Factors Predicting Self-Management Behavior among Patients with Uncontrolled Essential Hypertension
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Abstract
Purpose: To study self-management behavior and predictive power of age, gender, education level, health literacy, social support, and patient-provider communication on self-management behavior among patients with uncontrolled essential hypertension.
Design: Correlational predictive study.
Methods: The sample consisted of 84 patients with uncontrolled essential hypertension whose blood pressure was 140/90 mmHg or higher. The subjects were recruited from 3 public health centers, under Bangkok Health Department, Bangkok Metropolitan Administration. A convenience sampling was used to recruit 84 subjects. Data were collected using questionnaires including personal data and treatment, Multidimensional Scale of Perceived Social Support, Health Literacy assessment Scale, Patient-provider Communication Questionnaire, and Self-management Behavior Questionnaire. The reliability of the questionnaires were .88, .81, .84, and .90, respectively. Data were analyzed using descriptive statistics and multiple regressions with stepwise method.
Main findings: Self-management behavior of patients with uncontrolled essential hypertension was at a low level ( = 2.00, SD = 1.09). Social support was the single best predictor (step 1), 15.10% of the variance was accounted and health literacy was the next best predictor, after social support was included in the model (step 2). Health literacy accounted for an additional 8.1% (R2 change = .081) of the variability. Altogether, they could explain 23.20% of variability in self-management (R2 = .232, F = 12.259, p < .001). Social support was the most important predictor of self-management behavior among patients with hypertension (β = .368, p < .001), followed by health literacy (β = .285, p = .005)
Conclusion and recommendations: The study finding could be used as a guideline for
healthcare providers, in particular to nurses, for developing a self-management behavioral program for patients with hypertension by enhancing social support and promoting health literacy to practice self-management behavior effectively.
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References
His Majesty the King Office of Printing Mill; 2016. (in Thai).
2. National Health Security Office. National Health Security Office (NHSO) Annual report: fiscal year 2015. 1st ed. Bangkok: National Health Security Office; 2016. (in Thai).
3. Bengtsson U. Self-management in hypertension care. Göteborg, Sweden: Institute of Health and Care Sciences, University of Gothenburg; 2015. 85 p.
4. Riegel B, Carlson B. Facilitators and barriers to heart failure self-care. Patient Educ Couns. 2002;46(4):287-95.
5. Akhter N. Self-management among patients with hypertension in Bangladesh [master’s thesis]. Songkhla: Prince of Songkla University; 2010. 79 p.
6. Orem DE. Nursing concepts of practice. 4th ed. St.Louis: Mosby-Year Book; 1991.
7. Lee JE, Han HR, Song H, Kim J, Kim KB, Ryn JP, et al. Correlates of self-care behaviors for managing hypertension among Korean Americans: a questionnaire survey. Int J Nurs Stud. 2010;47(4):411-17.
8. Yang SO, Jeong GH, Kim SJ, Lee SH. Correlates of self-care behaviors among low-income elderly women with hypertension in South Korea. J Obstet Gynecol Neonatal Nurs. 2014;43(1):97-106.
9. Juntanon N, Singchai B, Worawong W. Self-care behavior of hypertension patients who live in Mueang District, Chumphon Province. Khon Kaen University Research Journal. 2011;16(6):749-58. (in Thai).
10. Sujamnong S. Factors related to selfmanagement of hypertensive patients, Taladkwan District Health Promoting Hospital, Nonthaburi Province. Journal of Boromarajonani College of Nursing. 2013;29(2):20-30. (in Thai).
11. Chang AK, Lee EJ. Factors affecting self-care in elderly patients with hypertension in Korea. Int J Nurs Pract. 2015;21(5):584-91.
12. McNaughton CD, Jacobson TA, Kriplani S. Low literacy is associated with uncontrolled blood pressure in primary care patient with hypertension and heart disease. Patient Educ Couns. 2014;96(2):165-70.
13. Schoenthaler A, Chaplin WF, Allegrante JP, Fernandez S, Diaz-Gloster M, Tobin JN, et al. Provider communication effects medication adherence in hypertensive African Americans. Patient Educ Couns.
2009;75(2):185-91.
14. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Asses. 1988;52(1):30-41.
15. Thai Hypertension Society. The guidelines on the treatment of hypertension 2012: update 2015. Bangkok: Thai Hypertension Society; 2015. (in Thai).
16. Cohen J. Statistical power analysis for the behaviolal seiences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
17. Pissamai B, Therawiwat M, Imanee N, Aree-ue S. Factors related to selfmanagement behaviors for persons with osteoarthritis. Journal of Public Health. 2012;42(2):54-67. (in Thai).
18. Wongpakaran N, Wongpakaran T, Ruktrakul R. A revised Thai Multi-Dimensional Scale of Perceived Social Support (MSPSS): Thai version. Clin Pract Epidemiol Ment Health. 2011;7:161-6.
19. Jindawong B, Bumreeaj S, Luvira V, Kuhiranyaratn P. Functional health literacy in patients at Srinagarind Hospital, Khon Kaen Province. In: 15th Graduate Research Conference; 28 March 2014; College of Local Administration, Khon Kaen University. Khon Kaen: Graduate School Khon Kaen University; 2014. p.1855-65. (in Thai).
20. Stewart AL, Nápoles-Springer AM, Gregorich SE, Santoyo-Olsson J. Interpersonal process of care: patient-reported measures for diverse groups. Health Serv Res. 2007;42(3 Pt1):1235-56.
21. Bokhour BG, Cohn ES, Cortés DE, Solomon JL, Fix GM, Elwy AR, et al. The role of patients’ explanatory models and daily-lived experience in hypertension selfmanagement. J Gen Intern Med. 2012;27(12):1626-34.
22. Truong PV, Jullamate P, Piphatvanitcha N. Factors related to self-management behaviors in hypertension older adults in Haiduong Province, Vietnam. Journal of Nursing and Health Sciences. 2016;10(3):56-64.
23. Kara Kaşikçi M, Alberto J. Family support, perceived self-efficacy and self-care behavior of Turkish patients with chronic obstructive pulmonary disease. J Clin Nurs. 2007;16(8):1468-78.
24. Hongkrajok H. Influences of health literacy, perceived self-efficacy, and patientshealth care provider communication on self-care behaviors among patients with primary hypertension [master’s thesis]. Chonburi: Burapa University; 2016. 93 p. (in Thai).