Association between Knowledge and Self-care Adherence among Elderly Hypertensive Patient in Dwelling Community

Reni Gusty; Nursyirwan Effendi; Khatijah Lim Abdullah; Yuliarni Syafrita

doi:10.3889/oamjms.2022.8342

Authors

Reni Gusty Department of Public Health Sciences, Faculty of Medicine, Universitas Andalas, West Sumatera, Indonesia https://orcid.org/0000-0001-8937-6239
Nursyirwan Effendi Department of Anthropology, Faculty of Social, Universitas Andalas, West Sumatera, Indonesia
Khatijah Lim Abdullah Department of Nursing, School of Medical and Life Science, Sunway University, Subang Jaya, Malaysia
Yuliarni Syafrita Department of Neurology, Faculty of Medicine, Universitas Andalas, West Sumatera, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8342

Keywords:

Medication, DASH diet, Weight management, Smoking, Physical activity

Abstract

BACKGROUND: Hypertension contributes significantly to the increase in cardiovascular disease cases, especially in the elderly. Knowledge and self-care compliance are needed, but in reality, awareness and regularity of control are still lacking in hypertensive patients in urban communities.

AIM: The aim of the study was to determine the relationship of knowledge with self-care and get an overview of existing knowledge and self-care in the elderly with hypertension.

METHODS: This is a quantitative and cross-sectional design recruited 383 hypertensive patients in three community health centers. Sampling with proportional random sampling from three health centers that have the highest cases of hypertension in the city of Padang. Knowledge instrument using hypertension knowledge-level scale. Moreover, hypertension self-care adherence using hypertension self-care activity level effects. Analysis using Chi-square test

RESULTS: The sample of this study was 383 respondents. About 66.3% are women, 88.3% have low education, and 86.9% do not work. 51.2% had duration of hypertension 0–5 years and the average age was 60.89 ± 8.072 years. About 94.8% of respondents have poor knowledge. Self-care practice showed 64% non-adherence to medication, 88.5% non-adherence to the DASH diet, and 82.5% non-adherence to weight management. However, 78.6% indicated non-smoking adherence and 100% alcohol avoidance adherence. There was a relationship between knowledge and adherence to weight management (p=0.000; odds ratio [OR] 6.7 (95% confidence interval [CI] for Exp B; 2.65–16.91)) and physical activity (p=0.000; OR 14.99 (95% CI for Exp B; 5.65–39.79)).

CONCLUSION: Providing comprehensive and repeated health education for the elderly with hypertension can increase their knowledge. The involvement of patients and families is needed to improve self-care behavior.

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References

World Health Organization. Raised Blood Pressure. Geneva: World Health Organization; 2018. Available from: https://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_tex/en [Last accessed on 2019 Jan 31].

Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. World J Cardiol. 2012;4(5):135-147 http://dx.doi.org/10.4330/wjc.v4.i5.135 PMid: 22655162

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206-52. https://doi.org/10.1161/01.HYP.0000107251.49515.c2 PMid:14656957

Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M, Lionakis N, et al. Hypertension in the elderly. World J Cardiol. 2012;4(5):135-47. https://doi.org/10.4330/wjc.v4.i5.135 PMid:22655162

Mpande N, Chinamasa CF, Manangazira P, Mungati M, Takundwa L, Bangure D, et al. Factors associated with uncontrolled high blood pressure amongst patients with hypertension at harare central hospital in zimbabwe. J Hypertens Cardiol. 2016;2(2):1-10. https://doi.org/10.14302/issn.2329-9487.jhc-16-1020

Tesfaye B, Haile D, Lake B, Belachew T, Tesfaye T, Abera H. Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: Cross-sectional study. Res Reports Clin Cardiol. 2017;8:21-9. https://doi.org/10.2147/rrcc.s132126

Yang ZQ, Zhao Q, Jiang P, Zheng SB, Xu B. Prevalence and control of hypertension among a community of elderly population in changning district of Shanghai: A cross-sectional study. BMC Geriatr. 2017;17(1):1-9. https://doi.org/10.1186/s12877-01-0686-y PMid:29281978

Easthall C, Barnett N. Using theory to explore the determinants of medication adherence; moving away from a one-size-fitsall approach. Pharmacy. 2017;5(4):50. https://doi.org/10.3390/pharmacy5030050 PMid:28970462

Warren-Findlow J, Basalik DW, Dulin M, Tapp H, Kuhn L. Preliminary validation of the hypertension self-care activity level effects (H-SCALE) and clinical blood pressure among patients with hypertension. J Clin Hypertens. 2013;15(9):637-43. https://doi.org/10.1111/jch.12157 PMid:24034656

Warren-Findlow J, Coffman MJ, Thomas EV, Krinner LM. ECHO: A Pilot Health Literacy Intervention to Improve Hypertension Self-Care. Health Lit Res Pract. 2019;3(4):e259-67. https://doi.org/10.3928/24748307-20191028-01 PMid:31893258

Erkoc SB, Isikli B, Metintas S, Kalyoncu C. Hypertension knowledge-level scale (HK-LS): A study on development, validity and reliability. Int J Environ Res Public Health. 2012;9(3):1018-29. https://doi.org/10.3390/ijerph9031018 PMid:22690180

Ernawati I, Fandinata SS, Permatasari SN. Translation and validation of the indonesian version of the hypertension knowledge-level scale. Open Access Maced J Med Sci. 2020;8:630-7. https://doi.org/10.3889/OAMJMS.2020.5152

Motlagh SF, Chaman R, Sadeghi E, Eslami AA. Self-care behaviors and related factors in hypertensive patients. Iran Red Crescent Med J. 2016;18(6):e35805. https://doi.org/10.5812/ircmj.35805 PMid:27621938

Putri SE, Rekawati E, Nurviyandari D, Wati K. Effectiveness of self-management on adherence to self-care and on health status among elderly people with hypertension. J Public health Res. 2021;10(S1):75-81. https://doi.org/10:(s1):2406 PMid:34060750

Ahmad A, Oparil S. Hypertension in women recent advances and lingering questions. Hypertens J. 2017;70(1):19-26. https://doi.org/10.1161/HYPERTENSIONAHA.117.08317 PMid:28483918

Ferdinand KC, Fleg JL. Hypertension across a woman’s life cycle. J Am Coll Cardiol. 2019;71(16):1797-813. https://doi.org/1016/j.jacc.2018.02.033 PMid:29673470

Gebremichael GB, Berhe KK, Beyene BG, Gebrekidan KB. Selfcare practices and associated factors among adult hypertensive patients in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, 2018. BMC Res Notes. 2019;12(1):489. https://doi.org/10.1186/s13104-019-4502-y PMid:31387617

Kilic M, Uzunçakmak T, Ede H. The effect of knowledge about hypertension on the control of high blood pressure. Int J Cardiovasc Acad. 2016;2(1):27-32. https://doi.org/10.1016/j.ijcac.2016.01.003

Chimberengwa PT, Naidoo M. Knowledge, attitudes and practices related to hypertension among residents of a disadvantaged rural community in southern Zimbabwe. PLoS One. 2018;14(6):e0215500. https://doi.org/10.1371/journal.pone.0215500 PMid:31237883

Estrada D, Sierra C, Soriano RM, Jordán AI, Plaza N, Fernández C. Grade of knowledge of hypertension in hypertensive patients. Enferm Clín (English Ed). 2020;30(2):99-107. https://doi.org/10.1016/j.enfcle.2018.11.003 PMid:30954394

Tan CS, Hassali MA, Neoh CF, Saleem F. A qualitative exploration of hypertensive patients’ perception towards quality use of medication and hypertension management at the community level. Pharm Pract (Granada). 2017;15(4):1074. https://doi.org/10.18549/PharmPract.2017.04.1074 PMid:29317924

Bhattacharya S, Thakur J, Singh A. Knowledge attitude, and practice regarding dietary salt intake among urban slum population of North India. J Fam Med Prim. 2018;7(3):526-30. https://doi.org/10.4103/jfmpc.jfmpc PMid:30112302

Aynalem GA, Bekele TA, Berhe TT, Endazenew G. Factors affecting adherence to lifestyle modification among patients with hypertension at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2019. SAGE Open Med. 2021;9:205031212110125. https://doi.org/10.1177/20503121211012523 PMid:33996085

Ajani K, Gowani A, Gul R, Petrucka P. Levels and predictors of self-care among patients with hypertension in Pakistan. Int J Gen Med. 2021;14:1023-32. https://doi.org/10.2147/ijgm.s297770 PMid:33790631

Sarrafzadegan N, Mansourian M, Alikhassi H, Sherafat A, Khosravi A. Self-Care Behaviours and Determinants Associated with Hypertension Control in Elderly Patients. J Pat Care, Vol.7 Iss. 3 No: 157 2021;1–8.

Wondmieneh A, Gedefaw G, Getie A, Demis A. Self-care practice and associated factors among hypertensive patients in Ethiopia: A systematic review and meta-analysis. Int J Hypertens. 2021;2021:5582547. https://doi.org/10.1155/2021/5582547 PMid:33898063

Seangpraw K, Ong-Artborirak P. Knowledge and behaviors toward health care for elderly patients with hypertension, and quality of life among informal caregivers in Northern Thailand. J Multidiscip Healthc. 2020;13:1771-80. https://doi.org/10.2147/JMDH.S284886 PMid:33293820

Karthikeyan G, Ranganayakulu D. Evaluation of hypertension knowledge and drug adherence among South Indian population. Int J Pharm Sci Res. 2014;5(9):4056-60. https://doi.org/10.13040/IJPSR.0975-8232.5

Burnier M. Drug adherence in hypertension. Pharmacol Res. 2017;125:142-9. https://doi.org/10.1016/j.phrs.2017.08.015 PMid:28870498

Martin LR, Feig C, Maksoudian CR, Wysong K, Faasse K. A perspective on nonadherence to drug therapy: Psychological barriers and strategies to overcome nonadherence. Patient Prefer Adherence. 2018;12:1527-35. https://doi.org/10.2147/PPA.S155971 PMid:30197504

Abed Y, Abu-Haddaf S. Risk factors of hypertension at UNRWA primary health care centers in gaza governorates. ISRN Epidemiol. 2013;2013:1-9. https://doi.org/10.5402/2013/720760

dos Santos RZ, Korbes AS, Martins ET, De Lucca M, De Lucca L, Karsten M, et al. Does hypertension knowledge influence levels of physical activity in hypertensive patients from a southern Brazilian community? Int J Cardiovasc Sci. 2021;34(5):542-9. https://doi.org/10.36660/ijcs.20200141

Akpa OM, Okekunle AP, Asowata JO, Adedokun B. Passive smoking exposure and the risk of hypertension among nonsmoking adults: The 2015-2016 NHANES data. Clin Hypertens. 2021;27(1):1-12. https://doi.org/10.1186/s40885-020-00159-7

Lusno MF, Haksama S, Wulandari A, Sriram S. Association between smoking and hypertension as a disease burden in Sidoarjo: A case-control study. Int J Appl Biol. 2020;4(2):9-16.

Hughes JR. Motivating and helping smokers to stop smoking. J Gen Intern Med. 2003;18(12):1053-7. https://doi.org/10.1111/j.1525-1497.2003.20640.x PMid:14687265

Mitra M, Wulandari W. Factors affecting uncontrolled blood pressure among elderly hypertensive patients in Pekanbaru City, Indonesia. Open Access Maced J Med Sci. 2019;7(7):1209-13. https://doi.org/10.3889/oamjms.2019.255 PMid:31049109