Self-management Among Elderly Patients With Hypertension and Its Association With Individual and Social Environmental Factors in China

Zhang, Xiaonan; Qiu, Chen; Zheng, Youli; Zang, Xiaoying; Zhao, Yue

doi:10.1097/jcn.0000000000000608

Cited by 12 publications

(10 citation statements)

References 24 publications

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“…Indeed, prolonged and complex disease do severely affects the physical and mental health of older patients and the ability of CDSM [ 34 ]. This study also discovered that older adults with low income and living alone had lower levels of CDSM, which is consistent with published findings [ 35 ]. These older adults often lack access to health information and have nobody to monitor and correct behaviors detrimental to disease management.…”

Section: Discussionsupporting

confidence: 93%

Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis

Wen

Wang

et al. 2022

BMC Public Health

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Background Chronic non-communicable diseases (CNCDs) are an urgent public health issue in China, especially among older adults. Hence, self-management is crucial for disease progression and treatment. Electronic health (e-health) literacy and self-efficacy positively correlate with self-management. However, we know little about their underlying mechanisms in older adults with CNCDs. Objective To explore the factors that influence chronic disease self-management (CDSM) and verify self-efficacy as the mediator between e-health literacy and self-management behavior in older patients with CNCDs. Methods This cross-sectional study included 289 older patients with CNCDs from Hunan province, China, between July and November 2021. E-health literacy, self-efficacy, social support, and CDSM data were collected through questionnaires. The influence of each factor on CDSM was explored with multiple linear regression analysis. Intermediary effects were computed via a structural equation model. Results The total CDSM score in the patients was 29.39 ± 9.60 and only 46 (15.92%) patients used smart healthcare devices. The regression analysis showed e-health literacy, self-efficacy, and social support were the factors that affected CDSM. Furthermore, the structural equation model revealed that self-efficacy directly affected CDSM (β = 0.45, P < 0.01), whereas e-health literacy affected it directly (β = 0.42, P < 0.01) and indirectly (β = 0.429, P < 0.01) through self-efficacy. Conclusions This study revealed that self-management among older patients with CNCDs is at a low level, and few of them use smart healthcare devices. Self-efficacy plays a partial intermediary role between e-health literacy and self-management in older patients with CNCDs. Thus, efforts to improve their CDSM by targeting e-health literacy may be more effective when considering self-efficacy.

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Section: Discussionsupporting

confidence: 93%

Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis

Wen

Wang

et al. 2022

BMC Public Health

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“…Self-care adherence for hypertension includes medication adherence, adoption of a low-salt diet, regular physical activity for 30 minutes on most days, loss or maintenance of weight, limiting alcohol intake, and ceasing tobacco use [ 12 ]. Adherence to these six self-care practices is important to control hypertension and prevent its devastating complications [ 13 , 14 ]. Not only automated self-care support but telemonitoring of patients self-care behavior also reduces uncontrolled systolic hypertension and improves control of hypertension [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis

Edmealem

Ademe

Gedamu

2022

International Journal of Hypertension

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Background. Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patients in Ethiopia. Thus, this systematic review and meta-analysis was done to determine the pooled estimate self-care adherence. Methods. This systematic review and meta-analysis was reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. An intensive search of online databases such as PubMed (MEDLINE), CINHAL, Google Scholar, and advanced Google search was made to access both published and unpublished articles that report self-care adherence among hypertensive patients in Ethiopia. The pooled estimate was done with STATA version 11 metan commands in a 95% confidence interval. The presence of heterogeneity and publication bias were detected by I2 and Egger’s test, respectively. A random-effect model was obtained, and subgroup analysis was done for the management of heterogeneity. Result. A total of 24 articles with a total of 7224 participants were included in the final systematic review and meta-analysis. The pooled estimate of overall self-care adherence among hypertensive patients was 36.98% (95% CI: 27.13–46.83). In subgroup analysis, the highest overall self-care adherence was observed in the Amhara region at 53% (95% CI: 46.54, 59.47). The pooled estimate of self-care dimensions such as medication adherence, low-salt diet, physical activity, smoking abstinence, alcohol abstinence, and weight management was 62.71%, 65.96%, 47.28%, 92.53%, 67.59%, and 52.54%, respectively. Conclusion. The pooled estimate of good self-care adherence among hypertensive patients was low. From the dimensions of self-care, the lowest level was in physical activity and the highest level was in smoking abstinence. Comparing all regions, the lowest level of overall self-care adherence was observed in Addis Ababa, Tigray region, and South Nations and Nationalities of Ethiopia. Screening of adherence to self-care and health education should be provided to every patient during every visit.

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“…Married older adults with higher level of education and their own income had better self‐care behaviours than those who were unmarried, had less education and had income from other sources such as charities. Zhang et al ( 2020 ) showed older patients with hypertension who are single and live alone and have lower education level need to pay more attention to self‐management behaviours such as exercise programs. The findings of Gholamnejad et al ( 2019 ) and Lee and Park ( 2017 ) revealed that education level and family support affected self‐care behaviour in older patients with uncontrolled hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…Zhang et al (2020) showed older patients with hypertension who are single and live alone and have lower education level need to pay more attention to self-management behaviours such as exerciseTA B L E 3Abbreviations: β, standardized coefficients beta; CI, confidence interval; Ref., reference group; SE, standard error.…”

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confidence: 99%

Association between fear of falling and self‐care behaviours of older people with hypertension

et al. 2023

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Aim This study investigated the association between fear of falling and self‐care behaviours of older people with hypertension. Design A cross‐sectional study. Methods This study was conducted in 2019 on 301 older people with hypertension above the age of 60 years in Tehran, Iran. Data were collected using a demographic questionnaire, the Persian Falls Efficacy Scale‐International, and a hypertension‐related self‐care behaviour questionnaire. Results Analyses revealed that gender, educational level and history of falling were significant factors associated with fear of falling; and marital status, educational level and income source were significant factors associated with self‐care behaviours ( p < 0.05). Partial correlations controlling for education revealed a significant positive correlation showing that high fear of falling is associated with worse health promotion self‐care behaviours and significant inverse correlations with psycho‐emotional, social and daily self‐care behaviours ( p < 0.05), meaning that high fear of falling is associated with better self‐care for these dimensions. Patient or Public Contribution This study involved patients in order to evaluate the validity and reliability of the questionnaires. The study was conducted on older people with hypertension referred to hypertension clinics in hospitals.

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Self-management Among Elderly Patients With Hypertension and Its Association With Individual and Social Environmental Factors in China

Cited by 12 publications

References 24 publications

Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis

Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis

Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis

Association between fear of falling and self‐care behaviours of older people with hypertension

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