Factors Predicting Self-Care Behaviors among low health literacy hypertensive patients based on Health Belief Model in Bushehr district, south of Iran

Authors

  • Azam Larki
  • Mahnoush Reisi
  • Rahim Tahmasebi

Keywords:

Self-Care Behaviors, health literacy, Hypertension, Iran

Abstract

Background: Hypertension is an important worldwide public-health challenge, which can lead to very serious consequences. The most important strategy for controlling blood pressure and maintaining it in the optimal range is patient compliance with self-care behaviors. The aim of this study was to determine the factors influencing adherence to self-care behaviors among low health literacy hypertensive patients based on health belief model. Methods: A cross-sectional study was conducted among 152 hypertensive patients with low health literacy during July and August 2017. Patients with limited health literacy were identified by S-TOFHLA questionnaires. The data were collected using H-scale for assessing self-care behaviors and, HK-LS for assessing knowledge of hypertension. A researcher made questionnaire was applied for collecting data of health belief model constructs. Data were analyzed by SPSS version 22 with using multiple logistic regression analyses. Results: The mean (±SD) age of participants was 56.86(8.7). The best compliance with self-care behaviors was related to lack of alcohol (78.9%) and tobacco use (55.9%), and the lowest was related to low salt diet (5.3%) and proper use of drugs (9.2%). Perceived self-efficacy was associated with all self-care behaviors except medication regimens. There was a significant association between perceived susceptibility about hypertension complications and adherence to both low-salt diet (OR = 3.47) and non-smoking Behavior (OR = 1.10). Individuals who had more perceived severity (OR = 1.82), had significantly greater adherence to their medication regimens compared to those who had less perceived severity. Perceived benefits and barriers were not significantly associated with either type of hypertension self-care behaviors. Conclusion: It seems that designing and implementation of educational programs to increase self-efficacy of patients and promote their beliefs about perceived susceptibility and severity of complications, may be usefulness of the results in order to improve self-care behaviors among low health literacy hypertensive patients.

References

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. The lancet. 2005;365(9455):217-23.

World Health Organization. WHO global health days 2013 [cited 2017]. Available from: http://www.who.int/campaigns/world-health-day/2013/event/en/.

world health organization. Silent killer, global public health crisis 2013 [cited 2017]. Available from: http://www.who.int/campaigns/world-health-day/2013/en/.

world health organization. Global Health Observatory (GHO) data 2017. Available from: http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/.

Zinat Motlagh SF, Chaman R, Ghafari SR, Parisay Z, Golabi MR, Eslami AA, et al. Knowledge, treatment, control, and risk factors for hypertension among adults in Southern Iran. International journal of hypertension. 2015;2015.

Mutua EM, Gitonga MM, Mbuthia B, Muiruri N, Cheptum JJ, Maingi T. Level of blood pressure control among hypertensive patients on follow-up in a regional referral hospital in Central Kenya. The Pan African medical journal. 2014;18.

Peters RM, Templin TN. Measuring blood pressure knowledge and self‐care behaviors of African Americans. Research in nursing & health. 2008;31(6):543-52.

Flynn SJ, Ameling JM, Hill-Briggs F, Wolff JL, Bone LR, Levine DM, et al. Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members. Patient preference and adherence. 2013;7:741.

Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L, et al. Meta-analysis: chronic disease self-management programs for older adults. Annals of internal medicine. 2005;143(6):427-38.

Warren-Findlow J, Seymour RB, Huber LRB. The association between self-efficacy and hypertension self-care activities among African American adults. Journal of community health. 2012;37(1):15-24.

Shima R, Farizah MH, Majid HA. A qualitative study on hypertensive care behavior in primary health care settings in Malaysia. Patient preference and adherence. 2014;8:1597.

Willens DE, Kripalani S, Schildcrout JS, Cawthon C, Wallston K, Mion LC, et al. Association of brief health literacy screening and blood pressure in primary care. Journal of health communication. 2013;18(sup1):129-42.

Kamran A, Ahari SS, Biria M, Malpour A, Heydari H. Determinants of patient’s adherence to hypertension medications: application of health belief model among rural patients. Annals of medical and health sciences research. 2014;4(6):922-7.

Janz NK, Becker MH. The health belief model: A decade later. Health education quarterly. 1984;11(1):1-47.

Orji R, Vassileva J, Mandryk R. Towards an effective health interventions design: an extension of the health belief model. Online journal of public health informatics. 2012;4(3).

Javadzade H, Sharifirad G, Reisi M, Tavassoli E, Rajati F. Health Literacy among Adults of Isfahan. Iran J Health Syst Res. 2013;9(5):540-9.

Baliz Erkoc S, Isikli B, Metintas S, Kalyoncu C. Hypertension Knowledge-Level Scale (HK-LS): a study on development, validity and reliability. International journal of environmental research and public health. 2012;9(3):1018-29.

Motlagh SFZ, Chaman R, Sadeghi E, Eslami AA. Self-Care Behaviors and Related Factors in Hypertensive Patients. Iranian Red Crescent Medical Journal. 2016;18(6).

Warren‐Findlow J, Basalik DW, Dulin M, Tapp H, Kuhn L. Preliminary Validation of the Hypertension Self‐Care Activity Level Effects (H‐SCALE) and Clinical Blood Pressure Among Patients With Hypertension. The Journal of Clinical Hypertension. 2013;15(9):637-43.

Domnariu CD, Cucu A, Furtunescu FL. World Health Organization guidelines on salt intake in adults and children. Acta Med Trans. 2013;18:166-8.

Organization WH. Reducing Salt Intake in Populations. Report of a WHO Forum and Technical meeting 2006. Geneva: World Health Organisation. 2014.

Martins LCG, Guedes NG, Teixeira IX, Lopes MVdO, Araujo TLd. Physical activity level in people with high blood pressure. Revista latino-americana de enfermagem. 2009;17(4):462-7.

World Health organization. A global brief on Hypertension Silent killer, global public health crisis. 2013.

Al-Dabbagh S, Aswad S. compliance of hypertensive patients to management in Duhok governorate using Morisky-green test. Duhok Med J. 2010;4(1):28-39.

Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health literacy to patients' knowledge of their chronic disease: a study of patients with hypertension and diabetes. Archives of internal medicine. 1998;158(2):166-72.

Lee EJ, Park E. Self-care behavior and related factors in older patients with uncontrolled hypertension. Contemporary Nurse. 2017(just-accepted):1-30.

Dehghani-Tafti A, Mahmoodabad SSM, Morowatisharifabad MA, Ardakani MA, Rezaeipandari H, Lotfi MH. Determinants of self-care in diabetic patients based on health belief model. Global journal of health science. 2015;7(5):33.

Khorsandi M, Fekrizadeh Z, Roozbahani N. Investigation of the effect of education based on the health belief model on the adoption of hypertension-controlling behaviors in the elderly. Clinical interventions in aging. 2017;12:233.

Shameena A, Badiger S. Retracted: Medication adherence and health belief model among hypertensive patients attending rural health centres of a tertiary care hospital in South India. International Journal Of Community Medicine And Public Health. 2017;4(4):1159-65.

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Published

2021-04-16

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Original Research