Practice and predictors of self-care behaviors among ambulatory patients with hypertension in Ethiopia

Abstract

Background Despite the benefits of evidence-based self-care behaviors in the management of hypertension, hypertensive patients have low rate of adherence to the recommended self-care behaviors. Studies related to self-care behaviors among hypertensive patients are limited in Ethiopia. Objective To assess the rate of adherence to self-care behaviors and associated factors among hypertensive patients. Method A cross-sectional study was conducted at the cardiac clinic of Ayder comprehensive specialized hospital among ambulatory hypertensive patients. Self-care behaviors were assessed using an adopted Hypertension Self-Care Activity Level Effects (H–SCALE). Data were collected through patient interview and review of medical records. Binary logistic regression analysis was performed to identify predictors of self-care behaviors. Result A total of 276 patients were included in the study. The majority of the participants were nonsmokers (89.9%) and alcohol abstainers (68.8%). Less than half of the participants were adherent to the prescribed antihypertensive medications (48.2%) and recommended physical activity level (44.9%). Moreover, only 21.45% and 29% were adherent to weight management and low salt diet recommendations, respectively. Our finding indicated that rural resident (adjusted odds ratio [AOR]: 0.45, 95% confidence interval [CI]: 0.21–0.97), comorbidity (AOR: 0.16, 95% CI: 0.08–0.31), and negative medication belief (AOR: 0.25, 95% CI: 0.14–0.46) were significantly associated with medication adherence. Female sex (AOR: 0.46, 95% CI: 0.23–0.92), old age (AOR: 0.19, 95% CI: 0.06–0.60) and lack of knowledge on self-care behaviors (AOR: 0.13, 95% CI: 0.03–0.57) were significantly associated with adherence to weight management. Female sex (AOR: 1.97, 95% CI: 1.03–3.75) and lack of knowledge on self-care (AOR: 0.07, 95% CI: 0.03–0.16) were significantly associated with adherence to alcohol abstinence. Female sex (AOR: 6.33, 95% CI: 1.80–22.31) and khat chewing (AOR: 0.08, 95% CI: 0.03–0.24) were significantly associated with non-smoking behavior. There was also a significant association between female sex and physical activity (AOR: 0.22, 95% CI: 0.12–0.40). Conclusion The rate of adherence to self-care behaviors particularly weight management, low salt intake, physical exercise, and medication intake was low in our study. Elders, females, khat chewers, rural residents, and patients with negative medication belief, comorbidity, and inadequate knowledge of SCBs were less adherent to self-care behaviors compared to their counterparts. Therefore, health care providers should pay more emphasis to patients at risk of having low self-care behaviors.

Levels and Predictors of Self-Care Among Patients with Hypertension in Pakistan

“…3 Likewise, in the Mediterranean region, 26% of the total population is affected by hypertension. 4 In developing countries, such as within the African region, hypertension has become concerning, with Ethiopia reporting an overall prevalence of 19.6%. 5 …”

“… 10 Past studies have shown effectiveness of self-care behaviors in reduction of BP and associated complications, plus escalation of the efficacy of medication and overall health regimes. 4 , 5 , 30 , 36 Given the potential substantial benefits of self-care, novel approaches, and interventions are required to enable a robust and responsive system that can assist in promoting self-care behavior among individuals with hypertension.…”

Faktor-Faktor yang Mempengaruhi Self-care Behavior pada Klien dengan Hipertensi di Komunitas

“…Dari 12 penelitian yang ditinjau beberapa faktor yang mempengaruhi self-care behavior pada klien dengan hipertensi di komunitas. Beberapa faktor yang mempengaruhi self-care behavior seperti faktor personal yang terdiri dari faktor sosio ekonomi, pendidikan, pengetahuan, peningkatan usia, dan persepsi terhadap penyakit (5,6,(11)(12)(13)(14) , self-efficacy yang merupakan kepercayaan seseorang dalam melakukan aktivitas tertentu, termasuk kepercayaan diri untuk melakukan aktivitas saat hambatan muncul (3,6,8,10,15) , dukungan keluarga yang merupakan upaya yang diberikan kepada anggota keluarga, baik moril maupun materiil, sehingga dengan dukungan itu seseorang merasa diperhatikan, mendapat saran, atau kesan yang menyenangkan pada dirinya (3,10,11) , dan spiritualitas yang merupakan pengalaman manusia secara umum dari suatu pengertian akan makna, tujuan dan moralitas (6) .…”

“…Faktor personal yang mempengaruhi self-care behavior adalah status sosio ekonomi,pendidikan, pengetahuan, peningkatan usia dan persepsi terhadap penyakit. status sosio ekonomi,pendidikan, pengetahuan, peningkatan usia dan persepsi secara signifikan mempengaruhi self-care behavior pada klien dengan hipertensi (5,12,14) .…”

“…Pendidikan berhubungan erat dengan pengetahuan dimana ketika pendidikan tinggi signifkan dengan pengetahuan yang tinggi yang dianggap sebagai dasar menggabungkan perilaku manajemen mandiri pada pasien klien dengan hipertensi (12,13) . Peningkatan pengetahuan telah dikaitkan dengan peningkatan perilaku perawatan diri pada klien dengan hipertensi, sedangkan pengetahuan yang tidak memadai dikaitkan dengan perilaku perawatan diri yang buruk (11,14) . Penelitian (5,6) telah menunjukkan bahwa klien dengan hipertensi dengan pendidikan kurang memiliki probabilitas lebih rendah untuk terlibat dalam perilaku perawatan diri pada hipertensi.…”