ผลของโปรแกรมส่งเสริมการรับรู้ความเชื่อด้านสุขภาพผ่านการพยาบาลทางไกลต่อพฤติกรรมการป้องกันโรคหลอดเลือดสมองในผู้ป่วยโรคความดันโลหิตสูงที่ควบคุมความดันโลหิตไม่ได้

Pattamaporn  Chanaman; Apinya  Wongpiriyayothar; Surachat  Sittipakorn

doi:10.60099/jtnmc.v38i04.266286

Authors

Pattamaporn Chanaman Faculty of Nursing, Mahasarakham University, Thailand
Apinya Wongpiriyayothar Faculty of Nursing, Mahasarakham University, Thailand
Surachat Sittipakorn Faculty of Nursing, Mahasarakham University, Thailand

DOI:

https://doi.org/10.60099/jtnmc.v38i04.266286

Keywords:

hypertension, health belief, tele-nursing, stroke prevention behaviors

Abstract

Introduction Hypertension is a significant factor contributing to stroke. Employing tele-nursing to foster health belief perception emerges as an approach to assist patients with uncontrolled hypertension, facilitating the adoption of effective stroke prevention behaviors.

Objectives To investigate the effects of a health belief perception promotion program using tele-nursing on stroke prevention behaviors in patients with uncontrolled hypertension.

Design This study utilized an experimental design with two-group pretest-posttest, applying the Health Belief Model as a conceptual framework.

Methodology The sample consisted of 30 patients with uncontrolled hypertension, selected from the outpatient hypertension clinic in a community hospital of a province in the Northeastern region. Through random sampling, patients were recruited and subsequently assigned to either the experimental or control groups, with 15 participants in each group. The experimental group received a health belief perception promotion program using tele-nursing, while the control group received a usual care. Data were collected using the Stroke Prevention Behaviors questionnaire, which demonstrated a reliability of .83. The data were analyzed using frequency, mean, standard deviation, Independent t-test, and Paired t-test.

Results The results revealed that following the program, the experimental group showed a mean score for stroke prevention behaviors (M = 3.51, SD = 0.54), which was significantly higher than the control group (M = 2.46, SD = 0.54, t = 7.937, p < .001) and also higher than before the program (M = 2.67, SD = 0.26, t = 5.005, p < .001). When considering each subscale, it was found that the experimental group demonstrated statistically significant higher mean scores in eating behaviors (M = 3.17, SD = 0.86), stress management (M = 3.52, SD = 1.08), using various substances (M = 4.03, SD = 0.92), and taking antihypertensive drugs (M = 4.53, SD = 0.47) compared to the control group (p < .05). There was no significant difference in the exercise behaviors between the control group (M = 1.37, SD = 1.01) and the experimental group (M = 1.90, SD = 1.25, Z = -1.383, p > .05)

Recommendation Healthcare teams should implement a health belief perception promotion program using tele-nursing within hypertension clinics to enhance health belief perception in patients with uncontrolled hypertension and continuously follow up their stroke prevention behaviors.

References

World Health Organization [WHO]. Hypertension. [internet]. 2023 [cited 2022 March 24]. Available from: https://www.who.int/news-room/factsheets/detail/hypertension

Campbell NRC, Burnens MP, Whelton PK, Angell SY, Jaffe MG, Cohn J, et al. World Health Organization guideline on pharmacological treatment of hypertension: Policy implications for the region of the Americas. Health Policy 2021;9:1-10. Available from: https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(22)00036-9/fulltext

Thiamkao S. Incidence of stroke in Thailand. Journal of neurology science of Thailand, 2023;39(2):39-46. (in Thai)

Health Insurance, Strategy and medical Information group, Wapi Pathum Hospital. Report of the meeting of the team that oversees and develops the patient care process in Wapi Pathum Hospital (2023). (in Thai)

Yodpera K. Factors related to self–protection behaviors from stroke of uncontrolled hypertension patients in Nong Saeng district, Saraburi province. Journal of Council of Community Public Health 2019; 1(2):17-27. (in Thai)

Nilnet N. Factors associated with the incidence of stroke among hypertensive patients in Bueng Kan province. Thai Journal of Health Education 2019; 4(1):62-75. (in Thai)

Chanaphan Y, Settheetham D. Factors associated with stroke prevention behavior among hypertension patients in Kumpawapi district, Udon Thani province. Journal of Sakon Nakhon Hospital 2018; 21(2):109-19. (in Thai)

Jiopraditkul S. Self–care behaviors and blood pressure controlling ability of essential hypertension patients, muang Potawas primary care unit. Journal of Health Research and Innovation 2020;3(1):15-29. (in Thai)

Rosenstock IM. Historical origins of the health belief model. Health education monographs winter 1974; 2(4): 328-33. Available from: https://www.jstor.org/stable/45240621

Pholpim P. Effect of health educational program for stroke on knowledge and perceived of hypertension patients in Chiang Kwan hospital. Journal of Health Research and Innovation 2021;2(3):167-75. (in Thai)

Sitthiyodying C. Health belief patterns that are related to self-care behavior. To prevent stroke in patients who cannot control their blood pressure, Napalai hospital Samut Songkhram province. Thai Journal of Health Education 2022; 2(2):46-60. (in Thai)

Charoensappakit N. The relationship between health belief patterns, awareness of warning symptoms, and stroke prevention behavior in patients with high blood pressure. Journal of Primary Care and Family Medicine 2020; 3(3):46-58. (in Thai)

Ngerndee K, Manoton A, Srisukkham T, Takaew T. Effectiveness of the health belief model application program towards behavior to prevent stroke of patients with high blood pressure, Mueang district, Phayao province. Thai Journal of Health Education 2021;44(2):171-186. (in Thai)

Wichaiyo W, Jongsamak P, Chaithong S, Khotbudda S. Factors predicting stroke preventive behaviors of hypertensive patients at Na Fai Sub-district health promoting hospital in chang wat Chaiyaphum. Thai Journal of Nursing 2021; 70(2): 27-36. (in Thai)

Kongwiwat K, Lamsawadikul W, Nuisorn M. Results of the development program Behaviors to prevent stroke of patients at risk Kanchanaburi province. Journal of Nursing and Health Care 2017; 35(3): 129-137. (in Thai)

Bunsat P, Piyabunditkul L. Results of prevention programs. Stroke in the high-risk group, Huai Bong subdistrict, Mueang district, Chaiyaphum province. Journal of Sakon Nakhon Hospital 2018; 21(2): 28-41. (in Thai)

Singko T, Carpenter S, Torsakulkaew T. Effects of a health belief promotion program on stroke prevention behavior and perceived benefits of maintaining behavior. In the elderly at risk group. Journal of Charoenkrung Pracharak Hospital 2020; 16(2): 42-60. (in Thai)

Munfu S. Results of the stroke prevention program for patients with high blood pressure. By applying the theory of health beliefs in Mueang Pan district Lampang province. Singburi Hospital Journal 2022; 31(1):68-78. (in Thai)

Elbialy AA, Bahgat ZF, El-ahwal L, El- Gamal SMA. Effect of Implementing Tele-nursing versus traditional nursing program on knowledge, life style modification and blood pressure control for hypertensive patients. IEJNSR 2022;3(1):484- 515. Available from: https://ejnsr.journals.ekb.eg/article_247231.html

Li Z, Yan LL, Enying G, Gu W, Turner EL, John A. Gallis, et al. Effectiveness of a primary care-based integrated mobile health intervention for stroke management in rural China (SINEMA): a clusterrandomized controlled trial. Stroke & vascular neurology 2021; 159-76. Available from: https://pubmed.ncbi.nlm.nih.gov/33909607/

Talebi F, Jesmi A, Rakhshani M, Tajabadi A. Effects of telenursing on the management of self-care behaviors in patients with chronic hypertension. J Health Res 2023;13(4):273-80. Available from: https://jrh.gmu.ac.ir/article-1-2174-en.html

Pitthayapong S, Numpoon J, Wattradul D, Kolyani S, Srisart A. Effects of a family caregivers’ capacity building program by telenursing on practices of post-stroke care and activities of daily life of the stroke patients. Thai Red Cross Nursing Journal 2023; 16(1):116-34. Available from: https://he02.tci-thaijo.org/index.php/trcnj/article/view/259999/180237 (in Thai)

Moonfoo S. Effects of a stroke prevention program for people with hypertension by applying health belief theory in Mueang Pan district, Lampang province. Singburi Hospital Journal 2022;31(1):68-78. Available from: https://he01.tci-thaijo.org/index.php/shj/article/view/257857/174453 (in Thai)

Announcement from the Nursing and Midwifery Council guidelines for tele-nursing (Tele-nursing) 2021. Royal Gazette volume 138, special section 33 d. (10 february 2564). (in Thai)

Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. (10th ed.). Philadelphia: Lippincott Williams & Wilkins 2019; 8(7):786. Available from: https://www.hindawi.com/journals/nrp/