Comparison of two models of nurse-led hypertension clinics in a primary health care setting

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Comparison of two models of nurse-led hypertension clinics in a primary health care setting

 

Author: Chiu, Wai-hing Caroline
Title: Comparison of two models of nurse-led hypertension clinics in a primary health care setting
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Hypertension -- Prevention.
Health education.
Primary health care.
Department: School of Nursing
Pages: v, 69 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2318145
URI: http://theses.lib.polyu.edu.hk/handle/200/4795
Abstract: Aim of the study. The aim of this study was to examine if there was difference in blood pressure, adherence to medication, self blood pressure monitoring, diet, exercise, smoking and alcohol consumption, health service utilization and patient satisfaction between hypertensive patients who received usual nurse education (control group) and those who received nurse education with the use of contract learning which was re-inforced by telephone follow up (study group). Background. Hypertension is a chronic condition that is commonly managed in the community. Nurse-led hypertension clinic has taken up the role in educating patients on self-monitoring and lifestyle modifications. A health education model that conducts health education in combination of learning contract for desired behavior which is re-inforced by phone follow up may motivate patients in assuming the responsibility on self management of the disease. Design / Methods. The study was a randomized control study which was conducted in a primary health care setting. Patients with a single reading > 140/90mmHg were selected and referred to the nurse-led clinic. The participants were randomized to the study group or the control group. The control group received the conventional protocol-driven health education on hypertension. The study group received the protocol-driven protocol, signing learning contract for desired behavior goals which were supported by phone follow up. Results. A total 63 subjects completed the study (study group = 31, control group = 32). The study group had a much better blood pressure control than the control group (study vs. control: 128/78 vs. 140/84, P<0.05). Independent t-tests shows that patients in the study group (-19.03+-16.9, P=< 0.05) had a greater reduction in systolic blood pressure when compared to that in the control group (-7.97+-20.3, P=< 0.05). The difference in systolic blood pressure control was statistically significant (t=2.35, P=< 0.05). Also, the reduction of the diastolic blood pressure in the study group (-11.68+-10.3, P=< 0.05) was more than that in the control group (-3.72+-10.63) (t=3.02, p=0.004), For behavior modifications, there was significant statistical difference in the home blood pressure monitoring between the study group and the control group (Z=-3.94, P =< 0.01). Statistical difference was also found in the exercise adherence (Z=-4.51, P=< 0.01). However, there was no significant difference in body weight (study vs. control: -0.1+-0.92 vs. 0.15+-1.03, t=0.79, p=0.43) and body mass index (study vs. control: -0.7+-3.6 vs. 0.06+-0.47, t=1.18, p=0.24). Significant statistical difference was not found on dietary adherence (Z=-l, P=0.32), medication adherence (Z=-1.187, P=<0.23), alcohol (Chi-square=0, P=1) and smoking cessation (Chi-square=3.05, P=0.08). Conclusion. Active patient participation and motivation in self care is a crucial factor in behaviour modification. It is important to apply a health education model that motivating the patients in assuming their own initiation and responsibilities in self-monitoring and self- management.

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