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Zhang Q, Gan W, Pei R, Bao X, Shimpuku Y, Chen S, Song L, Yin J, Wang Y, Zheng Y. Effectiveness of a BCW-based interactive pictorial health education program among patients with hypertension in the urban-rural fringe area in China. PATIENT EDUCATION AND COUNSELING 2025; 136:108782. [PMID: 40233601 DOI: 10.1016/j.pec.2025.108782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 03/20/2025] [Accepted: 04/07/2025] [Indexed: 04/17/2025]
Abstract
OBJECTIVE To evaluate the effects of the interactive pictorial health education (IPHE) program on enhancing high blood pressure-specific health literacy (HBP-HL), controlling blood pressure, and improving self-management behavior (SMB) and Health-related Quality of Life (HRQOL) among hypertensive patients with inadequate HBP-HL (HPIH) in the urban-rural fringe area in China. METHODS A quasi-experimental study with repeated measures was used. The intervention group (n = 60) received IPHE program, while the control group (n = 60) received health education lectures. Outcome measures were HBP-HL, systolic blood pressure (SBP), diastolic blood pressure (DBP), SMB and HRQOL evaluated at baseline (T0), six months (T6), nine months (T9), and 12 months (T12). RESULTS The effects of intervention factors on HBP-HL, SBP and HRQOL were stronger over time (P < 0.05), but not on DBP and SMB. The SMB scores were better in the intervention group at T6, T9 and T12 (P < 0.05). Compared to T0, the SBP and DBP in the intervention group decreased by 9.22 and 4.27 mmHg at T12. CONCLUSION The IPHE program can enhance HBP-HL, control blood pressure, and improve SMB and HRQOL among HPIH. PRACTICE IMPLICATIONS The IPHE program was an active and promising method to manage HPIH.
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Affiliation(s)
- Qinghua Zhang
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, Zhejiang, China; School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang, China.
| | - Wei Gan
- School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang, China.
| | - Ruqing Pei
- School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang, China; Linyi Mental Health Center, Linyi, Shandong, China.
| | - Xuemei Bao
- School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang, China; Department of Nursing, Chongqing Red Cross Hospital, Chongqing, China.
| | - Yoko Shimpuku
- Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Sanmei Chen
- Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Li Song
- School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang, China.
| | - Jinyu Yin
- School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang, China; Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China.
| | - Yujie Wang
- School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang, China; Department of Nursing, Jiangxi Medical College, Shangrao, Jiangxi, China.
| | - Yafei Zheng
- School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang, China.
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Cocchi C, Zazzara MB, Levati E, Calvani R, Onder G. How to promote healthy aging across the life cycle. Eur J Intern Med 2025; 135:5-13. [PMID: 40107887 DOI: 10.1016/j.ejim.2025.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2025] [Revised: 02/23/2025] [Accepted: 03/04/2025] [Indexed: 03/22/2025]
Abstract
The global rise in aging populations is challenging healthcare systems, especially in developed countries. Despite advancements in healthcare and living standards, the extension of lifespan has not been matched by an equivalent improvement in healthspan, leading to a higher prevalence of chronic diseases and disabilities in older adults. This review examines strategies to promote healthy aging throughout the life cycle, emphasizing the importance of a comprehensive strategy that integrates individual, healthcare, and environmental approaches. Individual strategies include lifestyle factors like diet, physical activity, and social connections. Healthcare approaches focus on improving health literacy, vaccinations, and screenings. Environmental approaches aim to mitigate climate change, reduce pollution, and design longevity-ready cities. A comprehensive strategy combining individual approaches, public health measures, innovative policies, and community support is essential for helping populations live longer, healthier, and more independent lives. Looking forward, this will be complemented by personalized approaches, focusing on individual traits and biological backgrounds. The key to this lies in geroscience, which studies the biological and molecular mechanisms of aging and how they contribute to age-related diseases and functional decline, aiming to design targeted interventions to slow aging and improve quality of life. Artificial intelligence will play a key role in analyzing these complex factors and creating innovative solutions. In conclusion, aging is shaped by various factors, requiring more than one solution. A combination of comprehensive and personalized strategies can bridge the gap between public health measures and personalized care, offering the scientific insights needed to slow aging and enhance quality of life.
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Affiliation(s)
- Camilla Cocchi
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Maria Beatrice Zazzara
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elena Levati
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Graziano Onder
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
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Xu J, Zhao X, Li F, Xiao Y, Li K. Prediction Models of Medication Adherence in Chronic Disease Patients: Systematic Review and Critical Appraisal. J Clin Nurs 2025; 34:1602-1612. [PMID: 39740141 DOI: 10.1111/jocn.17577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/25/2024] [Accepted: 11/19/2024] [Indexed: 01/02/2025]
Abstract
AIMS AND OBJECTIVES To summarise the currently developed risk prediction models for medication adherence in patients with chronic diseases and evaluate their performance and applicability. BACKGROUND Ensuring medication adherence is crucial in effectively managing chronic diseases. Although numerous studies have endeavoured to construct risk prediction models for predicting medication adherence in patients with chronic illnesses, the reliability and practicality of these models remain uncertain. DESIGN Systematic review. METHODS We conducted searches on PubMed, Web of Science, Cochrane, CINAHL, Embase and Medline from inception until 16 July 2023. Two authors independently screened risk prediction models for medication adherence that met the predefined inclusion criteria. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed to evaluate both the risk of bias and clinical applicability of the included studies. This systematic review adhered to the 2020 PRISMA checklist. RESULTS The study included a total of 11 risk prediction models from 11 studies. Medication regimen and age were the most common predictors. The use of PROBAST revealed that some essential methodological details were not thoroughly reported in these models. Due to limitations in methodology, all models were rated as having a high-risk for bias. CONCLUSIONS According to PROBAST, the current models for predicting medication adherence in patients with chronic diseases exhibit a high risk of bias. Future research should prioritise enhancing the methodological quality of model development and conducting external validations on existing models. RELEVANCE TO CLINICAL PRACTICE Based on the review findings, recommendations have been provided to refine the construction methodology of prediction models with an aim of identifying high-risk individuals and key factors associated with low medication adherence in chronic diseases. PATIENT OR PUBLIC CONTRIBUTION This systematic review was conducted without patient or public participation.
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Affiliation(s)
- Jingwen Xu
- School of Nursing, Jilin University, Changchun, China
| | - Xinyi Zhao
- School of Nursing, Jilin University, Changchun, China
| | - Fei Li
- Department of Endocrinology, The First Hospital of Jilin University, Changchun, China
| | - Yan Xiao
- School of Nursing, Jilin University, Changchun, China
| | - Kun Li
- School of Nursing, Jilin University, Changchun, China
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da Silva Serejo Cardoso R, Santana RF, Delphino TM, Gomes Brandão MA, de Souza PA, Lopes CT. Concept analysis of "Insufficient health literacy" in older adults and refinement of a diagnosis proposal. Int J Nurs Knowl 2025; 36:136-146. [PMID: 38783544 DOI: 10.1111/2047-3095.12469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE This study aims to conduct a thorough analysis of the concept of insufficient health literacy (IHL) in older adults and to refine a nursing diagnosis proposal while considering the specific characteristics of this demographic. METHODS A comprehensive concept analysis was undertaken using Walker & Avant's method as a framework. FINDINGS A systematic search across seventeen databases yielded 29 relevant studies for inclusion. Through analysis, we identified 15 antecedents, 3 attributes, and 7 consequents associated with IHL in older adults. CONCLUSIONS The concept analysis brought clarity to the understanding of IHL within older adults, facilitating the refinement of a diagnosis proposal. This process was instrumental in establishing a diagnostic structure that accounts for the unique needs and challenges faced by older adults. IMPLICATIONS FOR NURSING PRACTICE The structured diagnosis derived from the concept analysis provides a solid theoretical foundation for nurses specializing in Gerontology. By tailoring care interventions to address the specific requirements of older adults, this framework enhances the quality of nursing practice and contributes to improved patient outcomes in geriatric care settings.
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Affiliation(s)
| | - Rosimere Ferreira Santana
- Departamento de Fundamentos de Enfermagem, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Tallita Mello Delphino
- Departamento de Enfermagem Médico Cirúrgico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Priscilla Alfradique de Souza
- Departamento de Enfermagem Médico Cirúrgico, Escola de Enfermagem Alfredo Pinto, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Takáo Lopes
- Departamento Médico Cirúrgico, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
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Waris B, Butt NI, Afzal A, Ghoauri MSA, Khizar I, Mahmood K, Qureshi MA. Exploring Knowledge of Hypertension and Treatment Adherence in Hypertensive Patients From Lahore, Pakistan. Cureus 2025; 17:e81762. [PMID: 40330332 PMCID: PMC12051716 DOI: 10.7759/cureus.81762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2025] [Indexed: 05/08/2025] Open
Abstract
Objective This study aims to explore key factors influencing hypertension management, including demographic (e.g., age, gender, education level), clinical (e.g., presence of comorbid conditions), and behavioral influences (e.g., medication adherence, lifestyle choices such as diet and exercise). The study seeks to provide specific insights into the gaps in knowledge of hypertension and treatment adherence and identify potential barriers to effective treatment and lifestyle modifications. Methods This study was carried out in the Departments of Medicine and Cardiology at Chaudhary Muhammad Akram Teaching and Research Hospital, Azra Naheed Medical College, Superior University, Lahore, Pakistan, from November 2024 to February 2025. A total of 252 hypertensive patients, diagnosed for at least six months, aged ≥18 years, and of both genders, were enrolled using a nonprobability consecutive sampling technique after informed consent. Patients were excluded if they were unable to complete the questionnaire, had hypertensive emergencies, were critically ill or in the ICU, had an active myocardial infarction or stroke, were undergoing hemodialysis, or had a pre-existing psychiatric illness. A structured questionnaire was completed by the patients, collecting details including demographic and clinical information, the 12-item Hypertension Knowledge Test (HKT), and a 10-item domain regarding practices of hypertension control and treatment adherence. Both these questionnaires have been validated in previous studies. All data were entered into IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York) for statistical analysis. Results The mean age was 47.6±12.9 years, with 133 (52.8%) participants aged ≥45 years. The majority were female (154, 61.1%). Of the 252 patients, 201 (79.8%) were married, 136 (54.0%) had ≤5 years of education, and 152 (60.3%) were employed. The mean duration of hypertension was 7.7±6.0 years, with 146 (57.9%) having hypertension for ≥6 years. Diabetes mellitus was present in 134 (53.2%), ischemic heart disease in 94 (37.3%), and chronic kidney disease in 28 (11.1%). A positive family history of hypertension was reported in 179 (71.0%). The mean HKT score was 7.1±2.0, with the majority (203, 80.6%) having poor knowledge. A significant statistical association of good knowledge was seen with younger age (p <0.001), being unmarried (p = 0.001), being educated (p <0.001), being employed (p <0.001), duration of hypertension ≤5 years (p = 0.039), absence of ischemic heart disease (p = 0.002), absence of chronic kidney disease (p = 0.024), and having a positive family history (p <0.001). No association was seen with gender (p = 0.336) or diabetes mellitus (p = 0.053). Regarding medication adherence, 26 (10.3%) always forget to take their medication, while 65 (25.8%) do so most of the time. In terms of healthcare management, 68 (27.0%) always make their next doctor's appointment before leaving the office, while 99 (39.3%) do so most of the time. However, 21 (8.3%) have missed a scheduled appointment, and 54 (21.4%) do so most of the time. Conclusion This study underscores a significant gap in knowledge of hypertension and suboptimal adherence to treatment among hypertensive patients and highlights the need for educational programs and strategies to promote treatment adherence, especially among older patients and those with lower educational levels.
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Affiliation(s)
- Barak Waris
- Medicine and Allied Health Sciences, Chaudhry Muhammad Akram Teaching and Research Hospital, Azra Naheed Medical College, Superior University, Lahore, PAK
| | - Nauman Ismat Butt
- Internal Medicine/Rheumatology, Chaudhry Muhammad Akram Teaching and Research Hospital, Azra Naheed Medical College, Superior University, Lahore, PAK
| | - Ayesha Afzal
- Medicine and Allied Health Sciences, Chaudhry Muhammad Akram Teaching and Research Hospital, Azra Naheed Medical College, Superior University, Lahore, PAK
| | | | - Imania Khizar
- Medicine and Allied Health Sciences, Chaudhry Muhammad Akram Teaching and Research Hospital, Azra Naheed Medical College, Superior University, Lahore, PAK
| | - Khalid Mahmood
- Medicine and Allied Health Sciences, Chaudhry Muhammad Akram Teaching and Research Hospital, Azra Naheed Medical College, Superior University, Lahore, PAK
| | - Muhammad Atif Qureshi
- Internal Medicine and Medical Education, Chaudhry Muhammad Akram Teaching and Research Hospital, Azra Naheed Medical College, Superior University, Lahore, PAK
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Heydari H, Sadeghi R, Jamshidi E, Rahimiforoushani A, Nikbakht HA, Mashhadsari MRA. Effectiveness of community-based intervention using PATCH on disease perception, empowerment, and self-care in hypertension: a community trial protocol. Trials 2025; 26:91. [PMID: 40098019 PMCID: PMC11912653 DOI: 10.1186/s13063-025-08743-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 01/26/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND Hypertension plays a significant role in the global burden of cardiovascular diseases. The planned approach to community health (PATCH), as a community-based framework, highlights community participation in decision-making. This study aimed to determine the effectiveness of a community-based intervention using the PATCH on disease perception, empowerment, self-care behaviors, and blood pressure in patients with hypertension. METHODS This study will be a parallel randomized community trial. Twelve comprehensive rural health service centers (CRHSCs) are randomly selected as clusters. A total sample size of 428 individuals (214 in the intervention group and 214 in the control group) with hypertension covered by CRHSCs will be selected through cluster random sampling. The PATCH framework, developed by the Centers for Disease Control, will be employed to organize the community and empower it to address the issue in the intervention group. The control group will receive only the routine programs provided by the health system. Three months after the intervention, the outcome of hypertension perception will be assessed via the Disease Perception Questionnaire developed by Kamran et al., and empowerment will be measured via the Perceived Control Scale designed by Israel. Six months after the intervention, self-care behaviors will be evaluated through the Self-Care Behavior Assessment Questionnaire created by Han et al., and blood pressure will be assessed using a standard sphygmomanometer. Data analysis will be conducted via SPSS software version 20, which applies univariate and multivariate linear regression tests. DISCUSSION The protocol aligns with health policies in the domain of noncommunicable diseases, emphasizing sustainable and participatory approaches. If proven effective, the findings can be utilized in educational programs and policymaking efforts, paving the way for the broader implementation of community-based interventions. Moreover, this framework can empower social groups to take an active role in combating noncommunicable diseases, and if effective, its application could yield long-term health benefits for individuals and communities. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT), IRCT20231213060354N1. Registered on December 24, 2023. https://irct.behdasht.gov.ir/trial/74453.
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Affiliation(s)
- Hassan Heydari
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ensiyeh Jamshidi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimiforoushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ali Nikbakht
- Department of Biostatistics & Epidemiology, School of Public Health, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Reza Adel Mashhadsari
- Health Research Council, Health Research Institute, Health Vice-Chancellor of Babol University of Medical Sciences, Babol, Iran
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Wuyts E, Bultinck F, Goudman L, Ceulemans D, Crunelle CL, Van de Velde D, Van Puyenbroeck H, Moens M. Pain medication tapering in chronic pain patients: a concept analysis. J Clin Anesth 2025; 102:111784. [PMID: 39987591 DOI: 10.1016/j.jclinane.2025.111784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 01/28/2025] [Accepted: 02/12/2025] [Indexed: 02/25/2025]
Abstract
STUDY OBJECTIVE When risks and side effects of pain medication use outweigh its benefits, pain medication tapering (PMT) should be considered. PMT gained prominence in the treatment plan for patients with chronic pain (CP) and consist of heterogeneous components. This study aims to clarify the concept of PMT by conceptualizing essential components for use in CP patients. DESIGN Concept analysis based on the eight-step method of Walker and Avant. DATA SOURCES A comprehensive literature search up to July 2023 was performed in six databases: MEDLINE (via PubMed), Web of Science, Embase, Scopus, PsychINFO and the Cochrane database. PATIENTS CP patients on long-term pain medication therapy to whom PMT is beneficial. INTERVENTIONS Attributes, illustrative cases, antecedents, consequences and empirical referents were developed. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for transparency and reproducibility of the search, and to increase readability and clarity. MAIN RESULTS Out of 4,162 articles, 110 articles were included. Six attributes were identified: medication use and decrease, support, patient preparation/education, personalization, controlling and monitoring throughout and following tapering, and alternative treatments for pain relief. Three cases were developed, illustrating PMT programs containing all, some or none of the attributes. Antecedents such as suitability for tapering, convinced patient, experienced multidisciplinary team and well-established patient-physician relationship were identified, and consequences were described according to the International Classification of Functioning, Disability and Health, with results predominantly found in the body functions and structures category. CONCLUSION Conceptualization of PMT for patients with CNCP creates a common ground for improving current knowledge about PMT programs and can serve as a starting point for development of future research into PMT interventions.
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Affiliation(s)
- Elke Wuyts
- STIMULUS Research Group, Vrije Universiteit Brussel, 1090 Jette, Belgium
| | - Frenn Bultinck
- Research Centre on Digital Medicine (REDM), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Jette, Belgium
| | - Lisa Goudman
- STIMULUS Research Group, Vrije Universiteit Brussel, 1090 Jette, Belgium; Cluster Neurosciences, Center for Neurosciences (C4N), Vrije Universiteit Brussel, 1090 Jette, Belgium; Pain in Motion research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Jette, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Jette, Belgium; Florida Atlantic University, BC-71, Boca Raton, FL 33431, USA; Research Foundation Flanders (FWO), 1000 Brussels, Belgium
| | - Dries Ceulemans
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy Research Group, Ghent University, Ghent, Belgium
| | - Cleo Lina Crunelle
- Cluster Neurosciences, Center for Neurosciences (C4N), Vrije Universiteit Brussel, 1090 Jette, Belgium; Vrije Universiteit Brussel, Department of Psychiatry, Universitair Ziekenhuis Brussel, 1090 Jette, Belgium
| | - Dominique Van de Velde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy Research Group, Ghent University, Ghent, Belgium
| | - Hubert Van Puyenbroeck
- STIMULUS Research Group, Vrije Universiteit Brussel, 1090 Jette, Belgium; Department of Psychology (PSYC), Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Elsene, Belgium
| | - Maarten Moens
- STIMULUS Research Group, Vrije Universiteit Brussel, 1090 Jette, Belgium; Cluster Neurosciences, Center for Neurosciences (C4N), Vrije Universiteit Brussel, 1090 Jette, Belgium; Pain in Motion research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Jette, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Jette, Belgium; Research Foundation Flanders (FWO), 1000 Brussels, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, 1090 Jette, Belgium.
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Zhang L, Pan Q, Peng Y, Li S, Chen L, Lin Y. Postoperative self-management experiences among patients with aortic dissection: a phenomenological approach. BMC Cardiovasc Disord 2025; 25:4. [PMID: 39757176 DOI: 10.1186/s12872-024-04435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Accepted: 12/18/2024] [Indexed: 01/07/2025] Open
Abstract
OBJECTIVE The objective of this study is to examine the postoperative self-management experiences of patients with aortic dissection (AD) through qualitative interviews, providing a foundation for the standardized management of postoperative home care for these patients. METHODS Semi-structured interviews were conducted with 18 patients with AD postoperatively, in the cardiac surgery department of a tertiary hospital in Fujian Province between March and May 2020. This qualitative study used phenomenological methods and purposive sampling, with data analyzed using Colaizzi's seven-step approach to extract themes. RESULTS Based on the interviews, four primary themes related to postoperative self-management challenges were identified: limited disease-related knowledge, inadequate disease management behavior, insufficient communication with healthcare providers, and compromised psychological well-being. CONCLUSION Postoperative self-management among patients with AD presents several challenges. Healthcare professionals should provide targeted interventions tailored to the specific condition and individual differences of the patient in self-management. Such interventions are crucial for enhancing the postoperative self-management abilities of patients with AD, promoting rehabilitation, and enhancing the overall quality of life.
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Affiliation(s)
- Liwei Zhang
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
| | - Qiong Pan
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
| | - Yanchun Peng
- Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
| | - Sailan Li
- Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
| | - Liangwan Chen
- Department of Cardiac Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
| | - Yanjuan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China.
- Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China.
- Department of Nursing, Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
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Yuan W, Zhang Y, Ma L. Comparative Different Interventions to Improve Medication Adherence in Patients with Hypertension: A Network Meta-analysis. J Cardiovasc Nurs 2025; 40:E9-E23. [PMID: 37406171 DOI: 10.1097/jcn.0000000000001015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
BACKGROUND Hypertension has become a major public problem. One of every 4 adults has hypertension. Medications are critical in controlling blood pressure, but patient medication adherence is low. Therefore, it is very crucial to promote medication adherence. However, the complexity and variety of interventions cause clinical decision-making difficulties for health managers and patients. OBJECTIVE The aim of this study was to compare the effectiveness of different interventions to improve medication adherence in patients with hypertension. METHODS We searched PubMed, Cochrane Library, Web of Science, EMBASE, Wan Fang, China National Knowledge Infrastructure, China Science and Technology Journal Database, and China Biology Medicine disc databases for eligible studies. Medication adherence rate and medication adherence difference were assessed as outcomes. Sensitivity analysis and inconsistency detection were performed to evaluate whether the exclusion of high-risk studies affected the validity. The risk of bias was assessed using the risk of bias table in Review Manager 5.4. The surface under the cumulative ranking curve was used to estimate the rankings among different interventions. RESULTS Twenty-seven randomized controlled trials were included, and the interventions involved were categorized into 8 different categories. The network meta-analysis showed that the health intervention was the best to promote medication compliance in patients with hypertension. CONCLUSIONS Health intervention is recommended to improve medication adherence in patients with hypertension. CLINICAL IMPLICATIONS Health managers are recommended to provide health intervention to patients with hypertension to improve their medication adherence. This approach reduces morbidity, mortality, and healthcare costs for patients with cardiovascular disease.
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Fleary SA. The Relationship Between a Healthy People 2030 Health Literacy-Related Objective (HC/HIT02) and Cancer Prevention and Screening Behaviors. HEALTH COMMUNICATION 2025; 40:47-58. [PMID: 38557228 DOI: 10.1080/10410236.2024.2331797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Healthy People 2030 highlights the importance of both personal and organizational health literacy (HL) to improving population health. Yet, most research focuses on personal-level HL or fails to study the effect of both types of HL on health behavior. This study explored the relationships between organizational HL (Healthy People 2030 objective: decrease the proportion of adults who report poor communication with their health care provider), personal-level HL, and cancer prevention and screening behaviors. Data were collected using Qualtrics Panel. Participants who indicated they had a non-emergency room provider visit in the last 12 months were included in the analyses. Participants (n=549, Mean age = 41.44 years, SD = 15.91; 51.9% female; 54.3% White, 28.8% Hispanic/Latino/a/x) completed measures of personal and organizational HL and reported on their cancer prevention (e.g., cigarette smoking) and screening (e.g., mammogram) behaviors. Hierarchical linear and logistic regressions predicting cancer prevention and screening behaviors, respectively, from organizational HL, personal HL, and demographic covariates, were estimated. Regarding the results, higher organizational HL was related to higher fruit and vegetables consumption and physical activity after accounting for personal-level HL and demographic covariates. Higher personal-level HL was related to lower physical activity, binge-drinking, and cigarette smoking, and higher odds of pap smear screening, prostate-specific antigen testing, and completing all eligible screenings after accounting for organizational-level HL and demographic covariates. The findings support that personal-level and organizational HL may be differentially important to improving cancer prevention and screening behaviors. Policies that address improving both personal-level and organizational-level HL are needed.
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Affiliation(s)
- Sasha A Fleary
- Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy
- CUNY Institute for Implementation Science in Public Health
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Pereira A, Trombini R, Barbalho Y, Stival M, Lima L, Zandonadi R, Ginani V, Dusi R, Funghetto SS. Strategies for Effective Communication in Hypertension Management: Validation of Messages from a Mobile Application to Assist Hypertensive Older Adults in Adherence to Treatment, Nutrition and Physical Activity. Nutrients 2024; 16:4284. [PMID: 39770906 PMCID: PMC11677772 DOI: 10.3390/nu16244284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Revised: 11/28/2024] [Accepted: 11/29/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Poor adherence to antihypertensive treatment is a common problem among elderly hypertensive patients and one of the leading causes of inadequate blood pressure control. In this sense, it is essential to improve strategies for effective communication in managing hypertension treatment for this group. OBJECTIVE This study aimed to validate the text messages of a mobile application to aid adherence to antihypertensive treatment, nutrition, and physical activity among older adults with hypertension treated in Brazilian public primary health care. METHODS This descriptive, methodological development study with a quantitative approach was carried out between March and August 2024. RESULTS A total of 27 messages were constructed and validated by 13 experts, and this stage was divided into two rounds. The Content Validity index and percentage of agreement were used in the validation process. The messages were developed using theory, national guidelines, validation, and expert review. CONCLUSIONS Text messages for adherence to antihypertensive treatment involving medication, nutrition, and physical activity have enormous potential with the target audience studied.
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Affiliation(s)
- Alayne Pereira
- Graduate Program in Health Sciences and Technologies, University of Brasília, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.T.); (Y.B.); (M.S.); (L.L.) (S.S.F.)
| | - Raiza Trombini
- Graduate Program in Health Sciences and Technologies, University of Brasília, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.T.); (Y.B.); (M.S.); (L.L.) (S.S.F.)
| | - Yuri Barbalho
- Graduate Program in Health Sciences and Technologies, University of Brasília, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.T.); (Y.B.); (M.S.); (L.L.) (S.S.F.)
| | - Marina Stival
- Graduate Program in Health Sciences and Technologies, University of Brasília, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.T.); (Y.B.); (M.S.); (L.L.) (S.S.F.)
| | - Luciano Lima
- Graduate Program in Health Sciences and Technologies, University of Brasília, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.T.); (Y.B.); (M.S.); (L.L.) (S.S.F.)
| | - Renata Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Campus Universitario Darcy Ribeiro, Brasília 70910-900, Brazil; (R.Z.); (V.G.); (R.D.)
| | - Verônica Ginani
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Campus Universitario Darcy Ribeiro, Brasília 70910-900, Brazil; (R.Z.); (V.G.); (R.D.)
| | - Rafaella Dusi
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Campus Universitario Darcy Ribeiro, Brasília 70910-900, Brazil; (R.Z.); (V.G.); (R.D.)
| | - Silvana Schwerz Funghetto
- Graduate Program in Health Sciences and Technologies, University of Brasília, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.T.); (Y.B.); (M.S.); (L.L.) (S.S.F.)
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12
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Turki F, Turki I, Jedidi J, Said H. The effect of therapeutic education program on hypertensive Tunisian patients' knowledge: a randomized controlled trial. Ann Med Surg (Lond) 2024; 86:6561-6567. [PMID: 39525792 PMCID: PMC11543205 DOI: 10.1097/ms9.0000000000002628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 09/23/2024] [Indexed: 11/16/2024] Open
Abstract
Background Hypertension is a prevalent non-communicable disease and unequivocally one of the most serious health threats of the twenty-first century. The prevention of both immediate and long-term consequences depends on ongoing therapeutic education. Aims To assess Tunisian hypertensive patients' knowledge of hypertension and then evaluate the impact of an educational program on knowledge among this population. Methods A randomized controlled trial was carried out among 639 hypertensive patients in Tunisia. The control group received only basic medical care, while the experimental group acquired additionally an educational program. The data collection tool was a questionnaire that included an information sheet and the Hypertension Knowledge Level Scale (HK-LS). Results Before to the implementation of the program, only 12.1% of the participants had a good level of knowledge about hypertension (12.8% for the experimental group, vs. 10.5% for the control group, P=0.57). Following the program's deployment, the rate of good level of knowledge became 63.6% for the experimental group vs. 11.4% for the control group, P<0.001). The results revealed that the experimental group showed a significant amelioration in the total score of the HK-LS: from 58.49 to 76.94%, P<0.0001. In contrast, no significant amelioration was noted in the control group. Concerning the six dimensions of the scale, the amelioration in the experimental group was observed in all dimensions, except the treatment dimension. Conclusion Overall, the findings indicated low levels of knowledge about hypertension. This kind of approach proved an effective improvement in disease-related knowledge and may be essential for hypertension management.
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Affiliation(s)
- Fatma Turki
- Doctoral Commission “Health Sciences”, Faculty of Medicine of Sousse, University of Sousse
| | - Imen Turki
- Faculty of Medicine of Sousse, University of Sousse, Sousse
| | - Jihen Jedidi
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Houyem Said
- Department of Prevention and Security of Care, University Hospital of Sahloul, Sousse, Tunisia
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13
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Li N, Dong Y, Zhang G. County-Level Integrated Healthcare Practice in China: A Kaiser Permanente-Inspired Approach. Int J Integr Care 2024; 24:18. [PMID: 39758873 PMCID: PMC11697616 DOI: 10.5334/ijic.8610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 12/17/2024] [Indexed: 01/07/2025] Open
Abstract
Introduction China's rapidly aging population and rise in chronic diseases put immense strain on the country's healthcare system. To address these challenges, Yuhuan People's Hospital established County-level Integrated Health Organization (CIHO) as part of the Healthy China 2030 initiative. Description Based on the Kaiser Permanente (KP) model, the CIHO takes a multi-disciplinary, collaborative approach to deliver integrated care. It brings together various medical specialties, collaborates with community organizations and companies, and implements reforms in information technology and payment models. Through these efforts, the CIHO has significantly improved healthcare delivery in Yuhuan county. Discussion Population segmentation relies on data integration and segmentation tools to identify targeted healthcare needs. The allocation and collaboration of health workforce for residents with different health conditions are suggested to be dynamically designed according to both internal and external factors. Corresponding payment mechanism is also an important factor that needs to be taken into consideration. Conclusion The CIHO's success has provided a model for integrated, efficient healthcare that could be replicated in other regions of China and offer insights for rural areas in other countries facing similar demographic and epidemiological pressures.
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Affiliation(s)
- Na Li
- Ningbo Insight Hospital Management Consulting, No. 41 Xingning Road, Ningbo, Zhejiang Province, CN
| | - Yin Dong
- Yuhuan People’s Hospital, No. 18 Changle Road, Yuhuan, Taizhou City, Zhejiang Province, CN
| | - Gaofeng Zhang
- Yuhuan People’s Hospital, No. 18 Changle Road, Yuhuan, Taizhou City, Zhejiang Province, CN
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14
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Sadeghi H, Mohammadi Shahbolaghi F, Hosseini M, Fallahi-Khoshknab M, Ghaedamini Harouni G. Factors associated with self-management in older adults with multiple chronic conditions: a qualitative study. Front Public Health 2024; 12:1412832. [PMID: 39346598 PMCID: PMC11429008 DOI: 10.3389/fpubh.2024.1412832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 08/30/2024] [Indexed: 10/01/2024] Open
Abstract
Background and purpose Recognizing the importance of self-management in older adults with multiple chronic conditions (MCCs) is crucial for their quality of life. This qualitative study explored the factors linked to self-management among older adults with MCCs. Materials and methods The present study was conducted in three stages: an integrated review, qualitative interviews, and Delphi. The search used electronic databases including Web of Science, PubMed, Scopus, Magiran, SID, and Iranmedex. The results of 33 studies that met the inclusion criteria were analyzed using conventional content analysis. A data matrix was formed; and purposeful sampling was conducted among older adults with MCCs, family caregivers, and specialists. The data were collected through semi-structured interviews. Data analysis of 29 interviews was conducted simultaneously with data collection using oriented qualitative content analysis and the Elo and Kyngäs approach. Three rounds of Delphi were conducted via email correspondence with a group of 30 experts to develop and validate the proposed variables. Results The factors that influence self-management can be categorized into various categories. Biological factors, cognitive factors, co-morbidities, socio-economic factors, health-related behaviors, mental health, interactions with healthcare teams, Family relationships, medical facility resources, employee empowerment, health policy development, and cultural influences. Conclusion Self-management in older Iranian adults with MCCs is a complex and multidimensional phenomenon. By identifying the relevant factors, it is possible to design operational plans that promote self-management among the older adult population and are tailored to fit the specific needs of Iranian society.
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Affiliation(s)
- Hajar Sadeghi
- Nursing Department, Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farahnaz Mohammadi Shahbolaghi
- Nursing Department, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadali Hosseini
- Nursing Department, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Masoud Fallahi-Khoshknab
- Nursing Department, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Gholamreza Ghaedamini Harouni
- Social Welfare Management Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Kengne AP, Brière JB, Gudiña IA, Jiang X, Kodjamanova P, Bennetts L, Khan ZM. The impact of non-pharmacological interventions on adherence to medication and persistence in dyslipidaemia and hypertension: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2024; 24:807-816. [PMID: 38366854 DOI: 10.1080/14737167.2024.2319598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/13/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Suboptimal medication adherence is common among patients with cardiovascular diseases. We sought evidence on non-pharmacological interventions used to support adherence for patients with hypertension and/or dyslipidemia. METHODS We searched MEDLINE, EMBASE, MEDLINE In-Process, ClinicalTrials.gov, EUCTR, and conference proceedings from July 2011 to July 2021 to identify trials evaluating effects of health education, phone reminders, or digital interventions on medication adherence or persistence of adult patients with hypertension and/or dyslipidemia. Risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool v2. RESULTS Of 64 studies, 62 used health education approaches (e.g. educational interviews, motivational meetings, advice from physicians, and mobile health content), 16 phone reminders (e.g. text reminders, electronic pill-box linked reminders, bi-directional text messaging), and 10 digital applications as interventions (e.g., various self-management applications). All studies assessed medication adherence; only two persistence. Overall, 30 studies (83%) assessing health education approaches alone and 25 (78%) combined with other strategies, 12 (75%) phone reminders and eight studies (80%) digital applications combined with other strategies reported improved medication adherence. Two studies assessing health education approaches reported improved persistence. CONCLUSIONS Our findings indicate non-pharmacological interventions may positively impact adherence. Therefore, 'beyond the pill' approaches could play a role in preventing cardiovascular diseases.
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Affiliation(s)
| | | | | | - Xiaobin Jiang
- Health Economics and Market Access, Amaris Consulting, Shanghai, China
| | - Petya Kodjamanova
- Health Economics and Market Access, Amaris Consulting, Sofia, Bulgaria
| | - Liga Bennetts
- Health Economics and Market Access, Amaris Consulting, Montréal, Canada
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Simões CF, Lopes LPN, Lara LDS, Cortês AL. Health literacy for elderly patients with high blood pressure: A scoping review. Res Social Adm Pharm 2024; 20:846-859. [PMID: 38890034 DOI: 10.1016/j.sapharm.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/30/2023] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Hypertension is the chronic disease that most affects the elderly population worldwide and is the main modifiable risk factor for cardiovascular diseases. In hypertensive elderly patients, health literacy emerges as a key component for achieving better clinical outcomes. OBJECTIVE This study aims to describe the health literacy strategies used for elderly patients with arterial hypertension. METHODS A review of the scientific literature was conducted in accordance with recommendations from the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Three databases were used to identify relevant studies which were then assessed for eligibility, extracted, and categorized. RESULTS A total of 6442 articles were identified in the databases, out of which 1486 were duplicates and were removed. Based on titles and abstracts, 4887 articles were excluded, and 59 were eliminated through full-text analysis for not meeting the eligibility criteria. Ten studies were included in this scoping review. The identified strategies included face-to-face group educational sessions, face-to-face individual educational sessions, use of written educational materials, educational sessions through electronic devices and/or computers, individual counseling, physical exercise, and personal health diary. The most addressed topics were the nature of hypertension, nutrition, and physical exercise. The study environments highlighted the importance of involving a multidisciplinary team in health literacy strategies for elderly individuals whith hypertension. CONCLUSIONS Interventions with mixed measures were commonly used by the authors and encouraged disease self-management. Access to information and the promotion of critical thinking allowed patients to have better disease control. However, studies linking health literacy and elderly individuals with arterial hypertension are still scarce, indicating the need for further research.
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Affiliation(s)
| | | | - Lucienne da Silva Lara
- Instituto de Ciências Biomédicas e Centro de Pesquisa em Medicina de Precisão, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Aline Leal Cortês
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Matsuo R, Fujita K, Miyazono M, Miyasaka K, Yamanaka T, Yakushiji K, Nagai A. Validating the short-version European Health Literacy Survey Questionnaire for community-dwelling older adults in Japan. Health Promot Int 2024; 39:daae105. [PMID: 39180352 DOI: 10.1093/heapro/daae105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2024] Open
Abstract
The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is available in multiple languages, and shortened versions have also been developed. This study aimed to examine the reliability and validity of the short version of the questionnaire (HLS-Q12) developed for community-dwelling older adults in Japan. The HLS-Q12 was developed using 12 of the 47 items of the Japanese version of the HLS-EU-Q47. In this study, the survey was conducted by distributing self-administered questionnaires to community-dwelling individuals aged 65 years and older who consented to participate; their responses were collected by mail. The correlation between the HLS-Q12 and the HLS-EU-Q47 was tested to assess criterion validity. To test construct validity, nine novel hypotheses were proposed. We also conducted a confirmatory factor analysis of the HLS-Q12. Based on a resurvey after 5-7 days, test-retest reliability was examined using interclass correlation coefficients (ICCs) and Bland-Altman analysis. In total, 118 individuals provided valid responses to the questionnaire. The Spearman rank correlation coefficient between the HLS-Q12 and the HLS-EU-Q47 was r = 0.98 (p < 0.001), and eight of the nine hypotheses were supported. The ICC was 0.96 (p < 0.001), and the 95% limit of agreement was -0.26 ± 5.9, suggesting no systematic error. Thus, the Japanese version of the HLS-Q12 was found to be reliable with high criterion validity and reproducibility. Hence, the HLS-Q12 is a useful scale for measuring health literacy among older adults in Japan.
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Affiliation(s)
- Rika Matsuo
- Department of Nursing, School of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Kimie Fujita
- Division of Health Sciences, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
| | - Mami Miyazono
- Department of Nursing, School of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Keiko Miyasaka
- Department of Nursing, School of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Tomi Yamanaka
- Department of Nursing, School of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Kanako Yakushiji
- Division of Health Sciences, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
| | - Atsushi Nagai
- The Regional Liaison Center for Fukuoka Dental College-Fukuoka Nursing College-Fukuoka College for Health Science, Fukuoka Dental College, Fukuoka, Japan
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Demirel C, Kiliç SP. The effects of education based on the Roy adaptation model on medication adherence and psychosocial adjustment in hypertensive patients. JOURNAL OF VASCULAR NURSING 2024; 42:89-98. [PMID: 38823977 DOI: 10.1016/j.jvn.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/04/2023] [Accepted: 01/28/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND AND AIM Patient education utilizing nursing theory can enhance patient adherence to treatment and potentially decrease mortality rates. The objective of this investigation was to assess the impact of Roy's adaptation Model-focused education on medication adherence and psychosocial compliance in hypertensive patients. METHODS This study was conducted in N = 60 hypertensive patients (n = 30 control group and n = 30 experimental group) based on a randomized controlled trial design. In the pre-test phase of the study, data was collected using the Patient Information Form, the medication adherence rating scale (MARS), and the psychosocial adjustment to illness scale-self-report (PAIS-SR). After the pre-test phase, the experimental group received hypertension education and the "Hypertension Education Booklet" for a duration of four weeks. No education was provided to the control group patients; only routine follow-ups were conducted. In the post-test phase (after four weeks), both groups were reassessed using MARS and PAIS-SR. After completing the study, the control group patients who volunteered to participate in the education were provided with hypertension education and the "Hypertension Education Booklet" for a duration of four weeks (n = 4). RESULTS The post-test measurements of patients in the experimental group (after 4 weeks of education) revealed an increase in the mean MARS scores (6.50 ± 0.86) and a significant decrease in the total and subscale mean scores of PAIS-SR (24.12 ± 7.08) (p < 0.05). No changes were observed in the control group patients. CONCLUSION The results of the study revealed that the education based on the Roy's Adaptation Model increased hypertensive individuals' medication adherence and physiological, psychological, and social adjustment to the disease. RELEVANCE TO CLINICAL PRACTICE The education based on the Roy's Adaptation Model seems to be effective in increasing patients' adherence to treatment and adjustment to the disease. This model can be used in various diseases and societies, since it increases adjustment to the disease and the effectiveness of treatment.
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Affiliation(s)
- Cihat Demirel
- Muş Alparslan University, Varto Vocational School, Department of Medical Services and Techniques, Muş, Turkey.
| | - Serap Parlar Kiliç
- İnönü University Faculty of Nursing, Department of Internal Medicine Nursing, Malatya, Turkey
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Tjandrarini DH, Kristanti D, Wurisastuti T, Hidayangsih PS, Tuminah S, Paramita A, Kusrini I, Dharmayanti I, Dany F, Ahmadi F, Titaley CR. Pandemic Pressure: Changes in Hypertensive Management Adherence in Indonesia. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:134-140. [PMID: 38685560 DOI: 10.1016/j.anr.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/30/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024] Open
Abstract
PURPOSE This study aimed to determine factors associated with changes in adherence to hypertension management (medication adherence and blood pressure control) in respondents with hypertension before and during the COVID-19 pandemic in Bogor city, Indonesia. METHODS An observational study was conducted using two sources of data (before and during COVID-19 pandemic). Data before the pandemic were derived from the 2019 Cohort Study of non-communicable disease risk factors. Data during the pandemic were derived from an online survey conducted in September and October 2020. Information from 880 participants were analyzed. The dependent variable was the change in adherence to hypertension management before and during the COVID-19 pandemic. Multivariate analysis was performed using logistic polynomial regression. RESULTS Respondents who adhered to hypertension management decreased from 82.0% in 2019 to 47.8% in 2020. The likelihood of non-adherence (respondents who did not adhere to hypertension management both before and during the pandemic) increased in respondents below 55 years old, who did not own any healthcare insurance, who were not obese, and who had no other comorbidities. In the partial adherence group (respondents who did not adhere to hypertension management either before or during the pandemic), we found that most respondents adhered before the pandemic but no longer adhered during the COVID-19 pandemic. We found an increased partial adherence in young and highly educated respondents. CONCLUSIONS Efforts to improve adherence to hypertension management after the COVID-19 pandemic should target those who were young, highly educated, who did not have any healthcare insurance, and who did not perceive themselves as not having comorbidities.
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Affiliation(s)
- Dwi H Tjandrarini
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Dewi Kristanti
- Centre for Health Services Policy, Health Policy Agency, Jakarta, Indonesia
| | - Tri Wurisastuti
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Puti S Hidayangsih
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Sulistyowati Tuminah
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Astridya Paramita
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Ina Kusrini
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Ika Dharmayanti
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Frans Dany
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
| | - Feri Ahmadi
- Research Organization for Health, National Research and Innovation Agency, Cibinong Science Center, Bogor, West Java, Indonesia
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Andala S, Sofyan H, Hasballah K, Marthoenis. Knowledge and acceptance associated with medication adherence among hypertension individuals in Aceh province, Indonesia. Heliyon 2024; 10:e29303. [PMID: 38617921 PMCID: PMC11015454 DOI: 10.1016/j.heliyon.2024.e29303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024] Open
Abstract
Low adherence to anti-hypertensive medication is observed among individuals in Aceh, the westernmost province of Indonesia. Since uncontrolled hypertension has the potential to develop into a life-threatening disease, exploring medication adherence among this specific population is essential. Therefore, this study aimed to evaluate knowledge and acceptance associated with medication adherence among hypertensive individuals in Aceh Province. A cross-sectional study was conducted from March to July 2023 on 534 respondents diagnosed with hypertension, who were selected using the random sampling method. Demographic characteristics collected included body height and weight, age, gender, education, ethnicity, and occupation. Acceptance and knowledge were measured through a set of standardized questionnaires while the Morisky Medication Adherence Scale-8 was used for evaluating medication adherence. Logistic regression with a multinomial model was used to assess the correlations of acceptance and knowledge with medication adherence. The results showed that only 28.5 % of the respondents had high adherence to anti-hypertensive medication. Furthermore, a high level of acceptance towards hypertension significantly predicted medication adherence (p < 0.001; OR = 9.14 [95%CI: 3.49-23.94]). Knowledge about dosing frequency, the benefits of low-fat and sodium diets, and the negative impacts of drinking alcohol were correlated with high-level adherence (p < 0.01). Meanwhile, knowledge about renal complications correlated negatively with adherence level (p = 0.002; OR = 0.32 [95%CI: 0.16-0.66]). In conclusion, this study showed that acceptance and knowledge of hypertension correlated with the level of medication adherence.
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Affiliation(s)
- Sri Andala
- Graduate School of Mathematics and Applied Sciences, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
- STIKes Muhammadiyah Lhokseumawe, Lhokseumawe, 24300, Indonesia
- Dinas Kesehatan Kota Lhokseumawe, Lhokseumawe, 24300, Indonesia
| | - Hizir Sofyan
- Department of Statistics, Faculty of Math and Science, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Kartini Hasballah
- Department of Pharmacology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Marthoenis
- Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
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Zhou X, Zhang X, Gu N, Cai W, Feng J. Barriers and Facilitators of Medication Adherence in Hypertension Patients: A Meta-Integration of Qualitative Research. J Patient Exp 2024; 11:23743735241241176. [PMID: 38549805 PMCID: PMC10976505 DOI: 10.1177/23743735241241176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2025] Open
Abstract
The aim of this qualitative systematic review is to analyze the barriers and facilitators to the uptake of antihypertensive medication in hypertensive patients. The databases of PubMed, Embase, Web of Science, CINAHL, Cochrane Library, MEDLINE, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical were searched from inception to June 2023. The studies were screened, extracted, and assessed independently by two researchers. Previously, the researchers used the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to assess the quality of the included studies. A total of 27 studies were considered, resulting in two combined findings: a good level of knowledge, belief, and behavior and adequate social support were facilitators of medication adherence in hypertensive patients. In contrast, lack of medication literacy, difficulty adapting to roles, reduced sense of benefit from treatment, limited access to healthcare resources, and unintentional nonadherence were barriers. Medication adherence in hypertensive patients remains a challenge to be addressed. Future research should explore how complex interventions using a combination of evidence-based strategies and targeting multiple adherence behaviors (eg, long-term adherence to medication) are effective in improving medication adherence.
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Affiliation(s)
- Xueying Zhou
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Xuefang Zhang
- Quality Management Office, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Ning Gu
- Department of Cardiology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Wenjing Cai
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Jingyi Feng
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
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Halder M, Kasemi N, Majumder M. Tobacco use and its associated factors among middle and old-aged women in India using LASI wave-1 data. PLoS One 2024; 19:e0298663. [PMID: 38442117 PMCID: PMC10914294 DOI: 10.1371/journal.pone.0298663] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Despite a global decline in tobacco use reported by the Global Adult Tobacco Survey (GATS), India stands out for its high number of tobacco users. While research in India often focuses on tobacco use among young adults, there's a notable lack of studies addressing tobacco use among middle and old-aged women. However, the national prevalence of tobacco use among middle and old-aged (45 years and above) women in India is 18.2%. Thus, this study seeks to identify the factors influencing tobacco consumption among middle and old-aged women in the country. METHODS The study has utilized secondary data from Longitudinal Aging Study in India (LASI) conducted in 2017-18. This study exclusively included a total of 38,180 middle and old-aged women who reported tobacco use. The analysis encompassed the utilization of Chi-square tests and Binary logistic regression to pinpoint the risk factors linked to tobacco use among middle and old-aged women. RESULTS Our study reveals a heightened likelihood of tobacco use among middle and old-aged women residing in the northeastern region of India. The study underscores the imperative to direct targeted efforts toward middle and old-aged women who fall into specific categories, including those who are widowed, separated, or unmarried, individuals who consume alcohol, those with lower socioeconomic and educational standings, residents of rural areas, those living in solitude, individuals experiencing depressive symptoms, and those who self-report poor health. CONCLUSION Given the heightened susceptibility of these demographic groups to tobacco use, it is crucial to prioritize tobacco prevention and cessation initiatives specifically tailored to their needs and circumstances.
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Carbonell-Soliva Á, Nouni-García R, López-Pineda A, Cordero-Fort A, Pérez-Jover V, Quesada JA, Orozco-Beltrán D, Nolasco A, Castellano-Vázquez JM, Mira-Solves JJ, Gil-Guillen VF, Carratala-Munuera C. Opinions and perceptions of patients with cardiovascular disease on adherence: a qualitative study of focus groups. BMC PRIMARY CARE 2024; 25:59. [PMID: 38365594 PMCID: PMC10870481 DOI: 10.1186/s12875-024-02286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/25/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Cardiovascular diseases are becoming more frequent throughout the world. Adherence to both pharmacological and non-pharmacological treatment, as well as lifestyles, is important for good management and control of the disease. This study aims to explore the opinions and perceptions of patients with ischemic heart disease on the difficulties associated with therapeutic adherence. METHODS An interpretive phenomenological study was carried out using focus groups and one semi-structured interview. The MAXQDA qualitative data analysis program was used for inductive interpretation of the group discourses and interview. Data were coded, and these were grouped by categories and then consolidated under the main themes identified. RESULTS Two in-person focus groups and one remote semi-structured interview were performed. Twelve participants (6 men and 6 women) from the Hospital de San Juan de Alicante participated, two of them being family companions . The main themes identified were aspects related to the individual, heart disease, drug treatment, and the perception of the health care system. CONCLUSIONS Adhering to recommendations on healthy behaviors and taking prescribed medications for cardiovascular disease was important for most participants. However, they sometimes found polypharmacy difficult to manage, especially when they did not perceive the symptoms of their disease. Participants related the concept of fear to therapeutic adherence, believing that the latter increased with the former. The relationship with health professionals was described as optimal, but, nevertheless, the coordination of the health care system was seen as limited.
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Affiliation(s)
- Álvaro Carbonell-Soliva
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
| | - Rauf Nouni-García
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
- Institute of Health and Biomedical research of Alicante, Alicante Spain General University Hospital of Alicante, Diagnostic center, Fifth floor. Pintor Baeza street, 12, Alicante, 03110, Spain
| | - Adriana López-Pineda
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain.
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain.
- Foundation for the Promotion of Health and Biomedical Research of the Valencian, Community. N-332, 03550 San Juan de Alicante, Alicante, Spain.
| | - Alberto Cordero-Fort
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain
- Biomedical Network Research Center for Cardiovascular Diseases (CIBERCV), Madrid, 28029, Spain
| | - Virtudes Pérez-Jover
- Health Psychology Department, Miguel Hernandez University of Elche, Elche, Spain
| | - Jose A Quesada
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
| | - Domingo Orozco-Beltrán
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
- University Hospital of San Juan de Alicante, San Juan de Alicante, Alicante, 03550, Spain
| | - Andreu Nolasco
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - Jose Maria Castellano-Vázquez
- Comprehensive Center for Cardiovascular Diseases, Montepríncipe University Hospital, HM Hospitales Group, Madrid, Spain
| | | | - Vicente F Gil-Guillen
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
- Institute of Health and Biomedical research of Alicante, Alicante Spain General University Hospital of Alicante, Diagnostic center, Fifth floor. Pintor Baeza street, 12, Alicante, 03110, Spain
- General University Hospital of Elda, Alicante, 03600, Spain
| | - Concepción Carratala-Munuera
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
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León-Herrera S, Oliván-Blázquez B, Samper-Pardo M, Aguilar-Latorre A, Sánchez Arizcuren R. Motivational Interviewing as a Tool to Increase Motivation and Adherence to a Long COVID Telerehabilitation Intervention: Secondary Data Analysis from a Randomized Clinical Trial. Psychol Res Behav Manag 2024; 17:157-169. [PMID: 38234406 PMCID: PMC10793119 DOI: 10.2147/prbm.s433950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/26/2023] [Indexed: 01/19/2024] Open
Abstract
Background Although motivational interviewing was originally developed to address abuse disorders, scientific evidence confirms that it is an increasingly used and effective approach in a wide range of therapeutic interventions. To date, however, no studies have analyzed the use of this tool in patients with persistent symptoms following coronavirus disease 2019, a condition known as Long COVID. Purpose To analyze the effectiveness of motivational interviewing with regard to the adherence to telerehabilitation for Long COVID using a mobile application. As a secondary objective, factors related to greater motivation before and after the motivational interviewing techniques were analyzed. Patients and Methods This longitudinal design substudy used a sample of 52 adult patients with Long COVID participating in the intervention group of a randomized clinical trial. This trial examined the effectiveness of a telerehabilitation program for this population using a mobile application. This program included three motivational interviews to achieve maximum treatment adherence. In this study, the main variables were motivation and adherence to application use. Sociodemographic and clinical data, personal constructs, and affective state were also collected. Subsequently, a descriptive, correlational, and regression statistical analysis was performed using the SPSS Statistics program. Results The median motivation prior to the first motivational interview was 8 (IQR 2), the median at the end of the last motivational interview was 8.5 (IQR 2.75), and the change in motivation levels after the three motivational interviews was 0.5 (IQR 1). Affective state and final motivation scores were predictors of greater adherence to telerehabilitation treatment. Conclusion A high level of motivation after participating in motivational interviewing appears to be related to higher levels of adherence to telerehabilitation in patients with Long COVID. This suggests that motivational interviewing may be an effective tool in the treatment of this disease.
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Affiliation(s)
- Sandra León-Herrera
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | | | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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25
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Peeters LE, Kappers M, Hesselink D, van der Net J, Hartong S, van de Laar R, Ezzahti M, van de Ven P, van der Meer I, de Bruijne E, Kroon A, Indhirajanti-Tomasoa S, van der Linde N, Bahmany S, Boersma E, Massey EK, van Dijk L, van Gelder T, Koch BC, Versmissen J. Antihypertensive drug concentration measurement combined with personalized feedback in resistant hypertension: a randomized controlled trial. J Hypertens 2024; 42:169-178. [PMID: 37796233 PMCID: PMC10713002 DOI: 10.1097/hjh.0000000000003585] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Adherence to antihypertensive drugs (AHDs) is crucial for controlling blood pressure (BP). We aimed to determine the effectiveness of measuring AHD concentrations using a dried blood spot (DBS) sampling method to identify nonadherence, combined with personalized feedback, in reducing resistant hypertension. METHODS We conducted a multicenter, randomized, controlled trial (RHYME-RCT, ICTRP NTR6914) in patients with established resistant hypertension. Patients were randomized to receive either an intervention with standard of care (SoC) or SoC alone. SoC consisted of BP measurement and DBS sampling at baseline, 3 months (t3), 6 months (t6), and 12 months (t12); AHD concentrations were measured but not reported in this arm. In the intervention arm, results on AHD concentrations were discussed during a personalized feedback conversation at baseline and t3. Study endpoints included the proportion of patients with RH and AHD adherence at t12. RESULTS Forty-nine patients were randomized to receive the intervention+SoC, and 51 were randomized to receive SoC alone. The proportion of adherent patients improved from 70.0 to 92.5% in the intervention+SoC arm ( P = 0.008, n = 40) and remained the same in the SoC arm (71.4%, n = 42). The difference in adherence between the arms was statistically significant ( P = 0.014). The prevalence of resistant hypertension decreased to 75.0% in the intervention+SoC arm ( P < 0.001, n = 40) and 59.5% in the SoC arm ( P < 0.001, n = 42) at t12; the difference between the arms was statistically nonsignificant ( P = 0.14). CONCLUSION Personalized feedback conversations based on DBS-derived AHD concentrations improved AHD adherence but did not reduce the prevalence of RH.
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Affiliation(s)
- Laura E.J. Peeters
- Erasmus MC, University Medical Center Rotterdam, Department of Hospital Pharmacy
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam
| | | | - D.A. Hesselink
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam
| | - J.B. van der Net
- Albert Schweitzer Hospital, Department of Internal Medicine, Dordrecht
| | - S.C.C. Hartong
- Albert Schweitzer Hospital, Department of Internal Medicine, Dordrecht
| | - R. van de Laar
- Ikazia Hospital, Department of Internal Medicine, Rotterdam
| | - M. Ezzahti
- Bravis Hospital, Department of Internal Medicine, Bergen op Zoom
| | | | | | - E.L.E. de Bruijne
- IJsselland Hospital, Department of Internal Medicine, Capelle aan den Ijssel
| | - A.A. Kroon
- Maastricht University Medical Center, Department of Internal Medicine, Maastricht
| | | | | | - S. Bahmany
- Erasmus MC, University Medical Center Rotterdam, Department of Hospital Pharmacy
| | - E. Boersma
- Erasmus MC, University Medical Center Rotterdam, Department of Cardiology, Rotterdam
| | - E. K. Massey
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam
| | - L. van Dijk
- Nivel, Netherlands Institute for Health Services Research, Department Pharmaceutical Care, Utrecht
- Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - T. van Gelder
- Erasmus MC, University Medical Center Rotterdam, Department of Hospital Pharmacy
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam
| | - Birgit C.P. Koch
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam
| | - Jorie Versmissen
- Erasmus MC, University Medical Center Rotterdam, Department of Hospital Pharmacy
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam
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Ritngam A, Kalampakorn S, Lagampan S, Jirapongsuwan A. Effectiveness of a Nurse-Led Workplace Intervention in Reducing Cardiovascular Risks Among Thai Workers: A Randomized Controlled Trial. J Prim Care Community Health 2024; 15:21501319241281211. [PMID: 39439266 PMCID: PMC11500231 DOI: 10.1177/21501319241281211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 08/09/2024] [Accepted: 08/20/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND The prevalence of cardiovascular diseases (CVD) is continuously increasing. A nurse-led workplace health promotion program (NWHPP) has demonstrated potential in reducing cardiovascular risks among employees. This study aimed to evaluate the effectiveness of the NWHPP in reducing CVD risks among at-risk workers. METHODS Sixty workers from 2 factories in Thailand, each with an estimated 10-year cardiovascular risk of 5% or higher (determined by the WHO/ISH cardiovascular risk prediction chart), were enrolled. Participants were randomly assigned to either the intervention or control group based on their factory. The intervention group received an 8-week program comprising 3 core components: redesigning healthcare services, strengthening self-management, and obtaining organizational support. Evaluations of the estimated 10-year CVD risk, systolic blood pressure (SBP), smoking status, and body mass index (BMI) were conducted at baseline and at 1- and 3-month follow-ups. RESULTS The intervention group showed significant improvements compared to the control group in CVD risk score (F = 4.827, P = .017) and SBP (F = 12.136, P < .001). Moreover, non-smokers were significantly higher in the intervention group (75.0%) compared with the control group (46.2%) after the 3-month follow-up (OR = 3.50; 95%CI 1.11-11.07; P = .030). However, BMI differences between the groups were not statistically significant. CONCLUSION The nurse-led workplace health promotion program effectively improved cardiovascular risk scores among at-risk workers. Developing workplace policies and environments that promote healthy behaviors is essential for reducing CVD risks among at-risk workers.
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Affiliation(s)
- Arisara Ritngam
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Rajthevi, Bangkok, Thailand
| | - Surintorn Kalampakorn
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Rajthevi, Bangkok, Thailand
| | - Sunee Lagampan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Rajthevi, Bangkok, Thailand
| | - Ann Jirapongsuwan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Rajthevi, Bangkok, Thailand
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Chapman N, Marques FZ, Picone DS, Adji A, Broughton BRS, Dinh QN, Gabb G, Lambert GW, Mihailidou AS, Nelson MR, Stowasser M, Schlaich M, Schultz MG, Mynard JP, Climie RE. Content and delivery preferences for information to support the management of high blood pressure. J Hum Hypertens 2024; 38:70-74. [PMID: 35948655 PMCID: PMC10803250 DOI: 10.1038/s41371-022-00723-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/22/2022] [Accepted: 07/05/2022] [Indexed: 11/09/2022]
Abstract
Blood pressure(BP) management interventions have been shown to be more effective when accompanied by appropriate patient education. As high BP remains poorly controlled, there may be gaps in patient knowledge and education. Therefore, this study aimed to identify specific content and delivery preferences for information to support BP management among Australian adults from the general public. Given that BP management is predominantly undertaken by general practitioners(GPs), information preferences to support BP management were also ascertained from a small sample of Australian GPs. An online survey of adults was conducted to identify areas of concern for BP management to inform content preferences and preferred format for information delivery. A separate online survey was also delivered to GPs to determine preferred information sources to support BP management. Participants were recruited via social media. General public participants (n = 465) were mostly female (68%), >60 years (57%) and 49% were taking BP-lowering medications. The management of BP without medications, and role of lifestyle in BP management were of concern among 30% and 26% of adults respectively. Most adults (73%) preferred to access BP management information from their GP. 57% of GPs (total n = 23) preferred information for supporting BP management to be delivered via one-page summaries. This study identified that Australian adults would prefer more information about the management of BP without medications and via lifestyle delivered by their GP. This could be achieved by providing GPs with one-page summaries on relevant topics to support patient education and ultimately improve BP management.
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Affiliation(s)
- N Chapman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - F Z Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University, Melbourne, VIC, Australia
- Heart Failure Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - D S Picone
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - A Adji
- Victor Chang Cardiac Research Institute/ St Vincent's Hospital, Sydney, NSW, Australia
| | - B R S Broughton
- Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Q N Dinh
- Centre for Cardiovascular Biology and Disease Research, Department of Physiology, Anatomy and Microbiology, La Trobe University, VIC, Melbourne, Australia
| | - G Gabb
- Cardiology Department, Southern Adelaide Local Health Network, Adelaide, SA, Australia
- Acute and Urgent Care, Central Adelaide Local Health Network, Adelaide, SA, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Medicine, Faculty of Health Science, University of Adelaide, Adelaide, SA, Australia
| | - G W Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - A S Mihailidou
- Department of Cardiology & Kolling Institute, Royal North Shore Hospital, St Leonards, 2065, NSW, Australia
- Faculty of Medicine & Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - M R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - M Stowasser
- Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - M Schlaich
- Dobney Hypertension Centre, Medical School-University of Western Australia, Perth, TAS, Australia
- Royal Perth Hospital Unit, Perth, WA, Australia
| | - M G Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - J P Mynard
- Heart Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Department of Biomedical Engineering, University of Melbourne, Melbourne, TAS, Australia
| | - R E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
- Sports Cardiology Lab, Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
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Wang A, Wan J, Zhu L, Chang W, Wen L, Tao X, Jin Y. Frailty and medication adherence among older adult patients with hypertension: a moderated mediation model. Front Public Health 2023; 11:1283416. [PMID: 38115848 PMCID: PMC10728772 DOI: 10.3389/fpubh.2023.1283416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Objective Medication adherence has a critical impact on the well-being of older adult patients with hypertension. As such, the current study aimed to investigate the mediating role of health literacy between frailty and medication adherence and the moderating role of educational level. Methods This cross-sectional study included patients admitted to the geriatric unit of a hospital. Participants were interviewed using the four-item Morisky Medication Adherence Scale, the Frailty Phenotype Scale, and the Health Literacy Management Scale. Spearman's correlation coefficients were used to assess the association between variables. Mediation and moderated mediation analyses were performed using Process version 4.1 via Model 4 and 14, respectively. Results Data from 388 participants were analyzed. The median (IQR [P25-P75]) score for medication adherence was 4.00 (2.00-4.00). Results revealed that after controlling for age, sex, hypertension complication(s) and body mass index, frailty significantly contributed to medication adherence (βtotal -0.236 [95% confidence interval (CI) -0.333 to -0.140]). Medication adherence was influenced by frailty (βdirect -0.192 [95% CI -0.284 to -0.099]) both directly and indirectly through health literacy (βindirect -0.044 [95% CI -0.077 to -0.014]). Educational level moderated the pathway mediated by health literacy; more specifically, the conditional indirect effect between frailty and medication adherence was significant among older adult hypertensive patients with low, intermediate, and high educational levels (effect -0.052 [95% CI -0.092 to -0.106]; effect -0.041 [95% CI -0.071 to -0.012]; effect -0.026 [95% CI -0.051 to -0.006]). The relationship between frailty and medication adherence in older adult patients with hypertension was found to have mediating and moderating effects. Conclusion A moderated mediation model was proposed to investigate the effect of frailty on medication adherence. It was effective in strengthening medication adherence by improving health literacy and reducing frailty. More attention needs to be devoted to older adult patients with hypertension and low educational levels.
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Affiliation(s)
- Anshi Wang
- School of Public Health, Wannan Medical College, Wuhu, China
- Institutes of Brain Science, Wannan Medical College, Wuhu, China
| | - Jingjing Wan
- Department of Nursing, Anhui College of Traditional Chinese Medicine, Wuhu, China
| | - Lijun Zhu
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Weiwei Chang
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Liying Wen
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Xiubin Tao
- Nursing Department, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Yuelong Jin
- School of Public Health, Wannan Medical College, Wuhu, China
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Ma G, Fang H, Wang X, Meng Y, Zhu Y, Zhang C. Factors influencing self-quantification for patients with hypertension: A cross-sectional Study. Medicine (Baltimore) 2023; 102:e36185. [PMID: 38050204 PMCID: PMC10695629 DOI: 10.1097/md.0000000000036185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/27/2023] [Indexed: 12/06/2023] Open
Abstract
This study aimed to investigate the level of self-quantification among patients with hypertension and identify the factors influencing this behavior. This study aimed to investigate self-quantification levels and identify influencing factors among 400 patients diagnosed with hypertension. Employing a convenience sampling method, the research was conducted across diverse healthcare settings, including a tertiary hospital, 2 community hospitals, 2 pension institutions, and 5 residential areas. Participants underwent assessment using a self-quantification scale. The collected data underwent thorough analysis using various statistical methods, including descriptive analysis for an overview, 2 independent samples t test for mean comparisons, one-way analysis of variance for variations among groups, and multiple linear regression analysis to identify influential factors. This robust methodology was applied to gain comprehensive insights into the self-quantification behaviors of patients with hypertension. The total self-quantification score for patients with hypertension was found to be (96.64 ± 14.16). The average value for all dimensions was (3.22 ± 0.47). Notably, medical insurance type, education level, age, and complications were identified as significant factors influencing self-quantification among patients with hypertension. The study concludes that patients without medical insurance, with lower education levels, older age, and no complications tended to have lower levels of self-quantification. These findings underscore the necessity for targeted interventions to improve self-quantification in these specific patient groups. By addressing the identified influencing factors, healthcare providers can implement measures to enhance self-quantification among patients with hypertension.
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Affiliation(s)
- Guiyue Ma
- Nursing College, Anhui University of Chinese Medicine, Hefei, China
| | - Haiyan Fang
- Nursing College, Anhui University of Chinese Medicine, Hefei, China
| | - Xiang Wang
- Nursing College, Anhui University of Chinese Medicine, Hefei, China
| | - Yahui Meng
- Nursing College, Anhui University of Chinese Medicine, Hefei, China
| | - Yu Zhu
- Nursing College, Anhui University of Chinese Medicine, Hefei, China
| | - Chuanying Zhang
- Nursing College, Anhui University of Chinese Medicine, Hefei, China
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30
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Choi GW, Chang SJ, Kim HJ, Jeong HN. Understanding health literacy of deaf persons with hypertension in South Korea: A cross-sectional study. PLoS One 2023; 18:e0294765. [PMID: 38011166 PMCID: PMC10681163 DOI: 10.1371/journal.pone.0294765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Health literacy is strongly associated with health inequality among persons with deafness, and hypertension (HTN) is the most prevalent chronic disease among persons with deafness in South Korea. Despite its importance, research regarding the health literacy levels of persons with deafness with HTN in South Korea is lacking. This study aimed to comprehensively assess the health literacy levels of persons with deafness with HTN in South Korea, including linguistic, functional, and internet health literacy. METHODS In this descriptive cross-sectional study, 95 persons with deafness with HTN were recruited through facilities associated with the deaf community. From August 2022 to February 2023, data were collected through face-to-face surveys attended by a sign language interpreter and online surveys. The data were analyzed using descriptive statistics and Spearman's correlation. RESULTS Approximately 62.1% of the participants exhibited a linguistic health literacy level corresponding to less than that of middle school students, and the total percentage correct of functional health literacy was 17.9%. Each domain of internet health literacy was low. Significant correlations were found between some aspects of health literacy. CONCLUSIONS The study's findings highlight the low health literacy levels across various facets among persons with deafness with HTN in South Korea. Based on these findings, several strategies are suggested for developing HTN self-management interventions for persons with deafness. This study contributes to the foundational understanding of health literacy among persons with deafness with HTN in South Korea and provides valuable insights and guidance for developing HTN self-management interventions.
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Affiliation(s)
- Gi Won Choi
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Sun Ju Chang
- College of Nursing and The Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Hee Jung Kim
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Ha Na Jeong
- College of Nursing, Seoul National University, Seoul, Republic of Korea
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Maleki G, Norian R, Moeini B, Barati M, Maleki S, Afshari M. Factors related to medication adherence in patients with hypertension in Iran: a systematic review study. Blood Press Monit 2023; 28:221-235. [PMID: 37661726 DOI: 10.1097/mbp.0000000000000665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
OBJECTIVES This study aimed to review the available studies of the factors in Iranian hypertensive patients' adherence to drug treatment. METHODS Four Persian databases and seven English databases were searched. The articles, which were published from 2000 to 2022 in Persian and English and examined the adherence to drug treatment in the Iranian population of adults with high blood pressure, were reviewed. Based on the primary examination, 31 of the initial 1062 articles met the inclusion criteria and were included in the analysis. The evidence, which was provided by the examined articles, was summarized and discussed using the 5-dimensional framework of adherence to long-term treatments, which was developed by WHO. RESULTS The factors that significantly correlated with adherence to drug treatment in the examined studies were: (1) factors that were related to the health team or the health system: patients' satisfaction with their doctor-patient relationship; (2) factors that were related to the conditions: the number of concomitant diseases, high quality of life and the implementation of effective interventions; (3) factors which were related to the treatment: long duration of illness, short intervals between the visits, duration of treatment, lower numbers of drugs, and the patient's blood pressure control; and (4) factors that were related to the patient: self-efficacy, health literacy, social support, locus of control, illness perception, beliefs, attitude, knowledge, and cues to action. CONCLUSION It is possible to draw definite conclusions about the factors which affect adherence to drug treatment in patients with high blood pressure because most of the relevant studies have been cross-sectional. Therefore, in the future, valuable results can be obtained by conducting more studies that preferably use objective instruments for assessing adherence to drug treatment.
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Affiliation(s)
- Golara Maleki
- Department of Psychology, Sari Branch, Islamic Azad University, Sari
| | - Rohollah Norian
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran
| | | | | | | | - Maryam Afshari
- Social Determinants of Health Research Center
- Department of Public Health, School of Health
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Choi GW, Lee KE, Chang SJ, Kim HJ. Health education interventions for individuals with hearing impairment: A systematic review. PATIENT EDUCATION AND COUNSELING 2023; 114:107830. [PMID: 37301012 DOI: 10.1016/j.pec.2023.107830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study aims to systematically review health education interventions targeting individuals with hearing impairment. METHODS A total of 18 studies were selected based on search results from five databases, and quality appraisal was conducted using an appropriate tool based on the study design. The extracted results were described using qualitative analysis. RESULTS Among the selected studies, most interventions focused on specific cancers, and video materials were the most common delivery method. Various strategies were applied depending on the type of materials provided, in addition to sign language interpretation and the involvement of hearing-impaired related personnel. The interventions primarily resulted in a significant increase in knowledge. CONCLUSION This study suggests several recommendations, including expanding the scope of interventions to cover various chronic diseases, actively utilizing the features of video materials, considering health literacy, using peer support groups, and measuring behavior-related factors alongside knowledge levels. PRACTICE IMPLICATIONS This study makes a significant contribution to understanding the unique characteristics of the population with hearing impairment. Furthermore, it has the potential to facilitate the development of high-quality health education interventions for individuals with hearing impairment by providing insights into future research directions based on existing health education interventions.
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Affiliation(s)
- Gi Won Choi
- College of Nursing, Seoul National University, Seoul, Republic of Korea; Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Kyoung-Eun Lee
- Department of Nursing, Sunmoon University, Asan-si, Republic of Korea
| | - Sun Ju Chang
- College of Nursing, Seoul National University, Seoul, Republic of Korea; The Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.
| | - Hee Jung Kim
- College of Nursing, Seoul National University, Seoul, Republic of Korea; Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, Seoul, Republic of Korea
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Niksadat N, Ghaffari M, Ramezankhani A, Rakhshanderou S, Farahani AV, Negarandeh R. Experiences of patient education among people affected by cardiovascular disease: a qualitative study based on Andragogy model. BMC Health Serv Res 2023; 23:708. [PMID: 37386425 DOI: 10.1186/s12913-023-09622-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Patient education is a key component of patient care, positively affecting health promotion and self-care ability. In this regard, an extensive body of research supports the use of the andragogy model in patient education. The study aimed to explore the experiences of people with cardiovascular disease in patient education. METHODS This qualitative study involved 30 adult patients with cardiovascular disease who were hospitalized or had a history of hospitalization. They were purposively recruited with maximum variation from two large hospitals in Tehran, Iran. Data were gathered by conducting semi-structured interviews. Data collection was done by conducting semi-structured interviews. Then, the data were analyzed using directed content analysis and a preliminary framework based on six constructs of the andragogy model. RESULTS Data analysis resulted in the development of 850 primary codes, which were reduced to 660 during data reduction. These codes were grouped into nineteen subcategories under the six primary constructs of the andragogy model, i.e., need-to-know, self-concept, prior experience, readiness for learning, orientation to learning, and motivation for learning. The most common problems in patient education were associated with self-concept, previous experience, and readiness for learning components. CONCLUSION This study provides valuable information about the problems of patient education for adults with cardiovascular disease. Correction of the issues identified can improve care quality and patient outcomes.
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Affiliation(s)
- Negin Niksadat
- Department of Public Health, Faculty of health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Department of Health Education and Promotion, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohtasham Ghaffari
- Department of Health Education and Promotion, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Department of Health Education and Promotion, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshanderou
- Department of Health Education and Promotion, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Nair SC, Sreedharan J, Vijayan K, Ibrahim H. Estimation of health literacy levels in patients with cardiovascular diseases in a Gulf country. BMC Health Serv Res 2023; 23:518. [PMID: 37221529 DOI: 10.1186/s12913-023-09364-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/04/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. In the United Arab Emirates (UAE), the prevalence of deaths associated with CVD is higher than the global average, and the incidence of premature coronary heart disease is 10-15 years earlier than in Western nations. In patients with CVD, inadequate health literacy (HL) is significantly associated with poor health outcomes. The goal of this study is to assess HL levels among patients with CVD in the UAE to develop effective health system strategies for disease prevention and management. METHODS A nationwide cross-sectional survey to assess HL levels in patients with CVD was conducted between January 2019 and May 2020 in the UAE. The association between health literacy level with patient age, gender, nationality, and education was determined using the Chi-Square test. The significant variables were further analyzed by ordinal regression. RESULTS Of 336 participants (86.5% response rate), approximately half 51.5% (173/336) of the respondents were women, and 46% (146/336) of them attained high school level of education. More than 75% (268/336) of the participants were above the age of 50 years. Overall, 39.3% (132/336) of respondents possessed inadequate HL, and 46.4% (156/336) and 14.3% (48/336) demonstrated marginal and adequate HL, respectively. Inadequate health literacy was more prevalent among women, as compared to men. Age was significantly associated with HL levels. Participants under age 50 had higher adequate HL levels 45.6% (31/68), (95% CI (3.8-57.4), P < 0.001). There was no correlation between education and health literacy levels. CONCLUSION The inadequate HL levels found in outpatients with CVD is a major health concern in the UAE. To improve population health outcomes, health system interventions, including targeted educational and behavioral programs for the older population are necessary.
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Affiliation(s)
- Satish Chandrasekhar Nair
- Department of Academic Affairs, Tawam Hospital, Al Ain, United Arab Emirates.
- College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
| | - Jayadevan Sreedharan
- Department of Community Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - Karthik Vijayan
- School of Medicine, Shri Satya Sai Medical College and Research Institute, Nellikuppam, India
| | - Halah Ibrahim
- Department of Medicine, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
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Liu XT, Wang N, Zhu LQ, Wu YB. Assessment of knowledge, cultural beliefs, and behavior regarding medication safety among residents in Harbin, China. World J Clin Cases 2023; 11:2956-2965. [PMID: 37215410 PMCID: PMC10198069 DOI: 10.12998/wjcc.v11.i13.2956] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/09/2022] [Accepted: 04/04/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Medication misuse or overuse is significantly associated with poor health outcomes. Information regarding the knowledge, cultural beliefs, and behavior about medication safety in the general population is important.
AIM To conduct a survey on medication habits and explored the potential factors impacting medication safety.
METHODS The current survey included adults from 18 districts and counties in Harbin, China. A questionnaire on medication safety was designed based on knowledge, cultural beliefs, and behavior. Both univariate and multivariate analyses were used to explore the factors that impacted medication safety.
RESULTS A total of 394 respondents completed the questionnaires on medication safety. The mean scores for knowledge, cultural beliefs, and behavior about medication safety were 59.41 ± 19.33, 40.66 ± 9.24, and 60.97 ± 13.69, respectively. The medication knowledge score was affected by age (P = 0.044), education (P < 0.001), and working status (P = 0.015). Moreover, the cultural beliefs score was significantly affected by education (P < 0.001). Finally, education (P = 0.003) and working status (P = 0.011) significantly affected the behavior score.
CONCLUSION The knowledge, cultural beliefs, and behavior about medication safety among the general population was moderate. Health education should be provisioned for the elderly, individuals with a low education level, and the unemployed to improve medication safety in Harbin, China.
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Affiliation(s)
- Xuan-Tong Liu
- Department of Pharmacy, The Fourth Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Na Wang
- Department of Pharmacy, Heilongjiang Provincial Hospital, Harbin 150001, Heilongjiang Province, China
| | - Li-Qiu Zhu
- Ge Xin Community Health Service Center, Harbin 150001, Heilongjiang Province, China
| | - Yu-Bo Wu
- Department of Pharmacy, The Fourth Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
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Johnson E, Yoshida M, Hallway A, Byrnes M, Waljee J, Englesbe M, Howard R. "I Prefer to Stay Away": A Qualitative Study of Patients in an Opioid-Sparing Pain Management Protocol. Ann Surg 2023; 277:596-602. [PMID: 34787984 DOI: 10.1097/sla.0000000000005087] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to explore beliefs and behaviors of opioid pain medications among patients undergoing elective surgery. BACKGROUND Opioid dependence after surgery is a major contributor to the ongoing opioid epidemic. Recent efforts by surgeons and health systems have sought to improve the education patients receive regarding safe opioid use after surgery; however, little is known about patients' pre-existing beliefs surrounding opioids. METHODS Semistructured interviews were conducted with patients who underwent 1 of 4 common elective surgical procedures at 1 institution. Patients were specifically asked about their knowledge and beliefs about opioids before surgery and their opinions of opioid-sparing recovery after surgery. Coding was conducted through iterative steps, beginning with an initial cycle of rapid analysis, followed by focused coding, and thematic analysis. RESULTS Twenty-one patients were interviewed. Three major themes emerged regarding patient opinions about using opioids after surgery. First, there was widespread awareness among patients about opioid medications, and preoperatively, patients had specific intentions about using opioids, often informed by this awareness. Second, patients described a spectrum of opioid related behavior which both aligned and conflicted with preoperative intentions. Third, there was tension among patients about opioid-free postoperative recovery, with patients expressing support, opposition, and emphasis on tailoring recovery to patient needs. CONCLUSIONS Patients undergoing common surgical procedures often arrive at their surgical encounter with strong, pre-formed opinions about opioids. Eliciting these preexisting opinions may help surgeons better counsel patients about safe opioid use after surgery.
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Affiliation(s)
- Emily Johnson
- University of Michigan Medical School, Ann Arbor, MI
| | - Maxwell Yoshida
- Michigan Opioid Prescribing and Engagement Network, Ann Arbor, MI
| | | | - Mary Byrnes
- Center for Health Outcomes and Policy, Michigan Medicine, Ann Arbor, MI
- Department of Surgery, Michigan Medicine, Ann Arbor, Mi
| | - Jennifer Waljee
- Michigan Opioid Prescribing and Engagement Network, Ann Arbor, MI
- Center for Health Outcomes and Policy, Michigan Medicine, Ann Arbor, MI
- Section of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, MI
| | - Michael Englesbe
- Michigan Opioid Prescribing and Engagement Network, Ann Arbor, MI
- Section of Transplant Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, MI
| | - Ryan Howard
- Center for Health Outcomes and Policy, Michigan Medicine, Ann Arbor, MI
- Department of Surgery, Michigan Medicine, Ann Arbor, Mi
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Supporting Reproductive Care for Patients Requiring Solid Organ Transplant. Nurs Womens Health 2023; 27:53-64. [PMID: 36567068 DOI: 10.1016/j.nwh.2022.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/09/2022] [Indexed: 12/24/2022]
Abstract
After a solid organ transplant, individuals have the capability to maintain a successful pregnancy. However, many posttransplant pregnancies are unintended, thereby posing risks to health. There is a critical need to strengthen patient education regarding safe approaches to conception, general reproductive health, and childbearing capabilities. The complex needs of patients after transplant, including management of graft health and medication regimens, may distract from the usual reproductive care offered to other individuals of childbearing potential. Thorough education about immunosuppressant medications, contraceptive methods, and expected waiting periods before conceiving are essential. Nurses can work with each individual and direct the interprofessional health care team to provide effective, safe, comprehensive, and inclusive reproductive care to patients posttransplant.
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Cardoso RSS, Tosin MHS, de Oliveira BGRB, Moraes KL, Santana RF. The Multidimensionality of Low Health Literacy in Older Adults: A Scoping Review of International Studies. Clin Nurs Res 2023; 32:270-277. [PMID: 36625242 DOI: 10.1177/10547738221146461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This scoping review aims to map the dimensions encompassing the low health literacy (HL) of older adults, describing their respective causes and consequences. A three-step search strategy was conducted using 16 databases from nine portals and reference lists. Of the 4,259 identified studies, 2,845 were screened and 29 (1%) were included. Studies were published between 1999 and 2021, most of them in English (86.2%), from the American continent (48.3%) and with observational design (86.2%). Four dimensions encompassing the low HL of older adults were mapped: (1) patient dimension, (2) healthcare system dimension, (3) social/economic dimension, and (4) health condition dimension. This review highlights specific dimensions encompassing the low literacy in older adults with evidence about its causes and consequences. These results can guide future research and evidence-based practice involving HL of older adults.
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Affiliation(s)
| | - Michelle H S Tosin
- Fluminense Federal University, Niterói, RJ, Brazil
- Rush University Medical Center, Chicago, IL, USA
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Esen K, Kolcu M. The relationship between health literacy and self-care management in patients with hypertension attending primary healthcare centers. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01801-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Kim C, Kim M, Lee G, Park E, Schlenk EA. Effectiveness of nurse‐led interventions on medication adherence in adults taking medication for metabolic syndrome: A systematic review and meta‐analysis. J Clin Nurs 2022. [DOI: 10.1111/jocn.16589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/14/2022] [Accepted: 11/03/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Chun‐Ja Kim
- College of Nursing and the Research Institute of Nursing Science Ajou University Suwon South Korea
| | - Moonsun Kim
- Department of Nursing, Graduate School and College of Nursing Ajou University Suwon South Korea
| | - Ga‐Young Lee
- Department of Nursing, Graduate School and College of Nursing Ajou University Suwon South Korea
| | - Eunyoung Park
- Chungnam National University College of Nursing Daejeon South Korea
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Hossein Mirzaee Beni Z, Maasoumi R, Pashaeypoor S, Haghani S. The effects of self-care education based on the health literacy index on self-care and quality of life among menopausal women: a randomized clinical trial. BMC Womens Health 2022; 22:452. [DOI: 10.1186/s12905-022-02007-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 10/10/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Purpose
Aging is associated with many different health-related challenges for women such as menopause and its associated problems. Self-care (SC) is a factor with potential effects on menopause and its consequences. SC education based on health literacy has the potential to improve menopausal women’s SC. The aim of this study was to evaluate the effects of SC education based on the health literacy index (HLI) on SC and quality of life (QOL) among menopausal women.
Methods
This randomized clinical trial was conducted in Iran. Participants were 100 menopausal women purposively recruited from five comprehensive healthcare centers in the south of Tehran. They were randomly allocated to a control and an intervention group through block randomization. Intervention was an HLI-based SC education program implemented in four 1.5–hour weekly sessions through the lecture, group discussion, and question and answer methods. Data were collected before and eight weeks after the intervention using a demographic questionnaire, the Health Literacy for Iranian Adults scale, the Menopause-Specific Quality of Life Questionnaire, and the Menopausal Self-Care Questionnaire. The SPSS software (v. 22.0) was used to analyze the data through the Chi-square, Fisher’s exact, paired-sample t, and the independent-sample t tests as well as the analysis of covariance at a significance level of less than 0.05.
Findings
There were no significant differences between the intervention and the control groups respecting the pretest mean scores of QOL (88.15 ± 32.36 vs. 79.6 ± 36.99) and SC (104.75 ± 12.31 vs. 103.32 ± 13.8) (P > 0.05). However, the posttest mean scores of QOL and SC in the intervention group significantly differed from the control group (66.44 ± 28.41vs. 81.3 ± 38.04 and 125.6 ± 11.23 vs. 102.6 ± 14.34) (P < 0.05).
Conclusion
HLI-based SC education is effective in significantly improving menopausal women’s QOL and SC and can be used to improve health-related outcomes among menopausal women.
Clinical trial registration This research was registered (24/03/2020) in the www.thaiclinicaltrials.org with registration number: TCTR20200324002.
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Wu Y, Gu Y, Rao X, Cheng M, Chen P, He L. Clinical Effects of Outpatient Health Education on Fall Prevention and Self-health Management of Elderly Patients with Chronic Diseases. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:6265388. [PMID: 36072400 PMCID: PMC9441364 DOI: 10.1155/2022/6265388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022]
Abstract
Background Elderly patients with chronic diseases (CDs) have a higher predilection for falls, with more severe consequences once they fall. Therefore, it is necessary to explore an effective way to prevent falls in elderly patients with CDs. Objective To clarify the clinical effects of outpatient health education on fall prevention and self-health management in elderly patients with CDs. Methods This retrospective study enrolled 102 elderly patients with CDs who received treatment in the School of Medicine, Sir Run Run Shaw Hospital of Zhejiang University, between January 2019 and December 2020. Patients intervened by routine nursing were assigned to the regular group (n = 48), and those additionally treated with outpatient health education were included in the research group (n = 54). Assessment of patients' negative emotions (NEs) adopted the Self-Rating Anxiety/Depression Scale (SAS/SDS), determination of their sense of self-efficacy employed the Falls Efficacy Scale International (FES-I), and their self-care capacity evaluation used the Exercise of Self-Care Agency (ESCA). Patients' falls, hospitalization time, fall prevention knowledge, fall prevention-related health behavior, and nursing satisfaction were recorded. Results After the nursing intervention, lower SAS, SDS, and FES-I scores were determined in the research group versus the regular group; the total ESCA score assessed from various dimensions was higher in the research group; the research group also exhibited a markedly lower incidence of falls, and shorter hospitalization time than the regular group, with better mastery of fall prevention knowledge, fall prevention-related health behavior and nursing satisfaction. Conclusions Outpatient health education intervention can prevent senile patients with CDs from falling, promote their rehabilitation, and enhance their mastery of fall prevention knowledge; moreover, it can improve patients' healthy behaviors to prevent falls, mitigate their NEs, and improve their sense of self-efficacy and self-care ability, which has high clinical application value.
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Affiliation(s)
- Yongping Wu
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China
| | - Yueying Gu
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China
| | - Xiuhua Rao
- International Center, Mayo Clinic, Rochester, MN, USA
| | - Minling Cheng
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China
| | - Ping Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China
| | - Lina He
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China
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Gyamfi J, Vieira D, Iwelunmor J, Watkins BX, Williams O, Peprah E, Ogedegbe G, Allegrante JP. Assessing descriptions of scalability for hypertension control interventions implemented in low-and middle-income countries: A systematic review. PLoS One 2022; 17:e0272071. [PMID: 35901114 PMCID: PMC9333290 DOI: 10.1371/journal.pone.0272071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/12/2022] [Indexed: 11/20/2022] Open
Abstract
Background The prevalence of hypertension continues to rise in low- and middle-income- countries (LMICs) where scalable, evidence-based interventions (EBIs) that are designed to reduce morbidity and mortality attributed to hypertension have yet to be fully adopted or disseminated. We sought to evaluate evidence from published randomized controlled trials using EBIs for hypertension control implemented in LMICs, and identify the WHO/ExpandNet scale-up components that are relevant for consideration during “scale-up” implementation planning. Methods Systematic review of RCTs reporting EBIs for hypertension control implemented in LMICs that stated “scale-up” or a variation of scale-up; using the following data sources PubMed/Medline, Web of Science Biosis Citation Index (BCI), CINAHL, EMBASE, Global Health, Google Scholar, PsycINFO; the grey literature and clinicaltrials.gov from inception through June 2021 without any restrictions on publication date. Two reviewers independently assessed studies for inclusion, conducted data extraction using the WHO/ExpandNet Scale-up components as a guide and assessed the risk of bias using the Cochrane risk-of-bias tool. We provide intervention characteristics for each EBI, BP results, and other relevant scale-up descriptions. Main results Thirty-one RCTs were identified and reviewed. Studies reported clinically significant differences in BP, with 23 studies reporting statistically significant mean differences in BP (p < .05) following implementation. Only six studies provided descriptions that captured all of the nine WHO/ExpandNet components. Multi-component interventions, including drug therapy and health education, provided the most benefit to participants. The studies were yet to be scaled and we observed limited reporting on translation of the interventions into existing institutional policy (n = 11), cost-effectiveness analyses (n = 2), and sustainability measurements (n = 3). Conclusion This study highlights the limited data on intervention scalability for hypertension control in LMICs and demonstrates the need for better scale-up metrics and processes for this setting. Trial registration Registration PROSPERO (CRD42019117750).
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Affiliation(s)
- Joyce Gyamfi
- Teachers College, Columbia University, New York, NY, United States of America
- NYU School of Global Public Health, New York, NY, United States of America
- * E-mail:
| | - Dorice Vieira
- NYU School of Global Public Health, New York, NY, United States of America
- NYU Health Sciences Library, New York, NY, United States of America
- NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States of America
| | - Juliet Iwelunmor
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, United States of America
| | | | - Olajide Williams
- Columbia University Medical Center, New York, NY, United States of America
| | - Emmanuel Peprah
- NYU School of Global Public Health, New York, NY, United States of America
| | - Gbenga Ogedegbe
- NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States of America
| | - John P. Allegrante
- Teachers College, Columbia University, New York, NY, United States of America
- Mailman School of Public Health, Columbia University, New York, NY, United States of America
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Li Y, Cao Y, Ding M, Li G, Han X, Zhou S, Wuyang H, Luo X, Zhang J, Jiang J. Non-pharmacological interventions for older patients with hypertension: A systematic review and network meta-analysis. Geriatr Nurs 2022; 47:71-80. [PMID: 35850034 DOI: 10.1016/j.gerinurse.2022.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the most effective non-pharmacological interventions to control the blood pressure variation in older hypertensive patients. METHODS Primary endpoints were office systolic blood pressure (SBP) and diastolic blood pressure (DBP). The quality of evidence was assessed using the "risk of bias 2″ tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. We performed a Bayesian network meta-analysis using R-4.0.2 software to compare the efficacy of interventions. RESULTS 36 eligible studies (3,531 patients) with a median follow-up of 12 weeks, assessing 18 non-pharmacological interventions, were included. The percentages of high, moderate, low, and very low certainty evidence were 16.7%, 38.9%, 33.3%, and 11.1%, respectively. CONCLUSION High certainty evidence suggests that self-management education is most effective in lowering SBP and DBP in older patients with hypertension, followed by moderate-intensity aerobic exercise. Moderate-intensity resistance training is the most effective exercise for lowering SBP. REGISTRATION PROSPERO, #CRD42020209850.
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Affiliation(s)
- Yilun Li
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Yongwen Cao
- Planning and Finance Department of Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730000, Gansu, China
| | - Mingfeng Ding
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Gaiyun Li
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Xuemei Han
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Sheng Zhou
- Department of Radiology, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China; Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China.
| | - Haotian Wuyang
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Xiaolei Luo
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Jiawen Zhang
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Jingwen Jiang
- School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
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Dzerounian J, Pirrie M, AlShenaiber L, Angeles R, Marzanek F, Agarwal G. Health knowledge and self-efficacy to make health behaviour changes: a survey of older adults living in Ontario social housing. BMC Geriatr 2022; 22:473. [PMID: 35650537 PMCID: PMC9158350 DOI: 10.1186/s12877-022-03116-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older adults living in social housing are a vulnerable population facing unique challenges with health literacy and chronic disease self-management. We investigated this population's knowledge of cardiovascular disease and diabetes mellitus, and self-efficacy to make health behaviour changes (for example, physical activity). This study characterized the relationship between knowledge of health risk factors and self-efficacy to improve health behaviours, in order to determine the potential for future interventions to improve these traits. METHODS A cross-sectional study (health behaviour survey) with adults ages 55+ (n = 599) from 16 social housing buildings across five Ontario communities. Descriptive analyses conducted for demographics, cardiovascular disease and diabetes knowledge, and self-efficacy. Subgroup analyses for high-risk groups were performed. Multivariate logistic regressions models were used to evaluate associations of self-efficacy outcomes with multiple factors. RESULTS Majority were female (75.6%), white (89.4%), and completed high school or less (68.7%). Some chronic disease subgroups had higher knowledge for those conditions. Significant (p < 0.05) associations were observed between self-efficacy to increase physical activity and knowledge, intent to change, and being currently active; self-efficacy to increase fruit/vegetable intake and younger age, knowledge, and intent to change; self-efficacy to reduce alcohol and older age; self-efficacy to reduce smoking and intent to change, ability to handle crises, lower average number of cigarettes smoked daily, and less frequent problems with usual activities; self-efficacy to reduce stress and ability to handle crises. CONCLUSIONS Those with chronic diseases had greater knowledge about chronic disease. Those with greater ability to handle personal crises and intention to make change had greater self-efficacy to change health behaviours. Development of stress management skills may improve self-efficacy, and proactive health education may foster knowledge before chronic disease develops.
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Affiliation(s)
- Jasmine Dzerounian
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON L8P 1H6 Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Ontario L8S 4K1 Hamilton, Canada
| | - Melissa Pirrie
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON L8P 1H6 Canada
| | - Leena AlShenaiber
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON L8P 1H6 Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Ontario L8S 4K1 Hamilton, Canada
| | - Ricardo Angeles
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON L8P 1H6 Canada
| | - Francine Marzanek
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON L8P 1H6 Canada
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON L8P 1H6 Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Ontario L8S 4K1 Hamilton, Canada
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Virtual management of hypertension: lessons from the COVID-19 pandemic-International Society of Hypertension position paper endorsed by World Hypertension League and European Society of Hypertension. J Hypertens 2022; 40:1435-1448. [PMID: 35579481 DOI: 10.1097/hjh.0000000000003205] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The coronavirus disease 2019 pandemic caused an unprecedented shift from in person care to delivering healthcare remotely. To limit infectious spread, patients and providers rapidly adopted distant evaluation with online or telephone-based diagnosis and management of hypertension. It is likely that virtual care of chronic diseases including hypertension will continue in some form into the future. The purpose of the International Society of Hypertension's (ISH) position paper is to provide practical guidance on the virtual management of hypertension to improve its diagnosis and blood pressure control based on the currently available evidence and international experts' opinion for nonpregnant adults. Virtual care represents the provision of healthcare services at a distance with communication conducted between healthcare providers, healthcare users and their circle of care. This statement provides consensus guidance on: selecting blood pressure monitoring devices, accurate home blood pressure assessments, delivering patient education virtually, health behavior modification, medication adjustment and long-term virtual monitoring. We further provide recommendations on modalities for the virtual assessment and management of hypertension across the spectrum of resource availability and patient ability.
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47
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Kim B, Jang SI, Kim DH, Lee SG, Kim TH. Association Between Hypertension Management Education and Multiple Healthy Behaviors: A Cross-Sectional Study. Am J Health Promot 2022; 36:967-975. [PMID: 35354320 DOI: 10.1177/08901171221081097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to evaluate the association between hypertension management education and the adoption of multiple healthy behaviors. DESIGN Cross-sectional study. SETTING Data from the 2019 Community Health Survey in Korea. SUBJECTS Of the 213,900 participants in the 2019 database, 89,773 (42.0%) were hypertensive and 124,127 (58.0%) were normotensive. MEASURES Secondary data analysis included a 1:1 computer-assisted personal interview. "Multiple healthy behaviors" included not smoking, not drinking excessively, and walking briskly. "Hypertension management education" referred to information on hypertension management that participants received from clinics, hospitals, and public health centers, outside consultation with a doctor. ANALYSIS The association between hypertension management education and the adoption of multiple healthy behaviors was evaluated using multiple logistic regression. RESULTS In total, 89,773 (42.0%) participants were hypertensive. Among 61,589 patients with diagnosed hypertension, only 7,719 (12.5%) received hypertension management education. Participants who received such education were more likely to adopt multiple healthy behaviors (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.21-1.34) than their counterparts (OR = 0.91, 95% CI: 0.89-0.93). Participants with undiagnosed hypertension were least likely to adopt multiple healthy behaviors (OR = 0.89, 95% CI: 0.86-0.92). No causal relationships were ascertained because of the cross-sectional study design. CONCLUSIONS Education can improve the adoption of multiple healthy lifestyles among hypertensive patients. Patients should be encouraged to participate in hypertension management education.
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Affiliation(s)
- Bomgyeol Kim
- Department of Public Health, Graduate School, 37991Yonsei University, Seoul, Republic of Korea
| | - Sung-In Jang
- Department of Preventive Medicine, 37991Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Health Services Research, 37991Yonsei University, Seoul, Republic of Korea
| | - Do Hee Kim
- Department of Public Health, Graduate School, 37991Yonsei University, Seoul, Republic of Korea
| | - Sang Gyu Lee
- Department of Preventive Medicine, 37991Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Health Services Research, 37991Yonsei University, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Institute of Health Services Research, 37991Yonsei University, Seoul, Republic of Korea.,Graduate School of Public Health, 37991Yonsei University, Seoul, Republic of Korea
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48
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Guo YJ, Hu XY, Ji HJ, Wang LY, Zhou XY, Tang J, Zhao Q. The status and predictors of self-care among older adults with hypertension in China using the Chinese version of Self-Care of Hypertension Inventory - A cross-sectional study. Nurs Open 2022; 9:1241-1261. [PMID: 35014206 PMCID: PMC8859094 DOI: 10.1002/nop2.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/23/2021] [Accepted: 11/16/2021] [Indexed: 11/06/2022] Open
Abstract
AIM To investigate the status and predictors of self-care among older adults with hypertension in China by the Chinese version of Self-Care of Hypertension Inventory. DESIGN A cross-sectional questionnaire survey. METHODS A convenience sampling of 544 older adults with hypertension was surveyed using the Chinese version of Self-Care of Hypertension Inventory. SPSS25.0 software was used for statistical analysis of the data. Generalized liner model univariate analysis and the optimal scaling regression analysis were performed to investigate the predictors of self-care. RESULTS The status of self-care was poor with the median and inter-quartile range of total scores of self-care (140.00 ± 67), the scores of self-care maintenance (50 ± 24.76), the scores of self-care management (56.25 ± 29.41) and the scores of self-care confidence (54.79 ± 29.17). Age, family model, primary caregiver, maximum systolic blood pressure, coverage of medical insurance, disease duration, receiving self-care education, education level, economic burden and family history of hypertension were the most powerful predictors of self-care among older adults with hypertension.
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Affiliation(s)
- Yu-Jie Guo
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Xiao-Yun Hu
- School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Hong-Juan Ji
- Department of Rehabilitation, Affiliated Hospital of Nantong University, Nantong, China
| | - Long-Yuan Wang
- Second School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | | | - Jue Tang
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Qiao Zhao
- First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
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49
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Nuryanti Y, Faidiban RH, Sombuk H, Fabanjo IJ, Susantie NG, Sawaasemariay O, Suriani W, Mansa G. The Effectiveness of Interactive Patient Education on Adherence to Leprosy Medications in an Ambulatory Care Setting Indonesia: A Randomized Control Trial. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Poor treatment adherence has been linked to recurrence and the development of antibiotic resistance in leprosy patients. Previous research has shown that structured health education programs improve treatment adherence in other patients, but similar research in leprosy patients is lacking.
AIM: This study aimed to assess the effect of interactive patient education on adherence to leprosy medications in an ambulatory care setting in Indonesia.
METHODS: A randomized controlled trial (RCT) was conducted between January and April 2021. The research was conducted at a public health center in West Papua, Indonesia. This RCT employed 1:1 randomization to allocate participants to one of two groups. Eligibility criteria included those aged over 18 years old and diagnosed with leprosy at least 6 months. An interactive patient education program included four intervention steps that lasted 1 month, with four sessions lasting 60–90 min each week. The Morisky Medication Adherence Scale was used to assess medication adherence. The difference-in-differences technique was used to evaluate the variances between T0 and T1 and T0 for the intervention versus control groups (DID).
RESULTS: Approximately, 200 participants agreed to join in this study (response rate = 72.5%). An interactive patient education program improved outcomes relative to the control at T1; medication adherence increased 0.11 (95% CI 0.01–0.25). At T2, improved outcomes relative to the control were observed in medication adherence (DID coefficient 0.31 (95% CI 0.10–0.59).
CONCLUSIONS: This study demonstrates that an interactive patient education program could effectively enhance medication adherence. Therefore, it is advised that health care professionals working with leprosy patients participate in the development of patient education programs and establish therapeutic partnerships with their patients.
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50
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Niksadat N, Rakhshanderou S, Negarandeh R, Ramezankhani A, Farahani AV, Ghaffari M. Concordance of the cardiovascular patient education with the principles of Andragogy model. Arch Public Health 2022; 80:4. [PMID: 34983640 PMCID: PMC8725564 DOI: 10.1186/s13690-021-00763-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022] Open
Abstract
Background Patient education is a critical aspect of patient care and is considered a vital part of self-care (especially in patients with cardiovascular disease (CVD)) and health promotion. The literature supports incorporating the principles of the andragogy model (adult learning) into patient education. This study aimed to determine the concordance of the CVD patient education with the principles of the andragogy model. Methods This cross-sectional survey was conducted on 384 adult CVD patients from 2 selected hospitals of Tehran. The sampling method was convenient, and the data collection tool was a researcher-made questionnaire based on the principles of the andragogy model. Data were analyzed using SPSS16 statistical software. Results The mean age of the patients was 55.69 ± 13.01 years old. Frequency of distribution of the patients who, in total, selected the items of 4 or 5 for respecting the principles of andragogy model was as follows: 68.16% for the motivation, 66.29% for the need, 66.03% for the orientation, 54.16% for the experiences, 51.55% for the self-concept, and 44.65% for the readiness principle. Also, three principles of motivation (77.37) need (74.97), and orientation (74.78) had the highest mean, respectively, in terms of adhering to this model. But the most common problems in patient education were related to the principles of readiness (64.35), self-concept (68.19), and experiences (77.71) with the lowest mean. Conclusions The findings of this study provided valuable information on the flaws in patient education, including ignoring and disrespecting the principles of adult education. Correcting these detected defects and providing feedback to health professionals can improve the quality of patient education programs and patient satisfaction. Also, it empowers healthcare providers, patients, and families through effective education strategies.
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Affiliation(s)
- Negin Niksadat
- Department of Public Health, Faculty of health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.,Department of Health Education and Promotion, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshanderou
- Department of Health Education and Promotion, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Department of Health Education and Promotion, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani Farahani
- Cardiac primary prevention research center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohtasham Ghaffari
- Department of Health Education and Promotion, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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