Factors Predicting Stroke-Preventive Behaviors Among Patients with Hypertension
Keywords:
Disease prevention behaviors, Stroke, Hypertension, Health beliefs, Cues to actionAbstract
Patients with hypertension are a high-risk group for stroke. Health beliefs and behavioral modifications for disease prevention can effectively reduce this risk. This predictive correlational study aimed to examine stroke-preventive behaviors and investigate the factors predicting stroke-preventive behaviors among patients with hypertension receiving healthcare services at health promoting hospitals in suburban areas. A total of 146 participants were selected through multistage random sampling. Research instruments included questionnaires on personal factors, individual beliefs, cues to action for preventive health behaviors, and stroke-preventive behaviors. Content validity and reliability of the research instruments were approved. Data were analyzed using descriptive statistics, chi-square, and binary logistic regression.
The findings revealed that overall stroke-preventive behaviors among patients with hypertension were at a high level. Perceived self-efficacy and cues to action for preventive behaviors were significant predictors of stroke-preventive behaviors, collectively predicting 38.2% of the variance. Participants with a high level of perceived self-efficacy in stroke prevention were 4.839 times more likely to engage in appropriate stroke-preventive behaviors (95% CI: 1.894–12.365) compared to those with a low to moderate level. Additionally, participants with a high level of cues to action for stroke-preventive behaviors were 14.014 times more likely to exhibit appropriate stroke-preventive behaviors (95% CI: 2.872–68.386) compared to those with a low level, and 4.748 times more likely (95% CI: 1.892–11.913) compared to those with a moderate level.
This study suggests that strengthening patients’ levels of self-efficacy and enhancing cues to action can significantly improve the success of stroke-preventive behaviors among individuals with hypertension.
References
Bandura, A. (1977). Social learning theory. Prentice-Hall.
Bansra, N., Sirinua, S., & LamLak, P. (2023). Factors related to self-care behavior for stroke prevention amongst hypertensive patients in Mae Chai District, Phayao Province. Journal of Phrae Public Health for Development, 3(1), 1-16. (in Thai)
Bloom, B. S. (1971). Handbook on formative and summative evaluation of student learning. McGraw-Hill.
Boehme, A. K., Esenwa, C., & Elkind, M. S. V. (2017). Stroke risk factors, genetics, and prevention. Circulation Research, 120(3), 472-495. https://doi.org/10.1161/CIRCRESAHA.116.308398
Carpenter, C. J. (2010). A meta-analysis of the effectiveness of Health Belief Model variables in predicting behavior. Health Communication, 25(8), 661-669. https://doi.org/10.1080/10410236.2010.521906
Chanaphan, Y., & Settheetham, D. (2018). Factors associated with stroke prevention behavior among hypertension patients in Kumpawapi District, Udon Thani Province. Journal of Sakon Nakhon Hospital, 21(2), 109-119. (in Thai)
Chareonsin, S. (2021). Factors affectings stroke prevention behavior in hypertention patients, Mueang District, Nakhon Sawan Province. [Master’s thesis, Naresuan University]. http://nuir.lib.nu.ac.th/dspace/handle/123456789/2833 (in Thai)
Chimmamee, M., Jumnianpol, S., Buathong, T., Pitukthanin, A., & Tuangvirutkorn, N. (2020). Mid-life crisis of pre-elderly workers: The adaptation of formerly private sector employees aged over 45 who shift to work in informal sector. Journal of Demography, 36(2), 58-95. (in Thai)
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
Department of Disease Control Ministry of Public Health. (2019). Key message from World’s Paralysis Day 2019: My stroke zapped my energy. But not my passion. https://www.hfocus.org/content/2019/10/17959 (in Thai)
Eagly, A. H., & Steffen, V. J. (1984). Gender stereotypes stem from the distribution of women and men into social roles. Journal of Personality and Social Psychology, 46(4), 735-754. https://doi.org/10.1037/0022-3514.46.4.735
Homkaenchan, S., & Numkham, L. (2023). Factors related to stroke prevention behaviors in people with hypertension in Kluaymoung Public Health Service Center, Khelang Nakhon Municipality, Lampang Province. Journal of Public Health Research and Innovation, 1(2), 14-24. https://he01.tci-thaijo.org/index.php/jphri/article/view/262067/177251 (in Thai)
Hudsadin, L. (2020). Factors predicting with self–care behaviors in hypertensive agings in out–patient department Ranode Hospital. Journal of MCU Nakhondhat, 7(7), 373-386. (in Thai)
Jitapunkul, S. (1998). Principles of geriatric medicine. Chulalongkorn University Press.
Jones, C. J., Smith, H., & Llewellyn, C. (2014). Evaluating the effectiveness of Health Belief Model interventions in improving adherence: A systematic review. Health Psychology Review, 8(3), 253-269. https://doi.org/10.1080/17437199.2013.802623
Katanyutanon, T., Janpanya, W., Pabao, S., Baojungharn, S., Noipream, T., Parlee, S., & Saengkhan, J. (2017). Self-care behaviors of diabetic and hypertensive patients at a public health center in Bangmuang Subdistrict, Samutprakarn Province. APHEIT Journals, 6(2), 53-62. https://www.journals.apheit.org/jounal/science-july-2560/6_09_Self%20-%20Care%20%20Behaviors%20_proof1_formatted%20.pdf (in Thai)
Klinsakorn, C., & Saetan, S. (2020). Factors related to self-protective behavior of stroke with controlled hypertension patients who live in Danchang District, Suphanburi Province. Journal of Council of Community Public Health, 2(2), 62-77. https://he01.tci-thaijo.org/index.php/JCCPH/article/view/243512/166112 (in Thai)
Kumoh, C., & Chantra, R. (2015). Factors related to self-care behavior among diabetes mellitus patients in Sub-district health promoting hospitals, Pattani Province. The Southern College Network Journal of Nursing and Public Health, 2(2), 85-99. (in Thai)
Kumpangkaew, K., Somboontanont, W., & Leelahakul, V. (2015). Relationships between perceived risk, perceived warning signs and self-care behavior in older adults at risk of cerebrovascular disease. Nursing Journal of the Ministry of Public Health, 25(2), 40-56. (in Thai)
Lalun, A., & Vutiso, P. (2021). Factors predicting stroke preventive behaviors of hypertensive patients at Na Fai Sub-District Health Promoting Hospital in Chang Wat Chaiyaphum. Thai Journal of Nursing, 70(2), 27-36. (in Thai)
Ministry of Public Health. (2024). Morbidity and mortality rates of patients with stroke. Health data center: HDC. https://hdc.moph.go.th/pte/public/standard-report-detail/7ac059f4e4e3d08750d2ee23600556af
Muanmee, W. (2014). Factors influencing preventive behaviors for cerebrovascular disease among hypertensive patients in Bangrakum District, Phitsanulok Province [Master’s thesis, Naresuan University]. https://doi.nrct.go.th/ListDoi/listDetail?Resolve_DOI=10.14457/NU.the.2014.46 (in Thai)
Ngaosri, K. (2022). Soo-ng Wai Mai Kesian. https://thaitgri.org (in Thai)
Panthonglang, W., Namphonkrang, P., & Duangsanjan, W. (2018). Factors influencing the health behavior of uncontrolled hypertension patients. Songklanagarind Journal of Nursing, 38(4), 152-165. (in Thai)
Puthawong, W., Kittipichai, W., Silawan, T., & Munsawaengsup, C. (2014). Cerebrovascular disease risk factors among hypertensive patients in Phayao Province. Journal of Public Health, 44(1), 30-44. (in Thai)
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social Learning Theory and the Health Belief Model. Health Education Quarterly, 15(2), 175-183. https://doi.org/10.1177/109019818801500203
Siriraj Stroke Center. (2019). Stroke. https://www.sirirajstrokecenter.org/2019/2910.html
Sittiyodying, C. (2022). Prevention of stroke among patients with uncontrolled hypertension: The correlations between health beliefs and self-care behaviors. Journal of Health Sciences and Pedagogy, 2(2), 46-60. https://he02.tci-thaijo.org/index.php/JHSP/article/view/257469/46-60 (in Thai)
Sodaprom, D. (2020). Factors influencing preventive behaviors for cerebrovascular disease among elderly risk group in the Aranyik Tow municipality Mueang Phitsanulok District, Phitsanulok Province. [Master’s thesis, Naresuan University]. https://nuir.lib.nu.ac.th/dspace/bitstream/123456789/2493/3/DuangthidaSodaprom.pdf (in Thai)
Strategy and Planning Division of Office of the Permanent Secretary Ministry of Public Health. (2022). Public health statistics A.D.2022. https://spd.moph.go.th/wp-content/uploads/2023/11/Hstatistic65.pdf (in Thai)
Thai Hypertension Society. (2019). 2019 Thai guidelines on the treatment of hypertension. https://www.thaihypertension.org/hypertensiondetail.php?n_id=442 (in Thai)
Thongtang, P., & Seesawang, J. (2014). Lived experience among hypertensive older people. Nursing Journal, 41(Suppl.), 1–10. https://he02.tci-thaijo.org/index.php/cmunursing/article/view/32686 (in Thai)
Tijayoung, S. (2014). The factors influencing preventive behaviors amongst risk group stroke patients [Master’s thesis, Christian University of Thailand]. http://library.christian.ac.th/thesis/document/T035797.pdf (in Thai)
Wongchana, T. (2021). Factors affecting to preventive behavior of stroke patients among uncontrolled-hypertensive patients in Muang District, Phitsanulok Province [Master’s thesis, Naresuan University]. https://nuir.lib.nu.ac.th/dspace/bitstream/123456789/3875/3/61061130.pdf (in Thai)
World Stroke Organization [WSO]. (2020). World Stroke Organization annual report 2020. https://www.world-stroke.org/assets/downloads/WSO_Annual_Report_2020_online.pdf
Yodpera, K. (2019). 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, 1(2), 19-27. https://he01.tci-thaijo.org/index.php/JCCPH/article/view/241445/167899 (in Thai)
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