The Relationships between Health Beliefs, Perceived Self-Efficacy, and Coronary Artery Disease Prevention Behaviors among Patients with Uncontrolled Hypertension

Abstract

Introduction Uncontrolled hypertension is a major cause of coronary artery disease. The patients can reduce their risk of coronary artery disease by adopting appropriate health behaviors. 

Objectives This study aimed to 1) describe the health beliefs, perception of self-efficacy, and coronary artery disease prevention behaviors among patients with uncontrolled hypertension, and 2) examine relationships between health beliefs about coronary artery disease, perceived self-efficacy in coronary artery disease prevention, and coronary artery disease prevention behaviors among patients with uncontrolled hypertension. 

Design This study employed a descriptive correlational design using the Health Belief Model as a conceptual framework. The model’s five factors influencing health behaviors were selected for the study, including perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and perceived self-efficacy.

Methodology The study participants comprised 80 patients with uncontrolled hypertension who received services at a community health center of a hospital in the northeastern region. Participants were randomly selected using a random number table. The inclusion criteria were: 1) blood pressure > 140/90 mmHg, 2) aged 18 years and over, and 3) absence of comorbidities. The exclusion criteria included: 1) presence of abnormal symptoms during data collection, such as headaches and dizziness, and 2) complications of hypertension. The research instruments included questionnaires assessing: 1) health beliefs about coronary artery disease, 2) perceived self-efficacy in coronary artery disease prevention, and 3) coronary artery disease prevention behaviors. The content validity indices of the instruments were 0.93, 1.0, and 1.0, respectively. The reliability coefficients were 0.87, 0.72, and 0.70, respectively. Data were collected between March and April 2024. The data were then analyzed using descriptive statistics and Pearson’s product-moment correlation coefficients.

Results The majority of the participants were female (58.80%), older adults (57.50%), and had blood pressure levels between 140/90 and 159/99 mmHg (82.50%). Regarding health beliefs, the mean scores for perceived susceptibility to the risk of coronary artery disease (M = 3.08, SD = 0.42), perceived severity of coronary artery disease (M = 3.53, SD = 0.58), and perceived benefits of coronary artery disease prevention practices (M = 3.20, SD = 0.45) were at a moderate level. The mean score for perceived barriers to coronary artery disease prevention practices (M = 3.84, SD = 0.40) was at a high level. The mean scores for perceived self-efficacy in coronary artery disease prevention (M = 2.58, SD = 0.36) and coronary artery disease prevention behaviors (M = 3.47, SD = 0.34) were at a moderate level. The results of the correlation analysis indicated that perceived susceptibility to the risk of coronary artery disease, perceived benefits of coronary artery disease prevention practices, and perceived self-efficacy in coronary artery disease prevention had significant positive correlations with coronary artery disease prevention behaviors (r = .191, r = .500, and r = .714, respectively, p < .05). Conversely, perceived barriers to coronary artery disease prevention practices had a significant negative correlation with coronary artery disease prevention behaviors (r = -.593, p < .05). However, perceived severity of coronary artery disease did not show a correlation with coronary artery disease prevention behaviors.

Recommendation Nurses should develop strategies to promote health beliefs about coronary artery disease, focusing on enhancing perceived susceptibility, perceived benefits, and perceived barriers to practices, and promoting perceived self-efficacy among patients with uncontrolled hypertension to perform appropriate behaviors to prevent coronary artery disease.