Background and purpose: Hypertension is a major risk factor for stroke. Despite efforts to control hypertension with pharmacological and non-pharmacological therapies, the prevalence of and death from stroke is reported to be increasing. This study aims to determine the association of hypertension self-management with the incidence of stroke in patients with hypertension.Methods: A case-control study was conducted involving 44 patients suffering from hypertension and who had suffered a stroke as a case, as well as 44 patients with hypertension and no stroke as a control. Data on self-management of diet, physical activity, stress mitigation efforts, alcohol consumption, and medication adherence were collected using self administered questionnaire. Data on the diagnosis of hypertension, stroke and history of comorbidities were obtained from the patient's medical records. Multivariatee analysis using logistic regression was employed to assess the association between hypertension self-management with the incidence of stroke in patients with hypertension.Results: Characteristics of cases and controls did not differ in education, marital and socioeconomic status, but differed in age and employment. Multivariate analysis showed that there were three components of hypertension self-management associated with the incidence of stroke, namely poor adherence to medication (AOR=7.28; 95%CI: 2.19-24.17), poor self-management of stress (AOR=5.45; 95%CI: 1.56-18.99), and poor management of self-regulated diet (AOR=5.28; 95%CI: 1.31-21.32).Conclusions: Medication adherence, diet and stress management are the three main components of self-management that are associated with stroke events among hypertension patients. Efforts to increase medication adherence, diet and stress management should be enhanced.
While elderly population in Indonesia continues to increase, research around elderly and health care for elderly is still limited. The purpose of this study was to identify priority of research area on Gerontic Nursing in Indonesia. This was a descriptive study, using Delphi study with 2 survey rounds. Round 1 involved 34 participants purposely selected among nurses who worked in the area of and had a research interest in Gerontic Nursing. Open ended online questionnaire about priority areas was sent to potential participants. Data was analyzed for its similarity, resulted in 36 research areas around Gerontic Nursing. Round 2 involved 204 nurses with the same criteria as in round 1, selected using convenience sampling technique. Close ended questionnaire using Semantic Differential Scale range from 1 to 9 was sent via online to potential participants. Data was descriptively analyzed for median, interquartile range (IQR), and range. Findings indicated 10 levels of research priority. Level 1 research priority with Median of 9, IQR 1, and range 5 were long term care for elderly, family knowledge on caring for elderly, personal hygiene in elderly, competency of Gerontic Nurse, and nutrition in elderly. Nurse academics and researchers are suggested to collaborate with nurse practitioners in various settings to conduct research on these priority areas.
Introduction: Little do we understand about factors associated with functional disability in instrumental activities of daily living among the elderly living at home. This study aimed to explore the prevalence and determinant factors of functional disability in instrumental activities of daily living (IADL) among the elderly living in a rural area in Bali. Method: Using a cross-sectional design, 1,053 elderly aged 60 years and above living in a rural area in Bali were recruited. A structured interview by trained data collectors was conducted. Questionnaires used were the Lawton IADL Scale, the 5-item of Geriatric Depression Scale, and the adoption of questionnaires for vision, hearing, and communication problems from the Washington Group Short Set of Questions on Disability. A logistic regression model was applied to explore determinant factors. Results: Findings indicated that 26.1% of participants aged 75+ and 52.3% were female. Eight percent (8%) experienced functional disability in IADL, 1.9% lived alone, 11.8% indicated depression, 5.1%, 4.7%, and 1.6% of them had vision loss, hearing impairment, and communication problems, respectively. The strongest determinant factor for functional disability in IADL was depression (OR 7.869; 95% CI 4.657-13.296), followed by age (OR 4.602; 95% CI 2.764-7.663), and hearing impairment (OR 2.903; 95% CI 1.190-7.083). Conclusions: Depression is the strongest determinant factor for functional disability in IADL. Health professionals in rural areas should actively screen for depression to increase the ability of the elderly to fulfill their IADLs. Keywords: aged, depression, epidemiology, Indonesia
Background: People with hypertension are a vulnerable group to morbidity and mortality, especially during the Covid-19 pandemic. During the period of social restrictions, self-management of hypertension is recommended for patients especially in controlling their blood pressures. Families play an important role in the self-management carried out by the patient at home. Purpose: This study aimed to identify knowledge of families with hypertension about the self-management of hypertension. Methods: This study employed a descriptive design with a cross-sectional approach. The research was carried out in Serangan Village, South Denpasar District for 1 month. This study involved 145 families with hypertension. Data was collected using questionnaires. The data wqs analyzed univariately using SPSS version 20. Results: showed that most families had adequate knowledge of hypertension self-management (66.2%). However, the remaining 33.8% indicated poor knowledge on self-management. Based on the six components of hypertension self-management, most families in this study had adequate knowledge on diet management (66.2%), physical activity management (67.6%), stress management (89.0%), alcohol intake management (53.8%), smoking habit management (85.5%) and medication adherence (92.4%). Conclusion: Health care workers are suggested to strengthen family education about hypertension self-management especially those indicating poor knowledge via home visits with Pandemic protocols.
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