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Hipertansiyon Hastalarının Bakım Yönetimi: Sağlık İnanç Modeli Kullanımı
Abstract
Hipertansiyon dünyada önemli bir halk sağlığı sorunudur. Hipertansiyon hastasının öz bakımı ve hastalığı kontrol altında tutulmasının sağlanması için hemşireler tarafından yapılan sağlık eğitimleri ve danışmanlıklar önemli bir yer tutmaktadır. İncelenen çalışmalarda hipertansiyon yönetiminde teknolojinin gelişmesi ile beraber kısa mesajlaşma sistemleri, web tasarımı, akıllı telefon uygulamaları gibi teknoloji tabanlı girişimler ile hastaların hastalık yönetimini iyileştirmeye yönelik çalışmalar yürütüldüğü görülmektedir. Uygulanan teknoloji tabanlı girişimlerde model ve teoriler ile desteklenmiş eğitim içeriklerinin üzerinde de durulmaktadır. Bu açıdandır ki bu derlemede hipertansiyon hastalarında bakım yönetimi sağlamak için sağlık inanç modeli kullanım durumunu incelemek amaçlanmıştır. İncelenen çalışmalarda sağlık inanç modelinin nitel, tanımlayıcı ve deneysel çalışma şeklinde birçok çalışma tasarımında kullanıldığı görülmektedir. Hipertansiyon hastalarının kendi kendine bakım davranışları geliştirmede modelin öz-yeterlik, algılanan duyarlılık ve ciddiyet kavramlarını ele alan eğitim programlarının tasarlanması ve uygulanmasının önemli olduğu görülmektedir. Hipertansiyon hastaları için teknoloji tabanlı girişimli çalışmalarda da sağlık inanç model temelli sağlık eğitimi ve danışmanlıkların hastaların bilgi düzeylerini ve tedavi uyumlarını olumlu yönde etkilediği görülmektedir.
... Eylem ipuçları (harekete geçiren etmenler), bireyde davranışın gerçekleştirilmesini sağlayan iç ya da dış kaynaklı motivasyon olarak belirtilmektedir. Öz yeterlilik/etkililik ise bireyin olumlu sağlık davranışı göstermede ve sürdürmede kendine olan inancını ve kararlılığını ifade etmektedir (Arabacı ve Toraman, 2024;Gozum ve Capik, 2014). ...
Colorectal cancer screening saves lives and is cost-effective. It allows early detection of the pathology, and enables earlier medical intervention. Despite clinical practice guidelines promoting screening for average risk individuals, uptake remains suboptimal in many populations. Few studies have examined how sociobehavioural factors influence screening uptake in the context of behaviour change theories such as the health belief model. This systematic review therefore examines how the health belief model’s constructs are associated with colorectal cancer screening.
Four databases were systematically searched from inception to September 2019. Quantitative observational studies that used the health belief model to examine colorectal screening history, intention or behaviour were included.
A total of 30 studies met the criteria for review; all were of cross-sectional design. Perceived susceptibility, benefits and cues to action were directly associated with screening history or intention. Perceived barriers inversely associated with screening history or intention. The studies included also found other modifying factors including sociodemographic and cultural norms. Self-report of screening history, intention or behaviour, convenience sampling and lack of temporality among factors were common limitations across studies.
The health belief model’s associations with colorectal cancer screening uptake was consistent with preventive health behaviours in general. Future studies should examine how theory-based behavioural interventions can be tailored to account for the influence of socioecological factors.
High blood pressure is becoming a universal epidemic for both developed and developing countries; it is one of the main public health problems all over the world. This research was conducted to assess blood pressure self-care among hypertensive patients in Iran. This cross-sectional analytic study was conducted on 527 patients with hypertension recruited from Zarandieh, Iran in 2018. Data were gathered using questionnaires assessing socio-demographic information, social support, health belief model (HBM) constructs (perceived benefits to healthy behavior, barriers to healthy behavior, perceived disease threat, self-efficacy to engage in healthy behavior, and cues to action), and self-care activities to address blood pressure. A stepwise multiple linear regression analysis was used to determine factors associated with self-care behaviors. Overall, 512 patients (215 men and 297 women) participated in this study. Participants who were married, and more educated engaged in more self-care behaviors. At least one-half of the patients (47.6%) demonstrated a moderate level of self-care behaviors with a mean score of self-care equal to 9.32 ± 3.6 (out of 18). All the elements of HBM and social support were significant predictors of self-care behaviors and self-efficacy was the strongest predictor, followed (in descending order) by perceived barriers, social support, perceived disease threat, and perceived benefits. Health education based on HBM, enhanced with attention to social support, may help patient enact healthier behaviors to reduce blood pressure.
Aims:
To test prospective pathways of a Comprehensive Reminder System based on the Health Belief Model (CRS-HBM), stroke knowledge, health belief in health behaviour, blood pressure control and disability in hypertensive ischaemic stroke patients at 6-month post-discharge.
Design:
A nested cohort study design.
Methods:
Data were derived from a randomized controlled trial evaluating the effects of the intervention (N=174, performed during February 2015 to March 2016). Data were collected by questionnaires and analysed in structural equation modelling in Mplus software.
Results:
The proposed model provided a good fit to the data. This model accounted for 51.5% of the variance in health behaviour, 34.1% in blood pressure control and 5.7% in modified Rankin Scale score at 6-month post-discharge. The CRS-HBM had: 1) direct positive effect (β=0.391, p<0.001) and indirect positive effects (β=0.186, p=0.002) on health behaviour; 2) direct positive effect (β=0.356, p<0.001) and indirect positive effects (β=0.183, p=0.009) on blood pressure control; and 3) indirect negative effect (β=-0.146, p=0.008) on disability. Being female was linked to better health behaviour. Higher education predicted higher level of stroke knowledge and health belief.
Conclusions:
The CRS-HBM can not only directly but also indirectly improve patients' health behaviours by improving their health knowledge or health belief. Better health behaviour can improve patients' blood pressure control and reduce disability. Therefore, nurses need to pay more attention to not only patients' health knowledge but also their health belief when providing education.
Impact:
The CRS-HBM intervention accounted for 51.5% of variance in health behaviour, 34.1% in blood pressure control and 5.7% in modified Rankin Scale score at 6-month post-discharge. This research can help nurses improve health education strategies in post-discharge and community contexts to achieve better health results.
This study aims to investigate the use of theory in mobile health interventions for patient self-management of chronic conditions, with a focus on hypertension. We identified six theories in ten studies that were reviewed. These included Health Belief Model, Social Cognitive Theory, Self-Determination Theory, Theory of Planned Behavior, Transtheoretic Model, and Technology Acceptance Model. The findings are useful for further advancement of mobile health interventions to support chronic disease management.
Okul çağı çocukları, dış etkenlerle oluşabilecek zararlara karşı kendini korumada savunmasız gruplardandır.
Bu nedenle yaralanmalara sıklıkla maruz kalmaktadırlar. Kaza sonucu meydana gelen yaralanmalar çoğunlukla bu
gruplarda, özellikle çocuk ve adölesanlarda görülmektedir. Ancak bu konuda alınan önlemlerin çoğu zaman yetersiz
olduğu ve göz ardı edildiği bilinmektedir. Ülkemizde özellikle öğrencilere sunulan okul sağlığı hizmetlerinin
oldukça sınırlı olduğu bir gerçektir; oysaki okul kazalarına yönelik basit kişisel ve çevresel tedbirlerle istenmeyen
yaralanmaların önlenebileceği bildirilmektedir. Okullarda geliştirilecek programların çevre değişimi, davranış
değişimi, denetim ve politikaların geliştirilmesi konularını kapsaması, ders müfredatına entegre edilmesi
önerilmektedir. Programların etkililiğini artırmada modeller her zaman yol gösterici olmuştur. Sağlığı geliştirme
modellerinden biri olan Sağlık İnanç Modeli (SİM), kişilerin sağlığını; bireysel özellikler (sosyo-demografik
özellikler), algılar (duyarlılık, durumun ciddiyeti, yarar, engeller, öz-etkililiği) ve eyleme geçiriciler (hazır oluşluk)
ile etkilendiğini belirtmektedir. Bu derleme makalede amaç, okul sağlığı hemşireleri olarak; yaralanma riski yüksek
olan öğrenci toplumunda okul yaralanmalarını önlemede bir rehber olan Sağlık İnanç Modelini tanıtmak; modelin
okul yaralanmalarını önlemedeki etkisini yapılmış araştırmalarla ortaya koymak ve bu model ile yapılacak
çalışmalara yol göstermek amaçlanmıştır.
Anahtar sözcükler: Okul yaralanmaları; sağlık inanç modeli; araştırma kanıtları
The aim of this study was to determine the factors influencing adherence to self-care behaviors among low health literacy hypertensive patients based on health belief model. A cross-sectional study was conducted among 152 hypertensive patients with low health literacy. Patients with limited health literacy were identified by S-TOFHLA. The data were collected using H-scale for assessing self-care behaviors and, HK-LS for assessing knowledge of hypertension. A researcher-made questionnaire was applied for collecting data of health belief model constructs. Data were analyzed by SPSS version 22 with using multiple logistic regression analyses. Perceived self-efficacy was associated with all self-care behaviors except medication regimens. There was a significant association between perceived susceptibility and adherence to both low-salt diet (OR = 3.47) and nonsmoking behavior (OR = 1.10). Individuals who had more perceived severity (OR = 1.82) had significantly greater adherence to their medication regimens. Perceived benefits and barriers were not significantly associated with either type of hypertension self-care behaviors. It seems that designing and implementation of educational programs to increase self-efficacy of patients and promote their beliefs about perceived susceptibility and severity of complications may improve self-care behaviors among low health literacy hypertensive patients.
Purpose
Hypertension is one of the risk factors for cardiovascular diseases and stroke, and has a direct relationship with aging. The aim of this study was to investigate the effect of education based on the health belief model (HBM) on the adoption of hypertension-controlling behaviors in the elderly.
Methods
The present quasiexperimental study was conducted on 100 hypertensive elderly persons from Qom, Iran. The questionnaire was completed by the participants before, immediately after, and 3 months after the intervention.
Results
The results of repeated measure analysis of variance showed a significant difference in the scores of the constructs in the intervention and nonintervention groups before, immediately after, and 3 months after the intervention (P<0.001).
Conclusion
Education based on the HBM increases the performance and enhances the health beliefs regarding hypertension in the elderly population with hypertension. Therefore, it is recommended to consider the HBM to enhance self-care behaviors in the elderly.
The role of the nurse in improving hypertension control has expanded over the past 50 years, complementing and supplementing that of the physician. Nurses' involvement began with measuring and monitoring blood pressure (BP) and patient education and has expanded to become one of the most effective strategies to improve BP control. Today the roles of nurses and nurse practitioners (NPs) in hypertension management involve all aspects of care, including (1) detection, referral, and follow up; (2) diagnostics and medication management; (3) patient education, counseling, and skill building; (4) coordination of care; (5) clinic or office management; (6) population health management; and (7) performance measurement and quality improvement. The patient-centered, multidisciplinary team is a key feature of effective care models that have been found to improve care processes and control rates. In addition to their clinical roles, nurses lead clinic and community-based research to improve the hypertension quality gap and ethnic disparities by holistically examining social, cultural, economic, and behavioral determinants of hypertension outcomes and designing culturally sensitive interventions to address these determinants.
Hypertension is the main risk factor of many diseases and the main reason of death all over the world. Because the signs of hypertension are not clear, people do not feel its dangers and do not believe they are at risk. This problem makes preventing hypertension a great challenge for the health system. One factor that is related to lifestyle and is effective in preventing hypertension is increasing exercise. The aim of this study is investigate the effect of an education plan based on the health belief model on the physical activity of women who are at risk for hypertension.
This is a field experimental study. Field of study was two health care centers in Isfahan, which were selected through simple random sampling. Ninety-two females who were at risk for hypertension were the subjects of study. Subjects were selected through systematic sampling. Beck questionnaire was used to evaluate the physical activity of both experimental and control group subjects before and 2 months after the intervention. The intervention plan was three education sections that were conducted in 4 weeks. The data were analyzed by descriptive statistical tests and inferential tests of repetitive variance analysis and t-test through SPSS.
The results showed that the average of physical activity increased significantly in the intervention group 2 months after education (P = 0.03).
The findings of the study confirm the efficiency of education plan based on the health belief model on the physical activity of women who are at risk for hypertension.
Hypertension is a major health problem in developing and developed countries, and its increasing epidemy is a serious warning to take more attention to this silent disease.
This study was aimed to determine the factors of adherence to hypertension medication based on health belief model (HBM).
A cross-sectional study was conducted in a rural area of the Ardabil city in 2013. This study was carried out using a pre-structured and validated questionnaire. The questionnaire included information on demographic characteristics, lifestyle habits, HBM constructs and adherence to hypertension medication (Morisky 4-Item Self-Report Measure of Medication-taking Behavior [Morisky Medication Adherence Scale]). Data were analyzed with the use of SPSS version 18. P < 0.05 was considered as statistically significant.
A total of 671 hypertensive patients participated in the study (169 were males and 502 were females). The prevalence of adherence was 24% (161/671)% in the study population. Respondents with regular physical activity and nonsmokers were more adherent to hypertension medication when compared to respondents with sedentary lifestyle and smoking (P < 0.01). Based on HBM constructs, the respondents who perceived high susceptibility, severity, benefit had better adherence compared to moderate and low susceptibility, severity, and benefit.
The prevalence of adherence to hypertension management was low in study population, this due to inadequate perceived susceptibility, perceived, severity, perceived benefit and poor lifestyle factors. Improving adherence in hypertension patients need to recognize the value and importance of patient perceptions medications.
The two-gram salt-restriction-spoons, which can be used to reduce the salt intake of people, had been handed out for free by the Chinese government to the citizens several years ago, but only a small fraction of residents use such a spoon currently. Since no studies have been conducted to investigate relevant influencing factors, this study was designed to explore the determinants of salt-restriction-spoon using behavior (SRB) in China.
This cross-sectional study was conducted in Beijing, China. Altogether 269 rural residents and 244 urban residents aged over 18 were selected by convenience sampling method in 2012. Variables measured in a questionnaire designed according to the Health Belief Model (HBM) included socio-demographics, perceived susceptibility, perceived severity, perceived benefits, perceived objective barriers, perceived subjective barriers, self-efficacy, knowledge of hypertension, cues to action, and SRB. Answers to the questionnaire were obtained from all the participants, and 24-hour urine samples were collected to determine the 24-hour urinary sodium excretion (24HUNa). Path analyses were used to explore the determinants of SRB.
Approximately 22.7% and 45.3% of residents used a salt-restriction-spoon everyday in the rural and urban areas, respectively. The average 24HUNa was 211.19±98.39 mmol for rural residents and 109.22±58.18 mmol for urban residents. Path analyses shown that perceived objective barriers, perceived benefits, perceived severity, knowledge and age were related to SRB and 24HUNa for both rural and urban participants, among which perceived objective barrier (β = - 0.442 and β = - 0.543, respectively) was the most important determinant.
Improvement of the current salt-restriction-spoon and education on the right usage of the salt-restriction-spoon, the severity of hypertension, and the benefit of salt reduction are necessary, especially among those who are relatively young but at risk of hypertension, those who have lower education levels, and those who live in the rural areas.
Objective: Few large-scale studies have focused on the effect of gynecologic cancer compared with other biopsychosocial factors on willingness to seek treatment among women with sexual dysfunction. The aim of study was to identify predictors of the intention to treat female sexual dysfunction (FSD) among sociodemographic factors, physiologic factors, psychologic factors, gynecologic cancer, and health belief model (HBM). Materials and methods: This study was a cross-sectional, hospital-based survey conducted from October 2013 to September 2019. Participants included healthy women and gynecologic cancer survivors who were aged 20 years or older and had been in a monogamous relationship for at least 12 months. They were enrolled in the gynecologic departments in southern Taiwan. Those who met DSM-5 criteria of sexual dysfunction were analyzed with Structural equation modeling. Intention to seek treatment was the primary outcome. Results: 448 of 643 women met DSM-5 sexual dysfunction. The mean age was 42.0 years (range: 21.8–68.1 years). Fifty-eight percent of women reported sexual treatment intention. The model fit was good: χ2 = 367.42, P
Background:
The health behaviors and blood pressure control of patients with hypertension who have had a stroke are unsatisfactory. A protocol of a comprehensive reminder system has been published, and the results of 3 months of implementation have demonstrated improved patient health behaviors and blood pressure control. The continuity of the intervention effect on these variables after 3 months was not clear.
Objective:
The aim of this study was to determine the impact of a comprehensive reminder system intervention on health behaviors, medication adherence, blood pressure, disability, and stroke recurrence in patients with hypertension who have had a stroke from baseline to 6 months after discharge.
Method:
A multicenter, assessor-blinded, randomized controlled trial was conducted with 174 patients with hypertension who have had a stroke. The intervention consisted of health belief education, a calendar handbook, weekly short message services, and telephone interviews. Data were collected at baseline and at 3 and 6 months after discharge.
Results:
Repeated-measures analysis of variance and single-effect analysis revealed that, compared with the control group, improvements of health behaviors, medication adherence, blood pressure, and disability of participants in the intervention group were superior. From 3 to 6 months after discharge, these trends remained or continually improved, whereas a downward trend was observed in the control group. There were only 2 stroke recurrences within 6 months, and no statistically significant difference between groups was found.
Conclusion:
The comprehensive reminder system improved patients' health behaviors and medication adherence and reduced blood pressure and disability; the effect extended to 6 months after discharge.
Introduction:
Hypertension is a chronic disease that requires continuous and long-term care to prevent or delay the development of associated complications. Although various interventions for hypertension exist, case management in Brazil's primary healthcare is understudied. We examined nursing case management effectiveness for controlling blood pressure among Brazilian adults with hypertension in the public healthcare system.
Method:
A randomized controlled trial with a 12-month follow-up was conducted at a primary healthcare clinic in southern Brazil. Adult patients with hypertension were randomly allocated to intervention (n = 47) and usual care groups (n = 47). The nursing case management model includes nursing consultations, telephone contact, home visits, health education, and appropriate referrals. Patient outcomes (blood pressure, body mass index, waist circumference, quality of life, treatment adherence) were assessed at baseline and 6- and 12-month follow-up for the intervention group and at baseline and 12-month follow-up for the usual care group. Data were collected from only the intervention group at T6 to avoid contact between the researcher and the usual care group, and to check the care plan and modify it if necessary.
Results:
After the intervention, the intervention group's blood pressure decreased significantly compared to the usual care group. The differences in systolic and diastolic blood pressure between the groups was -8.3 (intervention)/1.1 (usual care) mmHg (p = .004) and -7.4/-0.6 mmHg (p = .007), respectively. The intervention group had significantly greater improvement in waist circumference (-2.0/1.2 cm), body mass index (- 0.4/0.3), and treatment adherence (4.8/-1.1) than the usual care group (all p < .05).
Conclusion:
Nursing case management in primary healthcare may be effective for improving outcomes among patients with hypertension.
Objectives:
To explore whether five variables of the health belief model were factors influencing self-care behaviors in young and middle-aged adults with hypertension.
Background:
The self-care behaviors of young and middle-aged adults with hypertension are suboptimal in China, and the factors associated with self-care behaviors have rarely been studied in the population.
Methods:
A questionnaire survey was adopted in the study. 382 eligible participants were recruited from two tertiary teaching hospitals using the convenience sampling.
Results:
The predictors of self-care behaviors in young and middle-aged adults with hypertension included age, complications related to hypertension, perceived susceptibility, severity, benefits, barriers and self-efficacy. Five aspects of health beliefs model accounted for 47.0% of total variance.
Conclusions:
The perceived susceptibility, severity, benefits, barriers, and self-efficacy were key factors affecting self-care behaviors in young and middle-aged adults with hypertension. A health education program targeting improving health beliefs for the population should be developed.
Antihypertensive drug adherence (ADA) is a mainstay in blood pressure control. Education through mobile phone short message system (SMS) text messaging could improve ADA. The authors conducted a randomized study involving 314 patients with hypertension with <6 months of antihypertensive treatment from the Preventive Health Program of 12 different primary care centers in Santiago, Chile. Patients were randomly assigned to receive or not receive SMS related to ADA and healthy lifestyle. Adherence was assessed by the self-reported four-item scale Morisky-Green-Levine questionnaire at baseline and after 6 months of follow-up, with four of four positive questions classified as good adherence. Group comparison for adherence was performed by means of a logistic regression model, adjusting by baseline adherence, age older than 60 years, and sex. A total of 163 patients were randomized to receive and 151 to not receive SMS. After 6 months of follow-up, ADA in the non-SMS group decreased from 59.3% to 51.4% (P=.1). By contrast, adherence increased from 49% to 62.3% (P=.01) in the SMS group. Text messaging intervention improved ADA (risk ratio, 1.3; 95% confidence interval, 1.0–1.6 [P<.05]). At 6-month follow-up, text messaging resulted in an increase in reporting ADA in this hypertensive Latino population. This approach could become an effective tool to overcome poor medication adherence in the community.
Objective:
Perceptions of illness affect cardiovascular disease (CVD) self-management. This study explores knowledge, attitudes, and beliefs regarding hypertension and hyperlipidemia management among 34 of African-American men with hypertension and/or hyperlipidemia, age 40-65, living in the Southeastern United States.
Methods:
In-person focus groups were conducted using semi-structured interview questions informed by the Health Belief Model (HBM).
Results:
Participants had a high level of knowledge about hypertension self-management, but less about cholesterol self-management. Perceived severity of both conditions was acknowledged, though participants perceived hypertension as more severe. Barriers to self-management included medication side effects and unhealthy dietary patterns. Facilitators included social support, positive healthcare experiences, and the value placed on family. Cultural implications highlighted the importance of food in daily life and social settings. Participants expressed how notions of masculinity affected self-management-noting the impact of feelings of vulnerability and perceived lack of control stemming from diagnosis and treatment expectations.
Conclusions:
The findings highlight gaps in knowledge of hyperlipidemia versus hypertension, and the impact of cultural context and perceptions on engagement in self-management behaviors.
Practice implications:
Public health practitioners and healthcare providers serving African-American men should address cultural factors and notions of masculinity which can hinder effective disease management among this population.
Objectives:
The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension.
Methods:
The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg.
Results:
Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey.
Conclusion:
Although some progress has been made in recognizing hypertension from 2003 to 2012, there is still a large population of untreated or inadequately treated hypertensives in Turkey. Strengthening of population-based efforts to improve the prevention, early detection, and treatment of hypertension is needed.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0.
Background
Hypertension, the leading global risk factor for mortality, is characterized by low treatment and control rates in low- and middle-income countries. Poor linkage to hypertension care contributes to poor outcomes for patients. However, specific factors influencing linkage to hypertension care are not well known. Objective
To evaluate factors influencing linkage to hypertension care in rural western Kenya. DesignQualitative research study using a modified Health Belief Model that incorporates the impact of emotional and environmental factors on behavior. ParticipantsMabaraza (traditional community assembly) participants (n = 242) responded to an open invitation to residents in their respective communities. Focus groups, formed by purposive sampling, consisted of hypertensive individuals, at-large community members, and community health workers (n = 169). ApproachWe performed content analysis of the transcripts with NVivo 10 software, using both deductive and inductive codes. We used a two-round Delphi method to rank the barriers identified in the content analysis. We selected factors using triangulation of frequency of codes and themes from the transcripts, in addition to the results of the Delphi exercise. Sociodemographic characteristics of participants were summarized using descriptive statistics. Key ResultsWe identified 27 barriers to linkage to hypertension care, grouped into individual (cognitive and emotional) and environmental factors. Cognitive factors included the asymptomatic nature of hypertension and limited information. Emotional factors included fear of being a burden to the family and fear of being screened for stigmatized diseases such as HIV. Environmental factors were divided into physical (e.g. distance), socioeconomic (e.g. poverty), and health system factors (e.g. popularity of alternative therapies). The Delphi results were generally consistent with the findings from the content analysis. Conclusions
Individual and environmental factors are barriers to linkage to hypertension care in rural western Kenya. Our analysis provides new insights and methodological approaches that may be relevant to other low-resource settings worldwide.
Osteoporosis is one of the most common metabolic bone diseases. The purpose of this study was to investigate the effect of a prevention program based on health belief model on osteoporosis among women.
In this quasi-case study, 120 patients (60 cases and 60 control), registered under the health centers in Fasa City, Fars Province, Iran were selected in 2014. A questionnaire consisting of demographic information, Health Belief Model (HBM) constructs was used to measure nutrition and walking performance for prevention of osteoporosis before, immediately after the intervention and six months later. Bone mineral density (BMD) was recorded at the lumbar spine and femur before and six months after intervention. Data were analyzed using SPSS19 via chi-square test, independent t-test, and Repeated Measures ANOVA at significance level of 0.05.
Immediately and six months after the intervention, the case group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, internal cues to action, nutrition and walking performance compared to the control group. Six months after the intervention, the value of lumbar spine BMD T-Score in the case group increased to 0.127, while in the control group it reduced to -0.043. The value of the Hip BMD T-Score in the intervention group increased to 0.125 but it decreased to -0.028 in the control group.
This study showed the effectiveness of knowledge, walking and diet on bone mass by HBM model. Hence, these models can act as a framework for designing and implementing educational interventions for the osteoporosis prevention.
We aimed to gain insight into antihypertensive medication adherence on the basis of a well-developed behavior theory.
A cross-sectional study of Chinese hypertensive patients was conducted using the health belief model as a theoretical framework.
The HBM explained 48.8% of the variance in antihypertensive medication adherence with an overall prediction accuracy was 82.8%. After adjusting for controlling factors, the HBM explained 50.5% of the variance in antihypertensive medication adherence with an overall prediction accuracy of 86.2%. Higher levels of perceived susceptibility (p=0.017), cues to action (p=0.034), and self-efficacy (p=0.002) and a lower level of perceived barriers (p<0.001) were significantly associated with better antihypertensive medication adherence. The risk factors of older age (p=0.037), longer duration of HTN (p=0.003), longer duration of drug use (p=0.001), and taking a combination of antiplatelet agents (p<0.001) were significantly associated with better antihypertensive medication adherence and influenced different HBM constructs.
The HBM is reliable in predicting medication adherence among Chinese hypertensive patients. Intervention programs in clinical practice could be guided by the relationship between risk factors and HBM constructs and antihypertensive medication adherence.
This study provides a structured understanding of the relationships between risk factors and HBM constructs and antihypertensive medication adherence.
Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Health psychology is a rapidly expanding discipline at the interface of psychology and clinical medicine. This new edition is fully reworked and revised, offering an entirely up-to-date, comprehensive, accessible, one-stop resource for clinical psychologists, mental health professionals and specialists in health-related matters. There are two new editors: Susan Ayers from the University of Sussex and Kenneth Wallston from Vanderbilt University Medical Center. The prestigious editorial team and their international, interdisciplinary cast of authors have reconceptualised their much-acclaimed handbook. The book is now in two parts: part I covers psychological aspects of health and illness, assessments, interventions and healthcare practice. Part II covers medical matters listed in alphabetical order. Among the many new topics added are: diet and health, ethnicity and health, clinical inrterviewing, mood assessment, communicating risk, medical interviewing, diagnostic procedures, organ donation, IVF, MMR, HRT, sleep disorders, skin disorders, depression and anxiety disorders.
Ölüm Nedeni İstatistikleri
- Tüik
A Health Belief Model-Based Motivational Interviewing for Medication Adherence and Treatment Success in Pulmonary Tuberculosis Patients
- N M Parwati
- I M Bakta
- P P Januraga
- I M A Wirawan
- Y Obirikorang
- C Obirikorang
- E Acheampong
- E Odame Anto
- D Gyamfi
- S Philip Segbefia
- M Opoku Boateng
- D Pascal Dapilla
- P K Brenya
- B Amankwaa
- E A Adu
- E Batu
- A Gyimah Akwasi
- B Amoah
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