The Nexus Between Adherence to Recommended Lifestyle Behaviors and Blood Pressure Control in Hypertensive Patients at Mutare Provincial Hospital, Zimbabwe: A Cross-Sectional Study

PURPOSE

To determine the association between the achievement of blood pressure (BP) control and adherence to recommended lifestyle behaviors among hypertensive patients seen at Mutare Provincial Hospital, Zimbabwe.

PATIENTS AND METHODS

A cross-sectional study was conducted using BP readings from three consecutive months. A structured interviewer-administered and pretested questionnaire with components derived from the World Health Organization Stepwise Survey was employed to extract information from 350 purposively selected participants. Measurement of BP was based on the Eighth Joint National Committee Guidelines. Bivariate and multivariate logistic regression analyses were computed using the SPSS package.

RESULTS

The mean age of the 350 participants was 67±11.38 years. Males made up 35% of the participants and BP control was achieved in 41.4% of the patients. Only 5.1% of the participants reported adherence to all the recommended lifestyle behaviors. Low adherence rates were reported for diet, medication, and physical activity. Bivariate analysis showed that participants who adhered to antihypertensive treatment and alcohol recommendations had reduced odds of having uncontrolled hypertension, while consuming deep-fat fried foods ≥3 times a week was associated with higher odds of uncontrolled BP (p<0.1). Logistic regression analysis revealed that participants who ate traditional whole-grain "sadza" or porridge were more likely to have controlled BP [adjusted odds ratio (AOR): 1.6; 95% confidence interval (CI): 1.0-2.5] while those who did not add salt at the table had reduced odds of having uncontrolled BP by 40% (AOR: 0.6; 95% CI: 0.4-0.9).

CONCLUSION

Overall, adherence to the recommended lifestyle behaviors which are known to be effective in controlling BP in Mutare was poor. Health workers should include comprehensive health education messages on the importance of compliance with dietary, medication, and physical exercise recommendations when counseling patients. The intervention crafting process should focus on identifying enablers of the recommended lifestyle behaviors in the community and the health delivery system.

Evaluating the Decent Work Scale Measurement Model in Zimbabwe

The Decent Work Agenda recognises the role of work and work-related contexts in giving meaning, fulfilment, opportunities for development and growth to the employed and those who aspire to work. The Decent Work Scale (DWS) is a commonly referenced measure to appreciate the experience of decent work in organizations. Limited research has examined the quality of the DWS measurement model in the developing countries, especially in sub-Saharan Africa. This study examined the factor structure of the DWS using bifactor modelling. The study also conducted invariance tests using multi-group confirmatory factor analysis. Last, the study evaluated the predictive validity of the decent work construct using covariance-based structural equation modelling. A probability sample from a large manufacturing firm in Zimbabwe informed the analysis. Bifactor analysis suggested the presence of a strong underlying general factor for DWS. The measure was invariant across gender groups. Decent work had significant, positive relationships with organisational learning and work engagement.