Purpose This study was conducted to explore the healthcare experience of residents participating in the CommunityBased Hypertension and Diabetes Registry Program. Methods This study used qualitative content analysis. Data were collected from in depth interviews of fifteen participants, who either participated in the program hosted by the Training Center for Hypertension and Diabetes for more than two years or participated in an intensive one-on-one education program. Results The results showed that the core theme in healthcare of participants was ‘Proactive healthcare with attention and systematic guidance of experts’. The positive reinforcement of staffs and the improvement of self-efficacy through effective close management were found to be positive influencing factors of participation. The theme consisted of the following categories: ‘Participation in the program with positive expectations on healthcare’, ‘Interest in body and health’, ‘Vitality in life’, ‘Confidence in dealing with disease’, ‘Thankfulness for close care and attention’, and ‘Desire for continuous care’. Conclusion When establishing policies on managing chronic diseases, a strategy that reflects the results of the study is required. It is necessary to build up emotional relationship among stakeholders, and expand opportunities for close healthcare such as one-on-one customized training, and mutual cooperation with various organizations in the local community.
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Purpose This study investigated the health literacy level of, the hypertension knowledge of, the self-management behaviors of, and the factors influencing self-management behaviors of the hypertensive elderly population residing in the urban and rural areas. Methods Data were collected from November to December 2017 by the trained research staff. For two months, a total of 160 subjects in urban and rural areas who had been taking antihypertensive medications consented to participate in the project. 157 participants completed the survey. Results: The health literacy score of the hypertensive elderly subjects was at 48.38±8.13, the hypertension knowledge score at 8.90±2.01 points, and the self-management behaviors score at 52.96±8.08. The factor that influenced the self-management behaviors of the hypertensive elderly subjects the most was the health literacy, followed by the residential area, and the hypertension knowledge. Conclusion The research findings suggest that a health promotion program for the hypertensive elderly population should be designed in consideration of the health literacy, the area of residence and the hypertension knowledge of the elderly.
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PURPOSE The purpose of this study is to identify the spatial distribution of hypertension prevalence and to investigate individual and regional-level factors contributing to the prevalence of hypertension in the region. METHODS This study is a cross-sectional research using the 2015 Community Health Survey. Total 64,473 people from 7 metropolitan cities were used for the final analysis. Geoda program was adopted to identify the regional distribution of hypertension prevalence and analyzed by descriptive statistics, one-way ANOVA and correlation analysis using SPSS statistics 23.0 program. Multi-level analysis was performed using SPSS (GLMM). RESULTS The prevalence of hypertension was related to individual level factors such as age, monthly household income, normal salt intake, walking practice days, and regional level factors including number of doctors per 10,000 population, number of parks, and fast food score. Besides, regional level factors were associated with hypertension prevalencies independently without the effects of individual level factors even though the influences of individual level factors ware larger than those of regional factors. CONCLUSION Respectively, both individual and regional level factors should be considered in hypertension intervention programs. Also, a national level research is further required by exploring various environmental factors and those influences relating to the hypertension prevalence.
PURPOSE This study was conducted to investigate the combined effects of abdominal obesity and alcohol drinking on the risk of hypertension in Korean adults (aged ≥30 yrs). METHODS Data of 13,885 subjects from the sixth Korea National Health and Nutrition Examination Survey were analyzed. The multiple logistic regression tests were used for the analysis, including potential covariates of the model. RESULTS Frequency of drinking, typical drinking quantity, and frequency of binge drinking had a positive relation to hypertension. The odds ratio of hypertension for risk drinkers with abdominal obesity was 4.81 compared to non-risk drinkers with normal waist circumstance, whereas the odds ratios of hypertension for risk drinkers with normal waist circumstance and non-risk drinkers with abdominal obesity were 1.58 and 2.37 respectively. CONCLUSION Both abdominal obesity and alcohol drinking patterns were strong risk factors of hypertension in the Korean adults. Risk drinkers with abdominal obesity showed a marked high risk in hypertension compared to those with a single condition alone.
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PURPOSE The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. METHODS Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. RESULTS The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). CONCLUSION This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.
PURPOSE The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. METHODS This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. RESULTS All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. CONCLUSION This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.
PURPOSE The purpose of this study is to examine factors influencing medication adherence in patients with hypertension. METHODS This study carried out a secondary analysis of data from the 2008 Korean National Health and Nutrition Examination Survey (KNHANES). Stratified sampling was used to select a participant sample that was representative of patients with hypertension throughout the country. Using the SPSS/WIN 18.0 program, data were analyzed using descriptive statistics, chi2 test, t-test, and logistic regression. RESULTS Of the patients with hypertension, 8.8% had showed non-adherence to medication. Medication adherence was associated with age, spouse, Medicare insurance, number of other diseases, and current smoking status. The cases with older age, a spouse, Medicare insurance, higher number of other diseases, and no current smoking status showed significantly high medication adherence. CONCLUSION Nursing interventions and further studies are needed to achieve high levels of medication adherence based on factors influencing medication adherence such as age, spouse, Medicare insurance, number of other disease, and current smoking status.
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PURPOSE This study was to estimate the effectiveness of an intervention program using the trans-theoretical model on the stages of change, the process of change, decisional balance, self-efficacy, the levels of medication adherence, and blood pressure difference. METHODS A similar experiment was conducted using a nonequivalent control group pre- and post-test design. The study subjects were 108 hypertensive patients. The program was administered to the experimental group while educational materials were given to the control group. Descriptive analysis, 2-test, t-test, and repeated measures ANOVA were used with SPSS 17.0 to analyze collected data. RESULTS After treatment with this program, the experimental group showed stage of change (chi2=52.917, p<.001), cognitive (F=13,528, p<.001), behavioral process of change (F=10.808, p<.001), benefits (F=5.569, p=.012), loss of medication adherence (F=15.661, p<.001), self-efficacy (F=5.407, p=.011), levels of medication adherence (F=51.442, p<.001). CONCLUSION There was a significant improvement in the experimental group who participated in the TTM medication adherence intervention program. Given that this intervention program motivated and stimulated hypertensive patients to adhere to the prescribed medications, the TTM medication adherence intervention program is expected to be an effective and practical intervention method for health improvement.
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PURPOSE The purpose of this study was to evaluate the effects of hand moxa and hand press pellet on blood pressure, blood lipids and blood cell components in elderly women. METHODS This study was conducted as a quasi-experiment with none equivalent control group pre-post test design. The participants were elders who had essential hypertension. There were 18 members in the experimental group and 20 members in the control group. The experimental group received hand moxibustion and hand press pellet 3 times a week for 12 weeks. The results were analyzed using 2 test, t-test, Fisher's exact test and repeated measures ANOVA with the SPSS/WIN program. RESULTS There were significant decreases in blood pressure in the experimental group compared to the control group. No significant difference was observed in total triglyceride, LDL cholesterol and HDL cholesterol between the two groups. Differences in hemoglobin and hematocrit were not significant either. However, there were significant increases in RBC in the experimental group after the intervention. CONCLUSION The results suggest that combined hand therapy contributes to the decrease of blood pressure among the elderly with hypertension. Therefore combined hand therapy is recommended as a complementary nursing intervention strategy for the elderly with essential hypertension.
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PURPOSE The purpose of this study was to identify factors that influence medication adherence in patients with hypertension. METHODS One hundred sixty two patients with hypertension who visited the outpatient clinics of health centers in J City participated in the study. Data were collected through a questionnaire survey done from January 9 to February 25, 2008. To analyze the sample survey data, descriptive statistics, t-test, ANOVA, Scheffe's test, and multiple regression analysis were performed with SPSS/WIN 12.0. RESULTS Significant factors that affect medication adherence in patients with hypertension were autonomous motivation, competence, health status, and sex. These variables explained 24% of medication adherence (F=12.48, p<.001). CONCLUSION The results indicate that in order to improve the medication adherence of patients with hypertension it is important to develop nursing programs that focus on autonomous motivation and competence and to give consideration to differences in health status and sex. Also further studies are needed to confirm autonomous motivation related to health behavior in patients with hypertension.
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PURPOSE This study was conducted to compare health-related characteristics and self-care behavior between a controlled group and a non-controlled group of hypertension patients in a customized home visiting health service. METHODS This study was conducted as cross-sectional research. The subjects were 1,317 hypertension-controlled patients and 555 non-controlled ones. Data were collected using a structured questionnaire and analyzed by descriptive statistics, chi2-test, and t-test using the SPSS WIN 15.0 program. RESULTS Socio-demographic characteristics and self-care behavior were not significantly correlated between the groups. According to health-related characteristics, the health status was significantly higher in the hypertension-controlled group than in the non-controlled group. The cholesterol level was significantly lower in the hypertension-controlled group than in the non-controlled group. CONCLUSION Attention should be paid to patients who are not in good health status in order to control their hypertension. Also, it is necessary to educate the patients in order for them to manage their hypertension and cholesterol.