Journal of Education and Health Promotion

The effect of educational intervention on self‑care behavior in hypertensive older people: Applying the health belief model

. Leila Naeemi; . Seyedeh Shahrbanoo Daniali; . Akbar Hassanzadeh; . Majid Rahimi

Volume 12, Issue 11 , December 2022, , Pages 1-7

Abstract

  BACKGROUND: Hypertension is a worldwide health issue. Increasing aging has given rise to theprevalence of this problem. Disease management using educational intervention based on theoreticalframeworks ...  Read More BACKGROUND: Hypertension is a worldwide health issue. Increasing aging has given rise to theprevalence of this problem. Disease management using educational intervention based on theoreticalframeworks is effective for influencing self‑care behavior. The goal of this study is to investigate theeffects of educational intervention on self‑care behaviors that influence hypertension control amongthe elderly population during 2020 based on the health belief model.MATERIALS AND METHODS: A quasi-experimental study was conducted on rural older people inArdestan, Iran. Assessments were done before and after three educational intervention sessionswith a control group. The random sampling has done on 99 hypertensive elderly people in two ruralcenters of Ardestan from 2019 to 2020. Awareness variables, components of the health belief model,and blood pressure were assessed before and three months after the intervention. Data analysiswas done using descriptive and analytical statistics.RESULTS: The study groups did not differ significantly in terms of the variables studied at thebeginning of the study. After three months, the variables of awareness, self‑care, and perceivedsensitivity constructs, perceived severity, perceived benefits, and guide to action showed a significantrise in the experimental group compared to the control group. In addition, the effectiveness ofeducational intervention significantly increased self‑care behavior in the experimental group.CONCLUSIONS: Educational intervention based on the health belief model can be effective toreduce the barriers of self‑care behaviors. In order to have a lasting change in behavior, the useof behavioral change patterns that ecologically take into account interpersonal, organizational, andsocial factors is suggested too.

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Evaluation of medication adherence and its relevant factors among hypertensive patients: A cross‑sectional study in Shahrekord health‑care system

. Zabihallah Ahmadi; . Hossein Shahnazi; . Akbar Hassanzadeh

Volume 12, Issue 6 , July 2022, , Pages 1-6

Abstract

  BACKGROUND: Medication adherence means compliance with patient adherence to medication orders, including timely and correct consumption of medication prescribed by a physician. ...  Read More BACKGROUND: Medication adherence means compliance with patient adherence to medication orders, including timely and correct consumption of medication prescribed by a physician. The present study aimed to determine the extent of adherence to hypertension drug medication in patients covered by comprehensive health service centers of Shahrekord, Iran.MATERIALS AND METHODS: A cross‑sectional study examined 401 hypertensive patients registered in the Integrated Health Record System (SIB). SIB is a Persian term related to Health Record System. To collect data, Morisky Medication Adherence Scale was used. The questionnaire was completed by the patients and analyzed using SPSS (SPSS Inc., Chicago, Illinois, USA, version 26), Chi‑square test, independent t‑test, and analysis of variance.RESULTS: The results indicated that adherence to antihypertensive medication was low in 5.7% of patients, while 63.3% of patients had sufficient compliance. Forgetting to take medications (52.9%) was the most common reason for nonadherence to medication in hypertensive patients.CONCLUSION: Given that forgetting to take medications was the main reason for nonadherence to medication in hypertensive patients, designing and implementing necessary trainings by comprehensive health centers to realize the importance of daily use of medication by hypertensive patients and their families are recommended.

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A comparative study on the health‑promoting behaviors of patients with and without hypertensive heart disease in Iran

. Parastoo Baharvand; . Farideh Malekshahi; . Nafiseh Gheydar

Volume 12, Issue 2 , February 2022, , Pages 1-6

Abstract

  BACKGROUND: Health‑promoting behaviors can affect the psychological and physical consequences of hypertension. For the prevention and control of hypertension, lifestyle modification ...  Read More BACKGROUND: Health‑promoting behaviors can affect the psychological and physical consequences of hypertension. For the prevention and control of hypertension, lifestyle modification has been recommended. This study aimed to investigate the health‑promoting behaviors of patients with hypertensive heart disease in Iran and compare them with those of healthy people.MATERIALS AND METHODS: This was a descriptive comparative study with cross‑sectional design. Participants were 141 patients with hypertensive heart disease (mean age = 39 ± 10.2 years) referred to the cardiac clinic of Madani Hospital in Khorramabad, Iran, and 141 healthy people selected from those referred to the hospital. The Persian version of the revised Health‑Promoting Lifestyle Profile‑II (HPLP‑II) was used to evaluate the health‑promoting behaviors of participants. After collecting data, they were analyzed in SPSS v. 22 software using descriptive statistics and statistical tests including independent t‑test and one‑way ANOVA.RESULTS: The overall HPLP‑II score was 142.34 ± 30.48 in patients and 150.52 ± 37.07 in controls. The highest and lowest HPLP‑II dimension scores in both groups were related to health responsibility and stress management dimensions. There was a significant difference between groups only in dimensions of nutrition (P = 0.017) and physical activity (P = 0.016), and in the overall score (P = 0.044), whose scores were lower in patients compared to controls. The difference in HPLP‑II score of patients with different demographic characteristics (marital status, place of residence, gender, age, educational level, and occupation) was not statistically significant.CONCLUSION: Patients with heart disease caused by high blood pressure in Iran have poorer diet and physical activity compared to healthy people. Educational interventions with a focus on the importance of dietary regime and exercise are recommended for them.

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Factors predicting nutritional knowledge, illness perceptions, and dietary adherence among hypertensive middle‑aged women: Application of transtheoretical model

. Bahram Mohebbi; . Banafsheh Tafaghodi; . Roya Sadeghi; . Azar Tol; . Mir Saeed Yekanenejad

Volume 11, Issue 5 , June 2021, , Pages 1-7

Abstract

  BACKGROUND: Healthy dietary adherence might be one of the effective and modifiable factorsfor hypertension (HTN) control; therefor, empowering patients for self‑care management includinghealthy ...  Read More BACKGROUND: Healthy dietary adherence might be one of the effective and modifiable factorsfor hypertension (HTN) control; therefor, empowering patients for self‑care management includinghealthy food patterns play a key role in guiding their care, in partnership with health care providers.This study aimed to identify the factors predicting nutritional knowledge, illness perceptions, andadherence to a diet based on transtheoretical model (TTM) among hypertensive middle‑aged women.MATERIALS AND METHODS: A cross‑sectional survey was conducted on 164 patients withHTN attending west health centers of Tehran, Iran, in 2020. Simple random sampling was used.Sociodemographic characteristics of the respondents were collected, a valid and reliable measureon nutritional knowledge, illness perceptions, and adherence to diet, and a researcher‑mademeasure based on TTM constructs through in‑person interview was applied. Descriptive statisticsand general linear model were utilized for data analysis using SPSS version 25. The significancelevel was considered less than 0.05.RESULTS: Mean and standard deviation of participants was 50.82 ± 8.77 years. Multivariateregression analysis indicated that family income (P < 0.001) and body mass index (P < 0.001) predictednutritional knowledge and adherence to diet, respectively. Decisional balance and self‑efficacyconstructs predicted nutrition knowledge and illness perceptions (P < 0.001). In adherence to diet,overcoming the temptation construct was indicated as the only predictor (P < 0.001).CONCLUSION: Study findings highlighted the necessity of tailoring and implementing interventionsbased on TTM using appropriate strategies to promote quality of HTN management approach innutritional knowledge, illness perceptions, and dietary adherence.

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Colour coded client segmentation (CCCS) public health approach to educate the community to deal with problem of hypertension: A pilot study

. Sudip Bhattacharya; . Sheikh Mohd Saleem; . Dhananjay Kumar Singh; . Roy Rillera Marzo; . Amarjeet Singh

Volume 11, Issue 1 , January 2021, , Pages 1-5

Abstract

  INTRODUCTION: We know that risk communication is equally important as risk identification, whichis usually not communicated properly to the patients and resulting in poor outcomes, ...  Read More INTRODUCTION: We know that risk communication is equally important as risk identification, whichis usually not communicated properly to the patients and resulting in poor outcomes, especially inhypertensive patients.OBJECTIVE: Our study objective was to evolve and test a colour coded client segmentation basedpublic health approach to educate the community to deal with problem of hypertension.METHODOLOGY: This cross‑sectional pilot study was done in March 2020 among purposively approachedin a primary health centre to 100 people aged above 18 years, among them 41 gave written consent for thestudy and their demographic information was noted. They were given colour coded cards as per the currentblood pressure level and previous history of hypertension. On each colour coded card, specific advicewas written for that category. For all the participants, blood pressure and treatment seeking behaviour wasnoted. For hypertensive patients, adherence to medication and non‑pharmacological measures was noted.RESULTS: Mean age of the participants was 46.5 ± 13.06 years. Mean systolic blood pressure (SBP)and diastolic blood pressure (DBP) of the participants were 135 ± 16.85 mm Hg and 86 ± 11.42mm Hg, respectively. Among the participants, 10 (24.39%) had a known history of hypertension.Among them, as per the blood pressure levels measured on the day of the study 50% (5) had theirblood pressure levels under control. Interestingly 16 (39%) participants were found hypertensiveincidentally.DISCUSSION: It is evident from the studies that colour coded approach is used in multiple ways, inmultiple settings, for multiple diseases. To our knowledge, little focus has been given for hypertensivedisorders in the community level. We merely bother about making their risk profiling, even in thedigital age. Sometimes physicians in emergency become puzzled whenever patients collapsed in frontof them and we missed the “Golden Hour” for the treatment by searching patients’ medical details.CONCLUSION AND RECOMMENDATIONS: The above problem can be solved by risk profiling ofchronic patients by colour coded OPD/Health cards.

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Investigation of the quality of life of patients with hypertension in health centers

. Farbod Ebadi Fard Azar; . Mahnaz Solhi; . Fakhreddin Chabaksvar

Volume 10, Issue 7 , July 2020, , Pages 1-6

Abstract

  INTRODUCTION: Hypertension is one of the most critical factors for chronic diseases such ascardiovascular disease, stroke, arrhythmias, heart failure, and renal disease. The aim of ...  Read More INTRODUCTION: Hypertension is one of the most critical factors for chronic diseases such ascardiovascular disease, stroke, arrhythmias, heart failure, and renal disease. The aim of this studywas to evaluate the quality of life and its related factors in hypertensive patients.MATERIALS AND METHODS: This study was descriptive research. The sampling method wassimple random, i.e., 137 were selected among the ten health centers of the list of the existing patientsby simple random sampling. Data were collected using a questionnaire World Health OrganizationQuality of Life-BREF (Short Form-26). After collecting the questionnaires, the data analysis wascarried out using SPSS software and using statistical methods (e.g., number, percentage, mean,standard deviation, and MANOVA tests).RESULTS: The results showed that the mean score for the physical domain (52.82), the psychologicaldomain (50.26), the social domain (48.33), the environmental domain (46.1), and the total quality of life(49.60). Among the demographic variables, the education level variable (P =0.000), job (P = 0.013),and the duration of hypertension (P = 0.039) were significantly correlated with the quality of life ofpatients. The “levels of education” variables are significantly correlated with the physical domain(P = 0.000), psychological domain (P = 0.000), social domain (P = 0.000), and environmental domain(P = 0.000) of the quality of life. The “job status” variable is only significantly correlated with the socialdomain of the quality of life (P = 0.005). The “duration of hypertension” variable is only significantlyassociated with the physical domain of the quality of life (P = 0.011).CONCLUSION: The findings of the present study show that demographic variables such aseducational level, occupation, and duration of hypertension have a significant relationship with thequality of life domains of hypertensive patients. It is recommended that the principled education ofpatients is a step toward the improvement of the quality of life of patients.

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Improving hypertension surveillance from a data management prospective: Data requirements for implementation of population-based registry

. Mostafa Shanbehzadeh; . Hadi Kazemi-Arpanahi; . Arezo Arzani-Birgani; . Azimeh Karimyan; . Fatemeh Mobasheri

Volume 10, Issue 6 , June 2020, , Pages 1-8

Abstract

  BACKGROUND: Hypertension (HTN) has become a major public health problem which can causeserious complications when it is not well-controlled. Prevention and effective care of HTN requirea ...  Read More BACKGROUND: Hypertension (HTN) has become a major public health problem which can causeserious complications when it is not well-controlled. Prevention and effective care of HTN requirea population-based registry. Thus, establishing this registry can be used to collect comprehensive,timely, and reliable data on epidemiology cases. The aim is to create a registry for the collection ofhighly required prospective data that will present an in-depth analysis of the characteristics of allindividuals with HTN and track them over a particular chronological interval.MATERIALS AND METHODS: The study was divided into three phases: At first, a comprehensiveliterature review was conducted to determine the proposed data classes and data fields. Then, thefinal minimum data set was designed by a two-round Delphi consensus approach of 20 experts ofcardiologists, nephrologists, nutritionist, and health information management. Finally, a web-basedregistry system was developed by a Structured Query Language environment.RESULTS: A total of two clinical and nonclinical data categories with nine data classes and 68 datafields were selected for their inclusion in the registry following the consensus phase. A web-basedregistry was designed with a modular and layered architecture.CONCLUSIONS: This study provides an appropriate information infrastructure for active tracing andmonitoring of individuals with HTN. It has provided a practical information system allowing qualityimprovement, aggregate reporting for planning, and research purposes.

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Relationship between hypertension with irrational health beliefs and health locus of control

. Fatemeh Afsahi; . Mohsen Kachooei

Volume 10, Issue 5 , May 2020, , Pages 1-6

Abstract

  INTRODUCTION: Hypertension is one of the major health threats in the world today. The purposeof this study was to find the relationship between hypertension with irrational health belief ...  Read More INTRODUCTION: Hypertension is one of the major health threats in the world today. The purposeof this study was to find the relationship between hypertension with irrational health belief and healthlocus of controls.MATERIALS AND METHODS: The current work is a descriptive (case–control) study. One hundredpatients with hypertension and 100 healthy individuals were included in the study through availablesampling method. The Irrational Health Belief Scale and Multidimensional Health Locus of Controlquestionnaire were used. Data were analyzed using independent t‑test and logistic regression.RESULTS: The findings showed a significant relationship between the variables of irrational healthbeliefs and the external health locus of control in hypertension. For a unit increase in an irrationalhealth belief score, the chance of having high blood pressure increases by 6%, and for a unit increasein the score of external health locus of control, there is a 17% higher chance of having hypertension.The independent t‑test of irrational health belief also showed a statistically significant differencebetween the two groups (P < 0.01). There was also a statistically significant difference regardingthe health locus of control in the two groups of hypertension and healthy individuals in the subscaleof chance control (P < 0.01) and external locus of control (P < 0.01).CONCLUSION: The results of this study make it necessary to identify irrational health beliefs aswell as the health locus of control in individuals. Modification of these structures can be useful in theprevention and management of this chronic disease.

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Determinants of medication adherence among hypertensive patients using the Pender’s health promotion model

. Hossein Goudarzi; . Majid Barati; . Saeed Bashirian; . Babak Moeini

Volume 10, Issue 4 , April 2020, , Pages 1-7

Abstract

  BACKGROUND: Poor adherence in treatment and medication is a global issue in curing the chronicdiseases such as hypertension. The present study was conducted to identify the factors ...  Read More BACKGROUND: Poor adherence in treatment and medication is a global issue in curing the chronicdiseases such as hypertension. The present study was conducted to identify the factors related withmedication adherence among hypertensive patients referred to the health centers of Borujerd basedon the Pender’s Health Promotion Model (HPM).MATERIALS AND METHODS: This cross‑sectional study was conducted on 463 patients who werereferred to the comprehensive health centers of Borujerd city by cluster sampling method in 2019.The data were collected using a questionnaire including demographic variables and Pender’s HPMconstructs. Data were analyzed by SPSS 18 software using Pearson correlation coefficient andlinear regression.RESULTS: The mean and standard deviation of the participants’ age was 63.29 ± 11.2 years. Theresults showed that hypertensive patients had a relatively desirable level of medication adherencebehavior. Perceived barriers (β = −0.169), perceived self‑efficacy (β = 0.196), activity related affect(β = 0.232), and following medication regimen (β = 0.225) were the best predictors of performingthe medication adherence behavior. In total, different structures of the HPM explained 42.2% of thevariation of medication adherence behavior changes.CONCLUSIONS: According to the findings, the design of educational programs using HPM isrecommended to increase the medication adherence among hypertensive patients.

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Effect of alternate nostril breathing exercise on blood pressure, heart rate, and rate pressure product among patients with hypertension in JIPMER, Puducherry

. Kalaivani S; . Kumari MJ; . Pal GK

Volume 9, Issue 7 , July 2019, , Pages 1-8

Abstract

  INTRODUCTION: Hypertension has a direct relationship with the circulation, respiration, and functionof vital organs. Similarly, complementary therapy such as alternate nostril breathing ...  Read More INTRODUCTION: Hypertension has a direct relationship with the circulation, respiration, and functionof vital organs. Similarly, complementary therapy such as alternate nostril breathing exercise has adirect effect on mental and physical health.MATERIALS AND METHODS: This is a quantitative experimental research with randomizedcontrolled trial design. A total of 170 and 85 individuals were allotted to each group. Patients in thestudy group were instructed alternate nostril breathing exercise two times a day (10 min durationof exercise each time) for 5 days along with routine treatment, and patients in the control groupunderwent routine treatment.RESULTS: There was a marked reduction in systolic blood pressure (BP), diastolic BP, heart rate,and rate pressure product after the continuous 5‑day alternate nostril breathing exercise in the studygroup. P < 0.0001 demonstrated a statistically significant difference in systolic BP, diastolic BP,heart rate, and rate pressure product that existed pre‑ and post‑assessment on 1st day and 5th day.CONCLUSION: It can be concluded that regular simple alternate nostril breathing exercise effectivelyreduces hypertension.

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Abnormal sympathetic functioning is linked to familial hypertension in nonathletic young males

. Jayesh Dalpatbhai Solanki; . Ajay P. Kapadiya; . Hemant B. Mehta; . Chinmay J. Shah

Volume 9, Issue 4 , April 2019, , Pages 1-5

Abstract

  BACKGROUND: Sympathetic overactivity mediates abnormal cardiovascular outcome that is affectedby stress, lack of physical activity (PA), and familial hypertension (HTN). It can be assessed ...  Read More BACKGROUND: Sympathetic overactivity mediates abnormal cardiovascular outcome that is affectedby stress, lack of physical activity (PA), and familial hypertension (HTN). It can be assessed by bloodpressure‑based sympathetic function tests.OBJECTIVE: We studied sympathetic function tests in young nonathletic males in relation to measuresof obesity, PA, and familial HTN.METHODOLOGY: We recruited 100 males (mean age: 19 years) and measured body massindex (BMI) and body composition parameters by tetrapolar bioelectrical impedance such as total bodyfat, visceral fat, subcutaneous fat, and skeletal muscle mass. Using instrument cardiac autonomicneuropathy system of Recorders and Medicare System Company, India, blood pressures (supine,standing, and post hand grip) were recorded and studied quantitatively and qualitatively.RESULTS: Physically active and inactive individuals (n = 50 each) had comparable age, BMI,measures of obesity, and sympathetic function tests. However, individuals with familial HTN (n = 37)showed significantly higher obesity measures and blood pressures (supine: systolic bloodpressure [SBP] – 133 vs. 115 and diastolic blood pressure [DBP] – 79 vs. 76; standing: SBP – 136 vs.122 and DBP – 80 vs. 76; post hand grip: SBP – 136 vs. 125 and DBP – 86 vs. 81). Qualitatively,postural hypotension was seen in only two individuals, while worst grading was in post hand griptest significantly and more so in physically inactive group (30%, 28%, and 42% vs. 16%, 20%, and64%) and individuals with positive familial HTN (32%, 38%, and 30% vs. 17%, 13%, and 70%).CONCLUSION: Familial HTN, but not physical inactivity, affects sympathetic functioning in nonathleticyoung male medical personnel. It asks for other lifestyle modifications for better cardiovascular healthas primary prevention.

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Awareness and practice of aerobic exercise and yoga among hypertensive patients in Anand city

. Nirav Vaghela; . Daxa Mishra; . Jigar N. Mehta; . Hemal Punjabi; . Hena Patel; . Ishani Sanchala

Volume 9, Issue 2 , February 2019, , Pages 1-7

Abstract

  BACKGROUND: Aerobic exercise is helpful in reducing elevated blood pressure (BP). It was alsofound that yoga is useful in reducing raised BP. Thus, they both can be used in prevention ...  Read More BACKGROUND: Aerobic exercise is helpful in reducing elevated blood pressure (BP). It was alsofound that yoga is useful in reducing raised BP. Thus, they both can be used in prevention andtreatment of hypertension. Hence, the study aimed to observe both awareness and practice of aerobicexercise and yoga among hypertensive patients in Anand city.MATERIALS AND METHODS: A cross‑sectional descriptive study was conducted. A questionnairewas prepared containing 24 questions about awareness and practice of aerobic exercise and yogaamong hypertensive patients. The questions were explained to all the patients, and 200 patientswere recruited from Anand city through convenience sampling.RESULTS: Two‑hundred patients were included in this study, of which 100% were aware ofhypertension. 67.68% were aware of the role of aerobic exercise in hypertension, of which 58.29%practiced them. The awareness of the role of yoga in hypertension was noted in 33.67% of patients,of which only 13.07% practiced pranayama and 9.50% practiced asanas.CONCLUSION: There was a complete awareness of hypertension among hypertensive patients.A large number of patients were aware of the role of aerobic exercise in hypertension, but only few ofthe patients practiced them. However, there was less awareness of the role of yoga in hypertensionand even lesser number practiced them.

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Awareness, treatment, and control of hypertension among adult population in a rural community of Singur block, Hooghly District, West Bengal

. Nabarun Karmakar; . Kaushik Nag, Indranil Saha; . Ramanathan Parthasarathi; . Manas Patra; . Rabindranath Sinha

Volume 8, Issue 10 , October 2018, , Pages 1-6

Abstract

  BACKGROUND: Hypertension is an important treatable public health problem both globally and inIndia with an increasing prevalence significantly in both urban and rural population. It ...  Read More BACKGROUND: Hypertension is an important treatable public health problem both globally and inIndia with an increasing prevalence significantly in both urban and rural population. It is one of theleading causes of adult mortality and morbidity, but poorly controlled hypertension remains a majorhealth problem.OBJECTIVE: The objective of this study was to find out awareness, treatment, and controlof hypertension among study population and association of hypertension awareness withsociodemographic factors, if any.MATERIALS AND METHODS: This study was conducted from May 2013 to April 2014 in the ruralcommunity of Singur block, West Bengal. Data were collected with respect to sociodemographiccharacteristics as well as records related to hypertension such as awareness, treatment, and controlof hypertension. Blood pressure (BP) measurement of individuals aged 20 years and above of bothsexes was done. Pearson’s Chi‑square test was performed to find out the association between thecategorical variables. SPSS 19.00 software was used for analysis.RESULTS: Nearly 48.2% of the participants were aware of their elevated BP; 47.1% of the participantswere taking pharmacological treatment, mostly allopathic and only 8.8% had their BP under control.A  statistically significant association was found between age, education, and socioeconomicstatus (per capita income) with awareness of hypertension.CONCLUSION: Lack of awareness of the disease and very low rate of control of hypertensionamong those who were treated became the major issues. These findings emphasize the need fordissemination of knowledge about the disease and counseling of the patients during treatmentcontinuation.

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Hypertension prevalence, awareness, treatment and its correlates among people 35 years and older: Result from pilot phase of the Azar cohort study

. Zohreh Ghorbani; . Seyed Morteza Shamshirgaran; . Samad Ghaffari; . Parvin Sarbakhsh; . Farzad Najafipour; . Nayyereh Aminisani

Volume 8, Issue 4 , April 2018, , Pages 1-8

Abstract

  BACKGROUND AND OBJECTIVE: There is remarkable alteration in hypertension prevalenceand awareness, and their correlates among various geographic locations and ethnic groups. Theaim of ...  Read More BACKGROUND AND OBJECTIVE: There is remarkable alteration in hypertension prevalenceand awareness, and their correlates among various geographic locations and ethnic groups. Theaim of this study was to report hypertension prevalence, awareness, and its correlates as well ashypertension treatment, and control among Azari people aged 35 years and older.MATERIALS AND METHODS: The pilot phase of the Azar Cohort Study; a state level of a nationwidePERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015.All people 35 years of age and above were invited to take part in this study. A comprehensive range ofdifferent biomarkers, lifestyle, socioeconomic factors, and health‑related factors was collected. Bloodpressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to presentgeneral characteristics of the study population as frequency tables. Separate multiple logistic regressionmodels were built to assess the predictors of hypertension prevalence.RESULTS: A total of 1038 people were included in this study. The overall prevalence of hypertensionwas 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% wereusing the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment;age (odds ratios [OR] adj = 1.12 95% confidence interval [CI]: 1.09–1.15), gender (ORadj = 1.65 95% CI:1.08–2.51), obesity ORadj = 2.51 (1.40–4.88), waist‑to‑hip ratio (WHR) (ORadj = 1.70 (1.05–2.75), andcomorbidities (ORadj = 2.51 (1.72–3.66) were independent predictors of hypertension.CONCLUSION: Age, sex, body mass index, WHR, and comorbidities were known as predictorsof hypertension in this study, health promotion strategies including lifestyle modification to reduceoverweight/obesity and secondary prevention programs for early detection of hypertension in high‑riskgroups according to age, gender, and disease profile are recommended.

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Barriers to medication adherence in patients with hypertension: A qualitative study

. Arash Najimi; . Firoozeh Mostafavi; . Gholamreza Sharifirad; . Parastoo Golshiri

Volume 8, Issue 2 , February 2018, , Pages 1-7

Abstract

  INTRODUCTION: Barriers to medication adherence in patients with hypertension can have significantdifferences that made researchers confute to conclude that medication adherence is required ...  Read More INTRODUCTION: Barriers to medication adherence in patients with hypertension can have significantdifferences that made researchers confute to conclude that medication adherence is required tobe more explored, and then, beneficial interventions develop to decrease these barriers. Thus, thecurrent study was aimed to identify barriers to adherence in Iranian society.MATERIALS AND METHODS: A qualitative content analysis was carried out. Participants were asfollow: Patients with hypertension who had clinic records in the health centers of Isfahan University ofMedical Science. Purposive sampling method was conducted and continued until data saturation, aswell. Semi‑structured interview was selected as the best‑qualified technique to select data. Data wereanalyzed using qualitative content, constant comparative analysis, and MAXQDA (Ver 10) software.RESULTS: After study and separation of basic concepts, 1620 basic codes were extracted frominterviews. Classes were made based on codes and after multiple reviews, summarizing as wellas similarity. Primary themes were identified using more explorations and comparison of classes.Based on the nature, the conceptual themes were named. These themes include (1) environmentalchallenges of life, (2) incompatibility of patients; (3) forget to take medicine, and (4) inefficientrecommendations of family.CONCLUSION: Findings revealed that barriers to patient adherence to the treatment had fourdimensions that may be likely useful for managers and planners in the health field to plan and interveneregarding medication adherence as the most critical preventing factor for patients with hypertension.

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Development and study of self‑efficacy scale in medication adherence among Iranian patients with hypertension

. Arash Najimi; . Firoozeh Mostafavi; . Gholamreza Sharifirad; . Parastoo Golshiri

Volume 7, Issue 5 , September and October 2017, , Pages 1-6

Abstract

  BACKGROUND: This study was aimed at developing and studying the scale of self‑efficacy inadherence to treatment in Iranian patients with hypertension.METHODS: A mix‑method study ...  Read More BACKGROUND: This study was aimed at developing and studying the scale of self‑efficacy inadherence to treatment in Iranian patients with hypertension.METHODS: A mix‑method study was conducted on the two stages: in the first phase, a qualitativestudy was done using content analysis through deep and semi‑structured interviews. After dataanalysis, the draft of tool was prepared. Items in the draft were selected based on the extractedconcepts. In the second phase, validity and reliability of the instrument were implemented using aquantitative study. The prepared instrument in the first phase was studied among 612 participants. Totest the construct validity and internal consistency, exploratory factor analysis and Cronbach’s alphawere used, respectively. To study the validity of the final scale, the average score of self‑efficacy inpatients with controlled hypertension were compared with patients with uncontrolled hypertension.RESULTS: In overall, 16 patients were interviewed. Twenty‑six items were developed to assessdifferent concepts of self‑efficacy. Concept‑related items were extracted from interviews to studythe face validity of the tool from patient’s point of view. Four items were deleted because scored0.79 in content validity. The mean of questionnaire content validity was 0.85. Items were collectedin two factors with an eigenvalue >1. Four items were deleted with load factor <0.4. Reliability was0.84 for the entire instrument.CONCLUSION: Self‑efficacy scale in patients with hypertension is a valid and reliable instrument thatcan effectively evaluate the self‑efficacy in medication adherence in the management of hypertension.

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BASNEF Model intervention on blood pressure modification among hypertensive diabetic patients

. Azar Tol; . Hadiseh Farhandi; . Bahram Mohebbi; . Roya Sadeghi

Volume 7, Issue 3 , May and June 2017, , Pages 1-5

Abstract

  BACKGROUND: Prevalence of hypertension in patients with type 2 diabetes is two to three timesmore than nondiabetic patients. This study aimed at assessing the impacts of an educational ...  Read More BACKGROUND: Prevalence of hypertension in patients with type 2 diabetes is two to three timesmore than nondiabetic patients. This study aimed at assessing the impacts of an educational programbased on BASNEF Model on blood pressure modification among diabetic patients with hypertension.MATERIALS AND METHODS: Two hundred patients with type 2 diabetes were recruited in aneducational intervention study among two groups. The intervention group attended a 3‑monthself‑care educational program regarding hypertension control in addition to the regular care presentedfor both the groups. Another group received no extra program except regular treatment. To collectinformation about demographic characteristics, type 2 diabetes‑related variables, and BASNEF Modelconstruct items, a self‑designed questionnaire was utilized. Data analyzed by SPSS version 16 usingChi‑square, independent t‑test, and paired t‑test.RESULTS: Knowledge, behavioral beliefs, attitude to action, enabling factors, subjective norms, andpractice were significantly higher in intervention group as compared to the controls (P< 0.001). In addition,blood pressure revealed significant differences in intervention group before and after program using pairedt‑test (P= 0.001) while in the control group, there was no significant difference in blood pressure (P= 0.54).DISCUSSION: The study results revealed a significant change in blood pressure and model constructsin intervention group compared to control. This research suggested intervention program based onBASNEF Model has essentially effectiveness in blood pressure modification among diabetic patients.CONCLUSION: BASNEF Model has effectiveness to high blood modification among diabetic patientswith hypertension.

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Does Islamic spiritual program lead to successful aging? A randomized clinical trial

. Mahin Moeini; . Somaye Sharifi; . Zahra Zandiyeh

Volume 6, Issue 1 , 2016, , Pages 1-7

Abstract

  Context: Successful aging is a pattern of aging that has gained much attention during recentyears. One factor that has a negative impact on successful aging variables is hypertension. ...  Read More Context: Successful aging is a pattern of aging that has gained much attention during recentyears. One factor that has a negative impact on successful aging variables is hypertension. Thephenomenon of aging when accompanied with hypertension promotes spiritual needs. The aimof this study was to examine the effect of the Islamic spiritual program on successful aging inelderly patients with hypertension who were referred to health centers of Isfahan, Iran, in 2014.Settings and Design: This study was a randomized clinical trial. Materials and Methods: Theparticipants (52 elderly patients with hypertension) were randomly divided into experimentaland control groups. While the control group received training related to health promotion, theIslamic spiritual program was implemented in the experimental group for eight sessions in twohealth centers of Isfahan. The data collection tools consisted of the 12‑item General HealthQuestionnaire developed by Goldberg and the satisfaction with life scale developed by Diener.The questionnaires were completed in three steps; pretest, posttest, and follow‑up (1‑month).Statistical Analysis Used: Data were analyzed using SPSS statistical software version 20and Chi‑square, independent t‑test, and repeated measures ANOVA. Results: Statistical testsshowed that the mean score of general health and life satisfaction of the experiment group hada meaningful difference from that of the control group in the posttest stage (P < 0.001). Thisdifference was also meaningful in the follow‑up stage (P < 0.001). Conclusion: The results of thestudy indicated the effectiveness of an Islamic spiritual program on successful aging variables.

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A survey on the effect of implementation of a family‑centered empowerment model on blood pressure and empowerment dimensions in the elderly people with hypertension

. Mahrokh Keshvari; . Batool Hedayati; . Mahin Moeini; . Fatemeh Alhani

Volume 5, Issue 5 , December 2015, , Pages 1-10

Abstract

  Background: Noncommunicable diseases such as Hypertension are among theimportant factors of mortality and morbidity of the elderly people. The family‑centeredempowerment model (FCEM) ...  Read More Background: Noncommunicable diseases such as Hypertension are among theimportant factors of mortality and morbidity of the elderly people. The family‑centeredempowerment model (FCEM) has not been performed for elderly people with hypertension.Settings and Design: This clinical trial study was carried out on 62 elderly people withhypertension under the coverage of the Lenjan Health Network in 2013. After performing thesampling by using the cluster‑randomized method, the samples were divided randomly intothe experimental and control groups. Methods: For the experimental group, the (FCEM) wasimplemented based on the four steps. For the control group, it was only implemented theusual care and one training session. Research tools included questionnaires of demographicdata, empowerment assessment and a blood pressure‑measuring device. The post‑test wasperformed 1 week later. The blood pressure was recorded, and it was followed 1.5 month lateragain. Statistical Tests: Statistical tests for data analysis included χ2‑test, independent t‑test,Mann–Whitney, analysis of variance, and SPSS 20. Results: 1 week later and 1.5 month afterthe intervention, the mean blood pressure was significant in both groups (P < 0.001). also, thedifference in the mean score of empowerment dimensions was significant in the experimentalgroup 1 week later and 1.5 month after the intervention (P < 0.001). Conclusion: Implementationof the FCEM for elderly people with hypertension has been possible from a practical point ofview, and it has been associated with controlling and improving the blood pressure.

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Psychometric testing of an instrument designed to measure nutritional perceptions of hypertensive patients

. Aziz Kamran; . Leila Azadbakht; . Behzad Mahaki; . Gholamreza Sharifirad

Volume 4, Issue 4 , August 2014, , Pages 1-8

Abstract

  Introduction: Measurement tools designed to ensure the achievements of studies’ objectivesmust be evaluated. Based on the health promotion model (HPM), the present study wasconducted ...  Read More Introduction: Measurement tools designed to ensure the achievements of studies’ objectivesmust be evaluated. Based on the health promotion model (HPM), the present study wasconducted to assess the validity and reliability of the designed questionnaire of hypertensivepatients’ nutritional perceptions. Methodology: In a cross‑sectional study, the mentionedquestionnaire was assessed based on opinions of 11 experienced faculty members and671 hypertensive patients in rural areas in the year 2013. To evaluate the reliability, internalconsistency (Cronbach’s alpha) was calculated. Concerning the validity of the questionnaire,its content and construct validity were examined. Data analysis was performed usingStatistical Package for the Social Sciences version 18 (SPSS Inc., Chicago, IL, USA).Results: Spearman‑Brown and Cronbach’s alpha coefficients results were acceptable in allconstructs indicating a satisfactory reliability of the questionnaire. Questionnaire’s questionswere highly correlated with the total score signifying the internal consistency of the questions;therefore, all questions had a similar effect on the total score and the removal of each did noincrease the alpha significantly (all questions had acceptable reliability). Factor analyses showedthat all questions had acceptable factor loading and suitable validity. Moreover, the entireconstructs of the questionnaire were approved by experts with high validity coefficient of 0.9.Conclusion: The designed questionnaire for assessment of the HPM constructs regardinghypertensive patients’ nutritional issues had appropriate psychometric characteristics. Reliabilityand validity of the questionnaire were also satisfactory and its overall structure was approved.

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Noise exposure as a risk factor of cardiovascular diseases in workers

. Hossein Ali Yousefi Rizi; . Akbar Hassanzadeh

Volume 3, Issue 3 , March 2013, , Pages 1-4

Abstract

  Introduction: Workers in different jobs are exposed to noise, which can affect hearing loss andsleep disturbance in the long term. Excessive noise exposure may lead to increased bloodpressure, ...  Read More Introduction: Workers in different jobs are exposed to noise, which can affect hearing loss andsleep disturbance in the long term. Excessive noise exposure may lead to increased bloodpressure, reduced efficiency, and increased absenteeism. Materials and Methods: In thiscase‑control study, 80 workers were studied in terms of noise exposure and blood pressure.Noise exposure was measured by SEL 440 sound level meters according to ISO 1996 standard.Blood pressure of the case and control groups was measured in workplace, under standardcircumstances, using ALPK2 mercury sphygmomanometer during physical examination. Datawere analyzed by t‑test and Pearson’s correlation coefficient. Results: Mean level of noise was95.21 ± 2.56 db, which was significantly higher than permitted limit of 85 db (ACGIH 2009) (P <0.01). Diastolic blood pressure was normal in 28.8% and high in 50.1%, and between these in21.1% of workers. Mean difference of systolic blood pressure in two studied groups (P < 0.01)was meaningful. However, mean difference of diastolic blood pressure was not significant in twostudied groups (P > 0.05). There was a positive and weak relationship between noise and systolicblood pressure (r = 0.28, P < 0.006). Conclusion: Prolonged exposure to industrial noise is relatedwith high blood pressure as a risk factor of cardiovascular diseases. Therefore, it is recommendedthat training programs be held for workers, preventive measures for noise exposure at workplacebe taken, blood pressure of workers be attended to and special care be given to workers with ahistory of hypertension.

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