Self-Care in Patients With Hypertension in Indonesia
Abstract
Hypertension or elevated blood pressure is one of the leading causes of premature death worldwide. One strategy to better treat hypertension is to involve patients in their own self-care. This cross-sectional descriptive study was conducted in West Java, Indonesia, from June to July 2021. A convenience sample of 144 adults with hypertension was used. The inclusion criteria were: people aged 35 to 65; prescribed two or fewer antihypertensive drugs for hypertension; with a blood pressure of more than 140/90 mm Hg at baseline; able to control their blood pressure and self-titrate medicine; and able to read and write in Bahasa Indonesia. The SC-HI is a 24-item questionnaire that assesses self-care in hypertension on three dimensions: self-care maintenance, management, and confidence. Linear regression analyses were used to investigate self-care and its associated factors. The average age of the patients was 55.67 ± 10.65 years, 59.7% were female, 77.8% were married, and 48.6% had finished secondary school. The mean overall self-care score among the hypertensive patients was 2.43 (SD = 1.26). The self-care domain with the lowest mean score was in confidence (mean = 2.12, SD = 1.96) and the highest score was in maintenance (mean = 2.86, SD = 2.01). Gender, education level, and duration of hypertension contributed significantly to the variance in self-care with an R-squared of 23.4%. We found that the level of self-care in the hypertensive patients in general was inadequate. Patients should be educated and counseled about the importance of adherence to self-care in the management of hypertension.
Keywords: self-care, hypertension, self-management
References
[1] Lackland D. Note from the editor president’s column children’s art poster contest 2019 science and art attempt to describe. 2019;(163):1–11.
[2] Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334–57.
[3] Dorans KS, Mills KT, Liu Y, He J. Trends in prevalence and control of hypertension according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline. Journal of the American Heart Association. 2018;7(11):1–11.
[4] Tackling G, Borhade MB. Hypertensive heart disease. Treasure Island; 2021.
[5] Chia YC, Buranakitjaroen P, Chen CH, et al. Current status of home blood pressure monitoring in Asia: Statement from the HOPE Asia Network. The Journal of Clinical Hypertension. 2017;19(11):1192–201.
[6] Riskesdas. Riset kesehatan dasar 2018. Kementrian Kesehat Republik Indones; 2018.
[7] Yang S-O, Jeong GH, Kim S-J, Lee SH. Correlates of self-care behaviors among low-income elderly women with hypertension in South Korea. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2014;43(1):97–106.
[8] Chobanian A V, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA. 2003;289(19):2560–72.
[9] Silveira-Nunes G, Durso DFA, Cunha EHM, et al. Hypertension is associated with intestinal microbiota dysbiosis and inflammation in a Brazilian population. Frontiers in pharmacology. 2020;11:258.
[10] Niriayo YL, Ibrahim S, Kassa TD, et al. Practice and predictors of self-care behaviors among ambulatory patients with hypertension in Ethiopia. PLoS One. 2019;14(6):e0218947.
[11] McManus RJ, Mant J, Franssen M, et al. Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): An unmasked randomised controlled trial. Lancet. 2018;391(10124):949–59.
[12] 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. The Journal of Clinical Hypertension. 2013;15(9):637–43.
[13] Brook RD, Appel LJ, Rubenfire M, et al. Beyond medications and diet: Alternative approaches to lowering blood pressure: A scientific statement from the American Heart Association. Hypertension. 2013;61(6):1360–83.
[14] Weir MR, Maibach EW, Bakris GL, et al. Implications of a health lifestyle and medication analysis for improving hypertension control. Archives of internal medicine. 2000;160(4):481–90.
[15] Tucker KL, Sheppard JP, Stevens R, et al. Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389.
[16] Dickson VV, Lee C, Yehle KS, Abel WM, Riegel B. Psychometric testing of the selfcare of hypertension inventory. Journal of Cardiovascular Nursing. 2017;32(5).
[17] Ma C, Kelishadi R, Hong YM, et al. Performance of eleven simplified methods for the identification of elevated blood pressure in children and adolescents. Hypertension. 2016;68(3):614–20.
[18] Bilal M, Haseeb A, Lashkerwala SS, et al. Knowledge, awareness and self-care practices of hypertension among cardiac hypertensive patients. Global Journal Health Science. 2015;8(2):9–19.
[19] Zafar SN, Gowani SA, Irani FA, Ishaq M. Awareness of the risk factors, presenting features and complications of hypertension amongst hypertensives and normotensives. J Pak Med Assoc. 2008;58(12):711–5.
[20] Li X, Zhang X, Leathers R, et al. Notch3 signaling promotes the development of pulmonary arterial hypertension. Nature medicine. 2009;15(11):1289–97.
[21] Ong KL, Cheung BMY, Man YB, Lau CP, Lam KSL. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 2007;49(1):69–75.
[22] Mohamed SF, Mutua MK, Wamai R, et al. Prevalence, awareness, treatment and control of hypertension and their determinants: Results from a national survey in Kenya. BMC Public Health. 2018;18(Suppl 3):1219.
[23] Weber MA. Recently published hypertension guidelines of the JNC 8 panelists, the American Society of Hypertension/International Society of Hypertension and other major organizations: Introduction to a focus issue of the Journal of Clinical Hypertension. Journal of Clinical Hypertension. 2014;16(4):241–245.
[24] Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: A meta-analysis. Lancet. 2001;358(9290):1305–15.
[25] Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365(9455):217–23.