryam
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Alemayehu Feyissa
- Center for Disease Control and Prevention, Oromia Regional Health Bureau, Finfinnee, Ethiopia
| | - Alemayehu Gutasa
- Department of Pharmacy, Black Lion Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
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Almalki ZS, AlOmari BA, Alshammari T, Alshlowi A, Khan MF, Hazazi A, Alruwaily M, Alsubaie S, Alanazi F, Aldossary N, Albahkali R. Uncontrolled blood pressure among hypertensive adults with rheumatoid arthritis in Saudi Arabia: A cross-sectional study. Medicine (Baltimore) 2022; 101:e28763. [PMID: 35089255 PMCID: PMC8797535 DOI: 10.1097/md.0000000000028763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 11/04/2021] [Accepted: 01/15/2022] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Despite the availability and advancement of diagnostic and treatments with demonstrated benefits in minimizing cardiovascular morbidity and mortality, hypertension control rates remain suboptimal. Therefore, this research aimed to determine the prevalence of uncontrolled BP in rheumatoid arthritis (RA) patients and understand all potential risk factors for uncontrolled BP.We conducted a cross-sectional study on RA patients in 2 rheumatology clinics in 2 public hospitals in Riyadh. Patients' information such as demographics, comorbidities, drug use, and other clinical data were captured through a review of medical records and supplemented by patient interviews. Multivariate logistic regression was utilized for the analysis to identify the significant factors of uncontrolled BP (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg).In total, 834 subjects with RA and concomitant BP were involved in this cross-sectional study. The prevalence of uncontrolled BP was found to be 31.65% among all the study population. Multivariate analysis showed that males, subjects above 60 years of age, and smokers had a distinctly higher occurrence of uncontrolled BP. Among the patients with comorbid conditions, those with obesity, hyperlipidemia, diabetes, anemia, cancer, and reflex or gastroesophageal reflux disease also showed a significantly higher risk of uncontrolled BP (P < .05).The rate of uncontrolled BP was found to be alarmingly high in the study population. Age, gender, smoking, diabetes, obesity, hyperlipidemia, cancer, gastroesophageal reflux disease, and osteoporosis are independently linked with lack of BP control.
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Affiliation(s)
- Ziyad S. Almalki
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia
| | - Bedor Abdullah AlOmari
- Internal Medicine and Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | | | - Areej Alshlowi
- Clinical Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Mohd Faiyaz Khan
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia
| | - Ali Hazazi
- College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia
| | - Maha Alruwaily
- Clinical Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Sarah Alsubaie
- Clinical Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Faten Alanazi
- Clinical Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Norah Aldossary
- Clinical Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Raseel Albahkali
- Clinical Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia
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Guo YJ, Hu XY, Ji HJ, Wang LY, Zhou XY, Tang J, Zhao Q. The status and predictors of self-care among older adults with hypertension in China using the Chinese version of Self-Care of Hypertension Inventory - A cross-sectional study. Nurs Open 2022; 9:1241-1261. [PMID: 35014206 PMCID: PMC8859094 DOI: 10.1002/nop2.1165] [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: 08/24/2020] [Revised: 09/23/2021] [Accepted: 11/16/2021] [Indexed: 11/06/2022] Open
Abstract
AIM To investigate the status and predictors of self-care among older adults with hypertension in China by the Chinese version of Self-Care of Hypertension Inventory. DESIGN A cross-sectional questionnaire survey. METHODS A convenience sampling of 544 older adults with hypertension was surveyed using the Chinese version of Self-Care of Hypertension Inventory. SPSS25.0 software was used for statistical analysis of the data. Generalized liner model univariate analysis and the optimal scaling regression analysis were performed to investigate the predictors of self-care. RESULTS The status of self-care was poor with the median and inter-quartile range of total scores of self-care (140.00 ± 67), the scores of self-care maintenance (50 ± 24.76), the scores of self-care management (56.25 ± 29.41) and the scores of self-care confidence (54.79 ± 29.17). Age, family model, primary caregiver, maximum systolic blood pressure, coverage of medical insurance, disease duration, receiving self-care education, education level, economic burden and family history of hypertension were the most powerful predictors of self-care among older adults with hypertension.
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Affiliation(s)
- Yu-Jie Guo
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Xiao-Yun Hu
- School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Hong-Juan Ji
- Department of Rehabilitation, Affiliated Hospital of Nantong University, Nantong, China
| | - Long-Yuan Wang
- Second School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | | | - Jue Tang
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Qiao Zhao
- First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
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Shrestha J, Marasine NR, Lamichhane R, Marasini NR, Sankhi S. Attitude and self-care practice on hypertension among antihypertensive medication users in a tertiary care hospital Nepal. SAGE Open Med 2021; 9:20503121211040707. [PMID: 34422274 PMCID: PMC8377311 DOI: 10.1177/20503121211040707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 08/02/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Hypertension a “silent killer” is a serious global health problem, whose prevalence is increasing in Nepal. Objective: This study aimed to determine the attitude and practice of hypertension among anti-hypertensive medication users in a tertiary care teaching hospital in western Nepal. Methodology: A hospital-based cross-sectional study design was used among 136 hypertensive patients under medication, aged ⩾ 30 years, and visiting medical outpatient department, medical ward, and geriatric ward, using a non-probability convenience sampling technique. Semi-structured questionnaires were used for data collection through interviews. Descriptive and inferential statistics were used, and a p value < 0.05 was considered statistically significant. Results: Most of the patients were male (56.6%), mean ± standard deviation age was 56.74 ± 12.58. Majority of them were Hindu (69.9%), upper caste people (29.4%), illiterate (22.1%), and house maker (27.2%). Half of the patients (50.7%) had a positive attitude and more than half (52.2%) had performed adequate self-care practice. Selected variables such as educational status and dietary pattern and attitude were significantly associated, whereas no association was found between sociodemographic variables and self-care practice. Attitude and self-care practices were found strongly associated with one another (p = 0.002). Conclusion: Our study found that half of the study population had positive attitude, and more than half of them had performed adequate self-care practice. Hence, educational interventions and awareness programs on dietary aspects should be focused for improving the attitude and practice of all the patient groups.
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Affiliation(s)
| | | | - Rajendra Lamichhane
- Department of Public Health, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
| | - Nabin Raj Marasini
- Department of Public Health, La Grandee International College, Pokhara, Nepal
| | - Sabina Sankhi
- Department of Pharmacy, Modern Technical College, Lalitpur, Nepal
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Self-Care Practice and Associated Factors among Hypertensive Patients in Debre Tabor Referral Hospital, Northwest Ethiopia, 2020. Int J Hypertens 2021; 2021:3570050. [PMID: 34422407 PMCID: PMC8376450 DOI: 10.1155/2021/3570050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/07/2021] [Indexed: 12/11/2022] Open
Abstract
Background Hypertension prevalence is continuously rising and is projected to be 1.56 billion cases by the year 2025. Despite the great progress made in the treatment of hypertension, many patients still do not achieve optimal results and experience devastating complications due to uncontrolled high blood pressure. Objective The aim of this study is to assess self-care practice and associated factors among hypertensive patients. Methods An institution-based cross-sectional study was conducted at Debre Tabor Referral Hospital, Northwest Ethiopia, from October to November 2020. A single population proportion formula and systematic random sampling technique was used to recruit 392 study participants. The data were entered to Epi-Info software version 7.1 and then exported to SPSS version 23 for analysis. A descriptive statistic was expressed as percentage, frequency, and mean. Finally, multivariable logistic regression was used to identify factors associated with dependent variable using a p value of <0.05. Results A total 392 eligible hypertensive patients participated in the study. The self-care practice among hypertension patients was found to be 54.1%. Urban residency (AOR = 2.17; 95% CI, 1.2-3.9), social support (AOR = 2.12; 95% CI, 1.13-3.39), good knowledge (AOR = 1.83; 95% CI, 1.15-2.91), age between 40 and 64 (AOR = 3.15; 95% CI, 1.19-8.3), age ≥65 (AOR = 3.81; 95% CI, 1.35-10.7), and stress control (AOR = 1.6; 95% CI, 1.06-2.67) were predictors of hypertension self-care practice. Conclusion and Recommendation. The study revealed that almost one out of two hypertension patients had good hypertension self-care practice. Good social support, age greater than 40 years, urban residency, good basic knowledge, and having stress control were positively associated with hypertensive self-care practice.
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Putri SE, Rekawati E, Wati DNK. Effectiveness of self-management on adherence to self-care and on health status among elderly people with hypertension. J Public Health Res 2021; 10. [PMID: 34060750 PMCID: PMC9309624 DOI: 10.4081/jphr.2021.2406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/14/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adherence to self-care is the goal of nursing care for elderly people with hypertension to give them optimal functional health status. The purpose of this paper is to determine the effectiveness of self-management on adherence to self-care and management of health status elderly people living with hypertension in Pekanbaru City. Design and methods: This study design was quasi-experimental with a pre-post test with a control group. The self-management intervention was provided through four home visits to elderly people living with hypertension with a caregiver. Samples were taken by the consecutive sampling technique, and a total number 134 elderly people were participants. The instruments used were the adherence to self-care questionnaire and the Short Form 12 Health Survey (SF12) for elderly people. RESULTS The results showed that most of the respondents with hypertension were 60-74 years of age (84.3%), were female (67.9%), of Minang ethnicity (48.5%), had completed primary school (44%), were unemployed (81.3) %), had a family history of hypertension (50%), were non-smokers (52.2%), and had never drunk alcohol (95.5%). The effects of self-management were positive on adherence to caring for themselves (p<0.001) and on health status (p<0.001). The most influencing factor on self-care compliance and health status after being controlled by confounding variables was self-management (p<0.001). CONCLUSIONS This study recommends that nursing interventions on self-management for elderly people with hypertension in the community and should be integrated into the Community Health Nurses' (Perkesmas) program in Indonesia.
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Affiliation(s)
| | - Etty Rekawati
- Departement of Community Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java.
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Tadesse DB, Gerensea H. Self-care practice among hypertensive patients in Ethiopia: systematic review and meta-analysis. Open Heart 2021; 8:openhrt-2020-001421. [PMID: 34021068 PMCID: PMC8144031 DOI: 10.1136/openhrt-2020-001421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/12/2020] [Accepted: 10/19/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND In high-income and low-income countries, including Ethiopia, hypertension (HTN) is a serious public health concern. As a consequence, a massive self-care practice (SCP) is necessary, and the domains of SCP, including adherence to medication, physical activity, weight management, low-salt diet, non-smoking, moderate alcohol usage, and dietary management, are required. However, there is no nationwide study on HTN SCPs in Ethiopia. This meta-analysis, therefore, aimed to estimate the pooled level of HCP among individuals living with HTN in Ethiopia. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was used to report this systematic review and meta-analysis. We systematically searched the databases PubMed/MEDLINE, Embase, Google Scholar and Science Direct for studies conducted in Ethiopia. All observational studies published until July 2020 were included. Data were analysed using R V.3.5.3 software, and the pooled prevalence with 95% CIs was presented using tables and forest plots. The presence of statistical heterogeneity (I 2) within the included studies was evaluated. We used a funnel plot to identify evidence of publication bias. The random-effects meta-analysis model was employed to estimate the pooled proportion of good HTN SCPs.This was submitted for registration with the International Prospective Register of Systematic Reviews in March 2020 and accepted with the registration number CRD42020175743 (https://www.crd.york.ac.uk/PROSPERO). RESULTS Our search databases produced 356 papers. Twelve of these papers fulfilled the inclusion and were found suitable for the review. The total population in this study was 3938. Off these hypertensive populations, 44% (95% CI 34 to 53) had good SCP. The subgroup analysis for each component of SCP was done. The subgroup analysis of good adherence to low-salt diet, alcohol abstinence, medication adherence, non-smoking, physical exercise and weight management was 52% (95% CI 39% to 66%), 77% (95% CI 69% to 88%), 65% (95% CI 45% to 85%), 92% (95% CI 88% to 95%), 43% (95% CI 30% to 56%) and 51% (95% CI 32% to 69%), respectively. In conclusion, nearly half of patients with HTN had good SCPs.
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Affiliation(s)
| | - Hadgu Gerensea
- Department of Pediatric and Child Health Nursing, Aksum University, Aksum, Ethiopia
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Hussien M, Muhye A, Abebe F, Ambaw F. The Role of Health Care Quality in Hypertension Self-Management: A Qualitative Study of the Experience of Patients in a Public Hospital, North-West Ethiopia. Integr Blood Press Control 2021; 14:55-68. [PMID: 33948092 PMCID: PMC8088297 DOI: 10.2147/ibpc.s303100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/02/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Hypertension is becoming a global epidemic in all population groups. For its effective management and control, patients should have enhanced self-management skills and get adequate support from care providers. Although the quality of health care is critical in enhancing self-management behaviors of patients with hypertension, the issue has not been fully explored in the Ethiopian context. Therefore, the purpose of this study was to explore the experience of hypertensive patients on the quality of health care and the self-management practice in a public hospital in North-west Ethiopia. Patients and Methods This qualitative study involves a phenomenological approach. Participants were hypertension patients who are on treatment follow-up. They were recruited purposively with maximum variation approach. Eleven in-depth interviews and two key informant interviews were undertaken using a semi-structured interview guide with hypertensive patients and nurses respectively. Interviews were audio recorded, transcribed verbatim, translated into English, and then analyzed thematically by the investigators. Results The analysis identified two main themes and seven sub-themes. The first theme “experience in self-management practice” describes medication adherence, lifestyle modification, and self-monitoring of blood pressure. The second theme “experience in the quality of health care” discusses access to health services, patient-centered care, behavior of health care providers, and time and patient flow management. Conclusion The self-management practice of hypertensive patients is sub-optimal. Although several individual patient issues were identified, facility-level problems are mainly responsible for poor self-management practice. The main facility-level barriers, as reported by participants, include shortage of medicines, high cost of medicines, busyness of doctors due to high patient load, lack of appropriate education and counseling services, poor patient-provider interaction, and long waiting times. Intervention areas should focus on providing appropriate training for health care providers to enhance the patient–provider relationship. Improving the supply of hypertensive medications is also paramount for better medication adherence.
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Affiliation(s)
- Mohammed Hussien
- Department of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ahmed Muhye
- Department of Public Health, College of Medicine and Health Sciences, Dire-Dawa University, Dire-Dawa, Ethiopia
| | - Fantu Abebe
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.,Jhpiego Corporation, Ethiopia Country Office, Bahir Dar, Ethiopia
| | - Fentie Ambaw
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Wondmieneh A, Gedefaw G, Getie A, Demis A. Self-Care Practice and Associated Factors among Hypertensive Patients in Ethiopia: A Systematic Review and Meta-Analysis. Int J Hypertens 2021; 2021:5582547. [PMID: 33898063 PMCID: PMC8052173 DOI: 10.1155/2021/5582547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hypertension is one of the leading causes of morbidity and mortality in developing countries including Ethiopia. Self-care practice has been provided as one of the most important preventive mechanisms of hypertension and is considered as a basic treatment for hypertension. There is no national-level study that assesses hypertensive self-care practice in Ethiopia. Therefore, this study aimed to assess the pooled level of hypertensive self-care practices and associated factors in Ethiopia. METHODS This study was carried out using published and unpublished articles accessed from databases: PubMed/MEDLINE, HENARI, Google Scholar, Web of Science, Scopus, African Journals, and university repositories. Data were extracted using a standard data extraction format. Data analysis was carried out using STATA version 11. Heterogeneity across the included studies was assessed using Cochrane's Q statistics and I 2 test with its corresponding p values. Publication bias was determined using Egger's test and presented with a funnel plot. The pooled level of hypertensive self-care practice was estimated using a random-effects meta-analysis model. RESULTS This systematic review included 17 cross-sectional studies with 5,248 study participants. The overall pooled level of self-care practice among hypertensive patients in Ethiopia was 41.55% (95% CI 33.06, 50.05). Participant formal education (AOR = 2.82; 95% CI 2.18, 3.64) and good knowledge of hypertension (AOR = 4.04; 95% CI 2.19, 7.44) were significantly associated with self-care practice among hypertensive patients in Ethiopia. CONCLUSION In this study, more than half of hypertensive patients had poor hypertensive self-care practice in Ethiopia. Participant's formal education and good knowledge of hypertension were significantly associated with self-care practice among people living with hypertension in Ethiopia. Therefore, based on the evidence of this study, we recommended that programmers and policymakers should enhance the awareness of hypertensive patients on self-care practice domains and strengthen local programs working on noncommunicable diseases.
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Affiliation(s)
- Adam Wondmieneh
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Getnet Gedefaw
- Department of Midwifery, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Addisu Getie
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Asmamaw Demis
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
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Ajani K, Gowani A, Gul R, Petrucka P. Levels and Predictors of Self-Care Among Patients with Hypertension in Pakistan. Int J Gen Med 2021; 14:1023-1032. [PMID: 33790631 PMCID: PMC8006970 DOI: 10.2147/ijgm.s297770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/19/2021] [Indexed: 12/14/2022] Open
Abstract
Background Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan. Methods This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban cosmopolitan setting within Karachi Pakistan. Four hundred and two patients were screened using the H-SCALE questionnaire, while socio-demographic predictors of self-care and level of knowledge of hypertension were identified using a study-specific checklist. Self-care was assessed against six clinical domains including medication adherence, diet, weight management, physical activity, and abstinence from alcohol. Results Participants were recruited from the two largest tertiary care hospitals in Karachi. Good knowledge about hypertension, including its causes, management, and complications was reported by 4.47% of the participants. Highest levels of self-care adherence were found for abstinence from alcohol (100%), smoking cessation (83.33%), and medication compliance (71.89%), whereas lowest levels were found for diet (27.11%), and physical activity (24.88%). In terms of predictors for self-care, age, male gender, and self-checking of blood pressure at home, followed by the level of education were the most common predictors for each self-care behavior in the given population. Conclusion Overall knowledge of self-care for hypertension is sub-optimal among hypertensive patients in Pakistan which is reflected in their behaviors. There is a need to introduce healthcare educational programs in Pakistan which can improve self-care behaviors of hypertensive individuals and potentially reduce the prevalence of associated cardiovascular diseases and its complications.
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Affiliation(s)
| | - Ambreen Gowani
- School of Nursing, Aga Khan University, Karachi, Pakistan
| | - Raisa Gul
- School of Nursing, Aga Khan University, Karachi, Pakistan.,School of Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
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Ketata N, Ben Ayed H, Ben Hmida M, Abdelhedi Z, Ben Jemaa M, Trigui M, Maamri H, Yaich S, Kassis M, Feki H, Damak J. Prevalence and predictors of hypertension self-care practice in primary health-care facilities in Southern Tunisia. JOURNAL DE MÉDECINE VASCULAIRE 2021; 46:72-79. [PMID: 33752849 DOI: 10.1016/j.jdmv.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Unmanaged hypertension (HTN) is usually accompanied with complications leading to disability in older adults. It has been demonstrated that self-care practice is essential for blood pressure control and reduction of HTN complications. OBJECTIVE OF THE STUDY This study aimed to estimate the level of implementation of HTN self-care practice and to identify their associated factors. STUDY DESIGN It was a cross-sectional study conducted in Sfax, Southern Tunisia in April 2020. MATERIALS AND METHODS A total of 6 primary health-care facilities were approached for the study participants according to a single-stage cluster sample, by selecting six grapes randomly. A total of 270 participants were recruited, among whom 250 cases (92.6%) completed the questionnaire. RESULTS A total of 250 hypertensive patients were included in the study, giving a male to female ratio of 0.77. There were 125 participants (50%) aged over 65years. Overall, 137 cases (54.8%) had a high total self-care practice score. The independent factors of good HTN self-care practice were≥65years [Adjusted odds ratio (AOR)=9.5; P<0.001], university educational level of the participants (AOR=21.2; P<0.001), as well as receiving a health education, by health-care providers (AOR=2.5; P=0.012) and family members (AOR=4.36; P=0.004). Advanced hypertension stage (II and III) (AOR=0.45; P=0.032) and chronic pulmonary diseases, including asthma (AOR=0.42; P=0.027) and chronic obstructive pulmonary diseases (AOR=0.27; P=0.016) were independently associated with poor HTN self-care practice. CONCLUSION Advanced hypertension stage, pulmonary co-morbidities, education level and lack of self-care education were predictive factors of poor self-care practice. These findings suggested that such factors should be considered when planning HTN self-care education.
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Affiliation(s)
- N Ketata
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.
| | - H Ben Ayed
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - M Ben Hmida
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Z Abdelhedi
- High Institute of Nursing, University of Sfax, Sfax, Tunisia
| | - M Ben Jemaa
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - M Trigui
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - H Maamri
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - S Yaich
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - M Kassis
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - H Feki
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - J Damak
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
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Abstract
BACKGROUND According to evidence-based guidelines, adherence to blood pressure-lowering medication and lifestyle modifications is a crucial part of hypertension management. Self-care is an effective method for secondary prevention. However, patients continue to exhibit major deficits in terms of adherence, self-control, and self-care. Standardized instruments for the effective monitoring of patients' self-care abilities are still lacking. OBJECTIVE The objectives of this study were to produce a translation and cross-cultural adaptation of the Self-care of Hypertension Inventory (SC-HI) and to evaluate the psychometric properties of its Polish version. METHODS The scale underwent translation and psychometric assessment using the standard methodology (forward-backward translation, review, psychometric analysis, criterion validity). The study included 250 patients, with a mean age of 61.23 ± 14.34 years, treated in a hypertension clinic. RESULTS Mean self-care levels were evaluated in 3 domains: self-care maintenance (56.73 ± 18.57), self-care management (64.17 ± 21.18), and self-care confidence (62.47 ± 24.39). The Cronbach α for each domain showed satisfactory parameters: 0.755 for maintenance, 0.746 for management, and 0.892 for confidence. In the Polish version, the 3-factor structure of the SC-HI was not directly confirmed. Therefore, so-called modification indices were applied to obtain a standardized root mean square residual value less than 0.09 and a root mean square error of approximation value less than 0.06. CONCLUSIONS The SC-HI has been successfully translated and adapted for Polish settings, and is suitable for application among patients with hypertension.
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Leone DRR, Neves ACDOJ, Prado RT, Castro EABD. Assistência de enfermagem em diálise peritoneal: aplicabilidade da teoria de orem - estudo de método misto. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Resumo Objetivo Compreender a aplicabilidade da Teoria Geral de Enfermagem de Orem na assistência prestada aos pacientes em diálise peritoneal domiciliar. Método Estudo de método misto. Na etapa quantitativa realizou-se uma pesquisa transversal, descritiva e exploratória, com 34 pacientes em diálise peritoneal. Aplicou-se um instrumento para caracterização sociodemográfica e clínica e a escala de avaliação da capacidade para o autocuidado - Appraisal of Self Care Agency Scale Revised. Análise dos dados por estatística descritiva. Na abordagem qualitativa, utilizou-se a Teoria Fundamentada nos Dados. Realizaram-se 23 entrevistas domiciliares com 19 participantes. Análise dos dados seguiu as codificações aberta, axial e seletiva. Resultados Dos participantes, 59% tinham capacidade para o autocuidado operacionalizado. Os pacientes em diálise peritoneal atenderam, em diferentes graus, às seis categorias de requisitos de autocuidado de desvio de saúde para a realização da terapia em domicílio. O apoio e a educação destacaram-se como modalidade de sistema de Enfermagem. Conclusão e implicação para a prática A Teoria Geral de Enfermagem de Orem se aplica na assistência de Enfermagem a pessoas em diálise peritoneal. Sugere-se sua utilização como suporte teórico para o Processo de Enfermagem.
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Fotokian Z, Nasresabetghadam S, Jahanshahi M, Nasiri M, Hajiahmadi M. The effects of Orem's self-care theory on self-care behaviors among older women with hypertension: A randomized controlled trial. Nurs Midwifery Stud 2021. [DOI: 10.4103/nms.nms_9_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Psychometric Properties and Factorial Structure of Vietnamese Version of the Hypertension Self-care Profile Behavior Scale. J Cardiovasc Nurs 2020; 36:446-453. [PMID: 33273251 DOI: 10.1097/jcn.0000000000000770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Hypertension Self-care Profile Behavior (HTN-SCPB) scale is a self-report instrument with which a patient's self-care behavior can be assessed. However, its psychometric properties for adult patients with hypertension in Vietnam require clarification. OBJECTIVE The aim of this study was to translate the HTN-SCPB scale into Vietnamese and to assess its psychometric properties. METHODS The study included 220 adult patients with hypertension. To evaluate test-retest reliability, 133 participants were tested twice with a 3-week interval between tests. For construct validity, exploratory factor analysis was used to assess factor structure, and confirmatory factor analysis was used to evaluate the structural model fit of the scale. RESULTS Reliability was confirmed by internal consistency (Cronbach α = 0.79) and test-retest reliability (intraclass correlation coefficient, 0.88). The Kaiser-Meyer-Olkin value was 0.75, and Bartlett's test of sphericity was significant (P < .001) and adequate for exploratory factor analysis. A 5-factor structure was obtained, and the factors were named as follows: "advanced self-management skills," "adverse health behaviors," "medication adherence," "diet-related knowledge regarding hypertension," and "information skills." Confirmatory factor analysis revealed that the model fit indices were acceptable (root-mean-square error of approximation, 0.07) or slightly less than the good fit values (comparative fit index, 0.85; incremental fit index, 0.85; goodness-of-fit index, 0.88; adjusted goodness-of-fit index, 0.84; and Tucker-Lewis index, 0.82). CONCLUSIONS The Vietnamese HTN-SCPB scale had satisfactory validity and reliability for assessing self-care behaviors in patients with hypertension in Vietnam.
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Hussen FM, Adem HA, Roba HS, Mengistie B, Assefa N. Self-care practice and associated factors among hypertensive patients in public health facilities in Harar Town, Eastern Ethiopia: A cross-sectional study. SAGE Open Med 2020; 8:2050312120974145. [PMID: 33329893 PMCID: PMC7720317 DOI: 10.1177/2050312120974145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Self-care practice is the activity that a hypertensive patient undertakes intending to improve their health. Poor self-care practice leads to uncontrolled hypertension. Therefore, strategies designed to prevent and control hypertension-related death, disability, and morbidity should consider the level of the patient’s self-care practice and risk factors. This study assessed self-care practice and associated factors among hypertensive patients in public health facilities of Harar Town in eastern Ethiopia. Method: An institution-based cross-sectional study was conducted among 398 randomly selected hypertensive patients from 25 March 2019 to 16 April 2019. Pretested structured questionnaires adapted from validated tools were used to collect data from participants using electronic Open Data Kit software through face-to-face exit interview. Data were analyzed by SPSS version 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with self-care practice. Adjusted odds ratio with 95% confidence interval was used to report association and the significance was declared at p-value < 0.05. Results: Level of good self-care practice was 29.9% (95% confidence interval: 25.3% and 34.7%). Age ⩾ 60 years (adjusted odds ratio = 3.4, 95% confidence interval: 1.2 and 9.3), formal education (adjusted odds ratio = 2.3, 95% confidence interval: 1.3 and 4.2), absence of comorbidities (adjusted odds ratio = 1.8, 95% confidence interval: 1.1 and 3.1), adequate knowledge about hypertension (adjusted odds ratio = 4.7, 95% confidence interval: 2.5 and 8.8), good social support (adjusted odds ratio = 2.7, 95% confidence interval: 1.6 and 4.7), and being khat abstainer (adjusted odds ratio = 1.9, 95% confidence interval: 1.1 and 3.5) were significantly associated with good self-care practice. Conclusion: The prevalence of good self-care practice was low. In this study, good self-care practice was significantly associated with age, formal education, comorbidities, knowledge about hypertension, social support, and current khat chewing condition. Regular check-up and follow-up of patients’ compliance with self-management protocol, and more emphasis should be given to identify factors that potentially impeding patients’ adherence to hypertension self-management protocol.
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Affiliation(s)
- Feysal Mohammed Hussen
- Department of Public Health, College of Health Science, Kebridehar University, Kebridehar, Ethiopia.,School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Hassen Abdi Adem
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Hirbo Shore Roba
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bezatu Mengistie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Andualem A, Gelaye H, Damtie Y. Adherence to Lifestyle Modifications and Associated Factors Among Adult Hypertensive Patients Attending Chronic Follow-Up Units of Dessie Referral Hospital, North East Ethiopia, 2020 . Integr Blood Press Control 2020; 13:145-156. [PMID: 33122940 PMCID: PMC7591036 DOI: 10.2147/ibpc.s275575] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/25/2020] [Indexed: 12/21/2022] Open
Abstract
Background Hypertension is a major health problem throughout the world which affects over one billion people due to severe complications and inadequate control. Even though lifestyle modification is one of the most effective ways to prevent and control hypertension, only little emphasis has been given for it compared with treating hypertension with medication. Therefore, the aim of this study was to assess adherence to lifestyle modifications and associated factors among hypertensive patients attending Dessie referral hospital. Materials and Methods Institutional-based cross-sectional study design was conducted among 301 hypertensive patients during May and June, 2020. The study participants were selected with a convenient sampling technique due to the COVID-19 pandemic. Data were collected using pre-tested and structured face to face interviewer-administered questionnaire and checked, cleaned and entered into Epi data version 4.4 and exported to SPSS version 25.0 software for analysis. The associations between independent variables and dependent variable were analyzed using binary logistic regression models. Results A total of 301 respondents participated in the study yielding a response of 100%. The overall adherence in this study was only 23.6%. Independent predictors of adherence to lifestyle modifications were divorced (AOR=0.35; 95% CI (0.13–0.94)) and widowed (AOR=0.27; 95% CI (0.10–0.75)), secondary school education (AOR=4.85; 95% CI (1.54–15.22)), no regular income (AOR=0.22; 95% CI (0.08–0.65)) or monthly income of ≥3000 ETB (AOR=5.58; 95% CI (2.46–12.66)), having co-morbidities (AOR=2.37; CI (1.23–4.57)), good knowledge about the disease (AOR=1.83; CI (0.92–3.65)) and good self-efficacy (AOR=3.64; CI (1.75–7.55)). Conclusion and Recommendations The overall adherence to recommended lifestyle modifications was very low. The independent predictors were marital status, educational level, monthly income, having co-morbidities, knowledge and self-efficacy. Therefore, multifaceted and collaborative implementation of strategies about lifestyle modifications for hypertension prevention and control are needed to address barriers at the patient, provider, system and community levels.
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Affiliation(s)
- Atsedemariam Andualem
- Department of Nursing, School of Nursing and Midwifery, Wollo University, Dessie, Ethiopia
- Correspondence: Atsedemariam AndualemDepartment of Nursing, School of Nursing and Midwifery, Wollo University, P. O. Box: 1145, Dessie, EthiopiaTel +251925045070 Email
| | - Habtam Gelaye
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, Wollo University, Dessie, Ethiopia
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Knowledge on Hypertension and Self-Care Practice among Adult Hypertensive Patients at University of Gondar Comprehensive Specialized Hospital, Ethiopia, 2019. Int J Hypertens 2020; 2020:5649165. [PMID: 32373351 PMCID: PMC7191404 DOI: 10.1155/2020/5649165] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 02/07/2023] Open
Abstract
Background Patients with hypertension need to be aware of various aspects of hypertension and exercise self-care. But, there is limited information regarding this issue. Objective of the Study. This study was designed to assess knowledge on hypertension and self-care practice among adult hypertensive patients in the University of Gondar Comprehensive Specialized Hospital, Ethiopia. Materials and Methods Descriptive cross-sectional study was conducted among 384 hypertensive patients from April to May 2019. The study participants were selected using a systematic random sampling technique. Data were collected using a pretested interviewer-administered questionnaire. Descriptive statistics such as percentage and frequency of patients' knowledge on hypertension and their self-care practice were computed. Cross-tabulation was used to see the frequency and percentage of selected sociodemographic variables and knowledge level with self-care practice subscales. Finally, the results were summarized and presented in texts, figures, and tables. Results Among the study participants, 215 (56%) and 228 (59.4%) had good knowledge and self-care practice towards hypertension, respectively. The participants who had good knowledge had good self-care practice frequency. Conclusions In this study, knowledge on hypertension was low, while self-care practice was moderate on the self-care interventions. Hence, increasing patients' awareness and intervention on medication adherence, low salt diet consumption, physical activity, weight management, cigarette smoking cessation, and alcohol consumption reduction is important.
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Shim JS, Jung SJ, Kim HC. Self-reported diet management, dietary quality, and blood pressure control in Korean adults with hypertension. Clin Hypertens 2019; 25:24. [PMID: 31890276 PMCID: PMC6911701 DOI: 10.1186/s40885-019-0130-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/18/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Hypertension control is a major public health concern. Daily preventive practices of the affected individual are essential for controlling blood pressure (BP). We investigated the association of diet management practice, dietary quality, and BP control among Korean adults with known hypertension. METHODS We included 4107 participants aged 40-79 years who reported physician-diagnosed hypertension in the Korea National Health and Nutrition Examination Survey 2013-2016. Dietary management practice was defined by self-report, and dietary intakes were assessed by a 24-h dietary recall. Dietary quality and adherence were evaluated based on the Korean Healthy Eating Index (KHEI) using food and nutrient intakes assessed by a 24-h dietary recall. BP control was defined as systolic/diastolic BP < 140/90 mmHg. RESULTS While the prevalence of dietary management was higher in women than men, BP control rate was not different by sex. Dietary management practice had no significant association with BP control in both men and women. Only in men, dietary quality was positively associated with BP control (OR: 1.10 per KHEI 10 score increase, 95% CI: 1.00-1.20, p-value = 0.04). Men who had a highly adherent diet seemed to have a higher possibility of BP control, but there was no statistical significance (OR: 1.54, 95% CI: 0.84-2.81, p-value = 0.16). CONCLUSIONS A high-quality diet was positively associated with BP control in Korean men aware of their hypertension. Our findings highlight the beneficial impact of dietary management as a means for achieving blood pressure control.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
| | - Sun Jae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave. #505, Boston, MA 02115 USA
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Yonse-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea
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