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International Journal of Evidence Based Nursing And Practices Original Research

A Study to Evaluate the Impact of Health Education on Awareness of Long-term Complications of Hypertension Among Hypertensive Patients in A Selected Hospital, Bengaluru

  1. Madhushree A.V. Department of Medical Surgical Nursing, Kempegowda Institute of Nursing

Abstract

The rising burden of non-communicable diseases, particularly hypertension, poses significant public health challenges, especially in developing nations. This study aimed to assess the effectiveness of a health education program focused on lifestyle modifications to prevent hypertension-related complications among patients at selected hospitals in Bengaluru. Employing a quasi-experimental design, we recruited 60 hypertensive patients through purposive sampling. Initial knowledge was evaluated using a structured questionnaire, followed by an educational intervention provided on the same day. A post-test was conducted eight days later using the same instrument. Results indicated a mean pre-test knowledge score of 13.0%, which increased to 42.65% post-intervention, reflecting a 29.65% gain and a 69.5% overall improvement in knowledge. Statistical analysis, including a paired t-test, demonstrated a t-value of 37.71 and a p-value less than 0.01, confirming the effectiveness of the health education program in enhancing knowledge about hypertension and its long-term complications. These findings reveal a significant knowledge gap among hypertensive patients prior to the intervention, highlighting the necessity for targeted educational efforts. The health education materials, developed by the WHO, effectively communicated critical information, leading to improved patient understanding and engagement in self-management strategies. In conclusion, the study emphasizes the importance of structured health education in empowering hypertensive patients to manage their condition more effectively, thereby reducing the risk of long-term complications associated with hypertension. This approach is essential in addressing the growing prevalence of non-communicable diseases in developing contexts.

Keywords

References (48)

  1. C.Smeltzer, Brenda.G.Bare, Janice.L.Hinkle, Kerry.H.Cheever, Brunner andsuddarth′s textbook of medical surgical nursing.11th ed.Wolters Kluwer(India) pvt.Ltd.,New Delhi bussiness2008;pp232,786,1020-1033.
  2. M.Black, Ester Matassarin-Jacobs, Medical Surgical Nursing clinical management for continuity of care. 5th ed.W.B.Saunsers company2005;pp237,1387-1404.
  3. K. Textbook of preventive and social medicine, 2009.IndiaM/s. Banarsidas Bhanot;20th Edition:13, 315.
  4. FIGAR S, GALARZA C, PETRLIK E, HORNSTEIN L, RODRIGUEZLORIA G, WAISMAN G, et al. Effect of Education on Blood Pressure Control in Elderly PersonsA Randomized Controlled Trial. American Journal of Hypertension. 2006;19(7):737-743. doi:10.1016/j.amjhyper.2005.10.005
  5. Singh S, Shankar R, Singh GP. Prevalence and Associated Risk Factors of Hypertension: A Cross‐Sectional Study in Urban Varanasi. International Journal of Hypertension. 2017;2017(1). doi:10.1155/2017/5491838
  6. Steffi Veientlena, Prabu P. Prevalence of hypertension and determination of its risk factors inKorangrapady, Udupi district, coastal Karnataka, India. Asian J Pharm Clin Res. 2018;11(6):517-521. Available from: https://doi.org/10.1155/2017/5491838.
  7. Hemant Mahajan, Yasmeen Kazi, Bhuwan Sharma, GD Velhal. Assessment of KAP, Risk Factors and Associated Co-Morbidities in Hypertensive Patients. IOSR Journal of Dental and Medical Sciences (IOSRJDMS). 2012;1(2):06-14.
  8. Paulo Carl G. Mejia, Evelyn E. Feliciano, Alfredo Z. Feliciano, Jonaid M. Sadang, et al. The effectiveness of health education and lifestyle program in improving the Blood Pressure in hypertensive patients. International Journal of Advanced and Applied Sciences. 2019; 6(11):21-29. Available from: DOI:21833/ijaas.2019.11.004.
  9. Abdalla AA. Knowledge, attitude and practice towards therapeutic lifestyle changes in the management of hypertension in Khartoum State. Cardiovascular Journal of Africa. 2021;32(4):26-31. doi:10.5830/cvja-2021-011
  10. Shnaimer JA, Gosadi IM. Primary health care physicians’ knowledge and adherence regarding hypertension management guidelines in southwest of Saudi Arabia. Medicine. 2020;99(17):e19873. doi:10.1097/md.0000000000019873
  11. Doreen Busingye, Simin Arabshahi, Roger G Evans, Michaela A Riddell, Velandai K Srikanth,et al. Knowledge of risk factors for hypertension in a rural Indian population. 2019 ;(11): e011136. Available from: DOI: 1136/heartasia-2018-011136.
  12. Kilic M, Uzunçakmak T, Ede H. The effect of knowledge about hypertension on the control of high blood pressure. International Journal of the Cardiovascular Academy. 2016;2(1):27-32. doi:10.1016/j.ijcac.2016.01.003
  13. Turana Y, Tengkawan J, Chia YC, Nathaniel M, Wang JG, Sukonthasarn A, et al. Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. The Journal of Clinical Hypertension. 2020;23(3):513-521. doi:10.1111/jch.14099
  14. Das SK, Sanyal K, Basu A. Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country. International Journal of Medical Sciences. 2005:70-78. doi:10.7150/ijms.2.70
  15. Balasaheb Bansodea, MarbaniangaJang, BahadurPrasad. Risk factors of diabetes and hypertension among women in Karnataka,Elsevier; 2021:15(4),102139.
  16. Geevar Z, Krishnan MN, Venugopal K, Sanjay G, Harikrishnan S, Mohanan PP, et al. Prevalence, Awareness, Treatment, and Control of Hypertension in Young Adults (20–39 Years) in Kerala, South India. Frontiers in Cardiovascular Medicine. 2022;9. doi:10.3389/fcvm.2022.765442
  17. Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India. Journal of Hypertension. 2014;32(6):1170-1177. doi:10.1097/hjh.0000000000000146
  18. WHO Hypertension key facts. Available form:https://who.int/news-room/fact- sheets/detail/hypertension.
  19. Vinod K. Ramani1, Suresh K.P.2, Prevalence of hypertension and diabetes morbidity among adults in a few urban slums of Bangalore city, determinants of its risk factors and opportunities for control. Journal of Family Medicine and Primary Care; Published by Wolters Kluwer.2020;(24):10.4103/jfmpc.jfmpc_234_20.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567266/pdf/JFMPC-9- 3264.pdf.
  20. Iftekhar Quasem, Mrunal S.Shetye, Shiney C. Alex, Anjan Kumar Nag, P.S. Sarma, K.R. Thankappan et al. Prevalence, awareness, treatment and control of hypertension among the elderly in Bangladesh and India, a multicentre study; World Health Organization. 2001; 79 (6): 490–500.
  21. Cupples ME, McKnight A. Randomised controlled trial of health promotion in general practice for patients at high cardiovascular risk. BMJ. 1994;309(6960):993-996. doi:10.1136/bmj.309.6960.993
  22. Bramham K, Parnell B, Nelson-Piercy C, Seed PT, Poston L, Chappell LC. Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis. BMJ. 2014;348(apr157):g2301-g2301. doi:10.1136/bmj.g2301
  23. T. Hardy, Swati Sakhuja, Byron C. Jaeger, Elaine M. Urbina, MD, MS3; Shakira F. Suglia, ScD4; Daniel I. Feig, MD, PhD5,et al; Trends in Blood Pressure and Hypertension Among US Children and Adolescents 1999-2018. JAMA Netw Open.2021;4(4):e213917. Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778082
  24. Nancy H. Miller, Kathy Berra, Janet Long. Hypertension Awareness, Understanding, and Treatment of Previously Diagnosed Hypertension in Baby Boomers and Seniors: A Survey Conducted by Harris Interactive on Behalf of the Preventive Cardiovascular Nurses Association. The journal of clinical hypertension.2010:5;(12): 328–334. Available from: DOI: 1111/j.1751-7176.2010.00267.x
  25. Hongjun Ba1, Huimin Peng, Lingling Xu, Youzhen Qin, Huisheng Wang: Clinical Characteristics of Hospitalized Pediatric Patients with Hypertensive Crisis, The journal Frontiers in Cardiovascular Medicine. 2022:5;(9). Available from: doi:10.3389/fcvm.2022.891804.
  26. Cecilia Amponsem-Boateng, Weidong Zhang, Timothy Bonney Oppong, Godfrey Opolot, Emmanuel Kumi Duodu Kyere. A cross-sectional study of risk factors and hypertension among adolescent SeniorHigh School students. Dove Press journal: 2019:12 1173–1180.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662518.
  27. Suzanne Oparil, Maria Czarina Acelajado, George L. Bakris, Dan R. Berlowitz, Renata Cífková, Anna F. Dominiczak. HHS Public Access: 2019: 4: 18014. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477925.
  28. A Chockalingam. World Hypertension Day and global awareness. Can J Cardiol 2008;24(6):441-444.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643187.
  29. Surinder Kaur1, A. RightKumari Devi, Rashmi Panchal. Hypertension, World Hypertension Day andglobal awareness. Can J Cardiol 2008;24(6):441-444. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643187.
  30. Jafar Sadegh Tabrizi , Homayoun Sadeghi-Bazargani , Mostafa Farahbakhsh , Leila Nikniaz , Zeinab Prevalence and Associated Factors of Prehypertension and Hypertension in Iranian Population:The Lifestyle Promotion Project (LPP): 2016 Oct 26;11(10): e0165264. Available from: https://pubmed.ncbi.nlm.nih.gov/27783691.
  31. Olafiranye O, Zizi F, Brimah P, Jean-louis G, Makaryus AN, McFarlane S, et al. Management of Hypertension among Patients with Coronary Heart Disease. International Journal of Hypertension. 2011;2011:1-6. doi:10.4061/2011/653903
  32. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ. 2007;334(7599):885. doi:10.1136/bmj.39147.604896.55
  33. Vivek Bhat, Thanmayi Gs, Arvind Kasthuri. Stroke Awareness among Elderly Hypertensives in a Rural Area of Bangalore District, India. Pubmed. 2020(15);30(1):105467. Available from: doi:10.1016/j.jstrokecerebrovasdis.
  34. Pandian JD, Jaison A, Deepak SS, Kalra G, Shamsher S, Lincoln DJ, et al. Public Awareness of Warning Symptoms, Risk Factors, and Treatment of Stroke in Northwest India. Stroke. 2005;36(3):644-648. doi:10.1161/01.str.0000154876.08468.a0
  35. Liu X, Gui H, Yao S, Li Z, Zhao J. Age-Related Disparities in Stroke Knowledge Among Community Older Adults. Frontiers in Neurology. 2021;12. doi:10.3389/fneur.2021.717472
  36. Abate AT, Bayu N, Mariam TG. Hypertensive Patients’ Knowledge of Risk Factors and Warning Signs of Stroke at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Cross-Sectional Study. Neurology Research International. 2019;2019:1-7. doi:10.1155/2019/8570428
  37. Professor, Department of General Medicine, NRI Institute of Medical Sciences, Sangivalasa, Visakhapatnam, Andhra Pradesh, India, Rao DSSP, Ramani DSS, DNB(CTVS), Ex. Registrar, Department of Cardiothoracic Surgery, King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India, Kiran DPVS, Post-Graduate, Department of General Medicine, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India, et al. A descriptive study on the hypertensive crisis in Visakhapatnam, Andhra Pradesh, India. International Journal of Medical Research & Review. 2020;8(6):386-391. doi:10.17511/ijmrr.2020.i06.02
  38. Ove K Andersson, Torbjörn Almgren, Bengt Persson, Ola Samuelsson, Thomas Hedner, Lars BMJ. 1998 Jul 18; 317(7152): 167–171. Available from: doi:10.1136/bmj.317.7152.167
  39. Kebede T, Taddese Z, Girma A. Knowledge, attitude and practices of lifestyle modification and associated factors among hypertensive patients on-treatment follow up at Yekatit 12 General Hospital in the largest city of East Africa: A prospective cross-sectional study. PLOS ONE. 2022;17(1):e0262780. doi:10.1371/journal.pone.0262780
  40. Sarafidis PA, Li S, Chen SC, Collins AJ, Brown WW, Klag MJ, et al. Hypertension Awareness, Treatment, and Control in Chronic Kidney Disease. The American Journal of Medicine. 2008;121(4):332-340. doi:10.1016/j.amjmed.2007.11.025
  41. ZHENG Y, CAI GY, CHEN XM, FU P, CHEN JH, DING XQ, et al. Prevalence, awareness, treatment, and control of hypertension in the non-dialysis chronic kidney disease patients. Chinese Medical Journal. 2013;126(12):2276-2280. doi:10.3760/cma.j.issn.0366-6999.20130835
  42. Surinder Kaur, A. Kumari Devi, Rashmi Panchal. A Study to Evaluate the Effectiveness of Health Education program on Management of Hypertension for Hypertensive Clients in Terms of Knowledge, Compliance and Life Style in Khan Ahmedpur Village of District Ambala, Haryana; International Journal of Science and Research:2015:4(2). Available from: https://www.ijsr.net/archive/v4i2/SUB151368.pdf.
  43. Prakasa Rao S, Sweta Ramani S, Sai Kiran P, Kiran Prasad S. A descriptive study on the hypertensive crisis in Visakhapatnam, Andhra Pradesh, India.2020;8(6):387-391.
  44. Andersson OK, Almgren T, Persson B, Samuelsson O, Hedner T, Wilhelmsen L. Survival in treated hypertension: follow up study after two decades. BMJ. 1998;317(7152):167-171. doi:10.1136/bmj.317.7152.167
  45. Tabrizi JS, Sadeghi-Bazargani H, Farahbakhsh M, Nikniaz L, Nikniaz Z. Prevalence and Associated Factors of Prehypertension and Hypertension in Iranian Population: The Lifestyle Promotion Project (LPP). PLOS ONE. 2016;11(10):e0165264. doi:10.1371/journal.pone.0165264
  46. Kebede T, Taddese Z, Girma A. Knowledge, attitude and practices of lifestyle modification and associated factors among hypertensive patients on-treatment follow up at Yekatit 12 General Hospital in the largest city of East Africa: A prospective cross-sectional study. PLOS ONE. 2022;17(1):e0262780. doi:10.1371/journal.pone.0262780
  47. Muntner P, Anderson A, Charleston J, Chen Z, Ford V, Makos G, et al. Hypertension Awareness, Treatment, and Control in Adults With CKD: Results From the Chronic Renal Insufficiency Cohort (CRIC) Study. American Journal of Kidney Diseases. 2010;55(3):441-451. doi:10.1053/j.ajkd.2009.09.014
  48. Cai G, Zheng Y, Sun X, Chen X, the Survey of Prevalence, Awareness, and Treatment Rates in Chronic Kidney Disease Patients with Hypertension in China Collaborative Group. Prevalence, Awareness, Treatment, and Control of Hypertension in Elderly Adults with Chronic Kidney Disease: Results from the Survey of Prevalence, Awareness, and Treatment Rates in Chronic Kidney Disease Patients with Hypertension in China. Journal of the American Geriatrics Society. 2013;61(12):2160-2167. doi:10.1111/jgs.12551