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Health Education: Its Effectiveness 1 | P a g e

Health Education: Its effectiveness in managing Hypertensive patients

Roman Cedric G. Sinon Ma. Cristy M. Addun Socorro B. Gunnacao Anabel S. Luis Shaina May A. Rabang University of Saint Louis Tuguegarao

Health Education: Its Effectiveness 2 | P a g e TABLE O !O"TE"TS #age Title page Abstract.. Table of contents. Ac no!ledgement .. Abstract .. "#TR$%&CT"$# ..... Research 'uestions. Significance of the Study.. Theoretical (rame!or . )ealth *ducation )ypertension. Research +aradigm.. M*T)$%S Research %esign. Locale of the Study. +articipants,Sub-ects.. %ata Gathering "nstrument.. %ata Gathering +rocedure. %ata Analyses. R*S&LTS .... .. %"SC&SS"$# .................................. C$#CL&S"$#. R*C$MM*#%AT"$#,L"M"TAT"$#S . R*(*R*#C*S Appendices . Literature /ariable Synthesis Matri. Matri.. Tally.......

Appendi. A Appendi. B Appendi. C

Health Education: Its Effectiveness 3 | P a g e Appendi. % Letter to the participant.

A!$"O%LE&'E(E"T The researchers !ish to e.press their sincerest than s and gratitude to the follo!ing that ha0e e.tended their support1 no!ledge1 assistance1 guidance and cooperation in the successful completion of this study. Ms. Angelico (. Reyes R#1MS#1 their mentor of Research 2 and 31 for

%r. +yrene 'uilang1 for her suggestion in the use of appropriate statistical tools

R)& Mid!ife1

(amily1 Abo0e all to the Almighty Lord in )ea0en for his %i0ine Grace.

Health Education: Its Effectiveness 4 | P a g e

ABST)A!T

$ey*ords: )ypertension1 health education 4444444444444444444444444444444444444444444444444444444444444444444444 Introduction: Bac+ground of Study Globally1 cardio0ascular diseases are the number one cause of death. They account for appro.imately 25 million deaths in the !orld today each year. Complications of high blood pressure1 also called hypertension or raised blood pressure1 account for more than nine million of these deaths1 including about half of all deaths from heart disease and stro e. The number of people !ith high blood pressure rose from something li e 677 million in 2897 to almost 2 billion in 37791 and this number is e.pected to increase to 2.:6 billion people by the year 373:. That translates to about 2 out of e0ery ; adults being afflicted !ith hypertension based on <)$ data. Around 2; million (ilipinos1 or 3: percent of the current adult population in the country1 ha0e hypertension1 according to the %epartment of )ealth =%$)>. )eart disease and stro e remain as the leading causes of mortality in the country1 accounting for around ?: percent of total deaths among (ilipinos. %ata sho!s that in 37781 around 2651777 (ilipinos died from heart disease and stro e. )alf of the deaths are li ely related to high blood pressure1 according to the %$). The +hilippine Society of )ypertension defines )ypertension as another name for high blood pressure. "t is that condition !hen the pressure inside of your large arteries is too high. "t is also the most common cardio0ascular condition in the !orld. "t is more common as people gro! older and it occurs e@ually in men and !omen. )ypertension is not simply being tense or ner0ous. . )ypertension is often called Athe silent illerB for t!o reasons. (irst1 it produces no specific symptoms. Such things as diCCiness1 ner0ousness1 nosebleeds or headaches rarely ha0e anything to do !ith hypertension. )ypertension can be detected only by measuring your blood pressure. Secondly1 people !ho ha0e hypertension that is not treated are much more li ely to die from or be disabled by cardio0ascular complications such as stro es1 heart attac s1 heart failure1 heart rhythm irregularities1 and idney failure than people !ho ha0e normal blood

Health Education: Its Effectiveness 5 | P a g e pressure. $nce blood pressure rises continuously abo0e 237,97 mm)g1 the ris of cardio0ascular disease begins to increase. A state of preDhypertension is said to be present !hen the B+ is persistently bet!een 237D2?8 mm )g systolic or 97D98 mm )g diastolic. )ypertension is said to be present !hen the blood pressure is consistently abo0e 2;7 systolic or 87 diastolic. The higher the blood pressure1 the greater the cardio0ascular ris . The longer the duration of hypertension1 the greater the cardio0ascular ris . )ypertension can be treated successfully. Although it cannot be cured. *0ery hypertensi0e patient or indi0idual at high ris of de0eloping hypertension should follo! a healthy lifestyle. This means losing !eight if you are o0er!eight1 reducing any e.cess amount of salt that you eat1 increasing the amount of potassium and calcium in your diet1 a0oiding e.cess alcohol inta e =more than one drin a day>1 getting proper e.ercise1 and ne0er e0er smo e. A0oid e.cessi0e use of drugs that can increase your blood pressure such as decongestant tablets or nasal sprays and pain medications called nonDsteroidal antiDinflammatory drugs =#SA"%s>. "f your blood pressure remains or becomes high1 %octor may prescribe medication. *0en !ith adherence to a healthy lifestyle1 a personEs blood pressure may rise as they gro! older and they may1 at some point1 re@uire drug treatment. *0en if medication is re@uired1 a healthy lifestyle should be continued. That !ill ma e the medications more effecti0e and possibly reduce the amount of drugs re@uired. $nce medications are started1 it is e.tremely important to continue !ith the treatment. +eople !ho stop treatment almost al!ays return to their original blood pressure le0el or higher. The treatment for most patients is lifeDlong. Studies ha0e demonstrated that lo!ering the ele0ated blood pressure =B+> may reduce the ris for morbidity and mortality due to cardio0ascular diseases. Lac of B+ measurement !as associated !ith lo! a!areness and treatment =Fhao. et al. 372?>. Most people1 ho!e0er1 ha0e some difficulty maintaining healthy habits and ta ing their medicine as prescribed. Many people simply forget to ta e their medication. $thers stop ta ing their medication because they belie0e that it ma es them feel !orse or because it is too e.pensi0e. $thers stop because they feel better and mista enly belie0e that they no longer need the medication. Some stop because their blood pressure became normal !ith treatment and they mista enly thought that they !ere AcuredB. &ncontrolled hypertension is a serious problem. "t can cause heart disease1 heart attac 1 stro e or idney failure. According %epartment of )ealth people often ha0e no symptoms and are una!are of their high blood pressure. According to the Goint 26th Annual Con0ention of the +hilippine Society of )ypertension H the +hilippine Lipid Atherosclerosis Society1 it is a sad fact that at present1 diseases of the heart is no! the leading cause of death among (ilipinos. #inety percent of (ilipinos has at least one ris factor for cardio0ascular diseaseI be it unhealthy or improper diet1 lac of e.ercise1 or smo ing. "n addition1 the pre0alence of hypertension1 diabetes and dyslipidemia1 conditions associated !ith cardio0ascular disorders1 are also rising. Thus1 the promotion of healthy lifestyle1 based on a balanced diet1 moderation of alcohol inta e1 smo ing cessation1 and incorporation of ade@uate physical acti0ities in daily life1 is essential1 no! more than e0er.

Health Education: Its Effectiveness 6 | P a g e "n the research study conducted by $li0es1 et al =372?> sho!ed that "ncreasing trends in hypertension a!areness1 treatment1 and control suggest that campaigns to increase hypertension a!areness and treatment ha0e been successful in decreasing the blood pressure of the participants. This therefore calls for a need to de0elop simple !ays to lift the (ilipinos from the burden brought about by this ASilent Jiller diseaseB called )ypertension. *0en though there are programs of the %epartment of )ealth to manage )ypertension1 there is still need for the (ilipinos to be a!are and educated about their disease and on ho! to manage this condition and pre0ent further complications. And patients ha0e the right to be informed and health care pro0iders ha0e an important ey role and can be of great help in promoting health in patients !ith hypertension. Generally1 this research study therefore pursued to determine the effecti0eness of )ealth *ducation in managing )ypertension. )esearch ,uestions The study aims to ans!er the follo!ing @uestionsI 1. <hat is the blood pressure of sub-ects before and after the health education on management of )ypertension !ere doneK

2. "s there a significant difference in the blood pressure before and after health education on management of )ypertension !ere doneK Significance of the Study )ealth education is one of the most important things that should be implemented !ith the hypertensi0e patients. The aim of this successful health education is to orient patient regarding their condition and to increase their moti0ation to manage their high blood pressure. "n addition1 this !ill also pre0ent the occurrence of complications such as cardio0ascular diseases. )ence1 the ob-ecti0e of this study is to determine the significant change in -lood pressures of patients from -eing hypertensive to normal -lood pressure. The study is to impro0e management of hypertension in terms of patientEs beha0ior or moti0ation to manage high blood pressure brought about by their a!areness regarding their condition. This study also deepens the understanding on the relationship of nurseEs education on client and the effects on health status1 maintaining the normal blood pressure and management of hypertension. This study also gi0es benefit to the patients because of the no!ledge that they obtain about their disease. )evie* of Literature

Health Education: Its Effectiveness 7 | P a g e Theoretical rame*or+ )ealth +romotion Model =)+M> #ola +enderEs )ealth +romotion Model =)+M> !as created to ser0e as a Amulti0ariate paradigm for e.plaining and predicting health promoting component of lifestyleB =+ender1 28871 p.?36>. The model is used to assess an indi0idualEs bac ground and percei0ed perceptions of self among other factors to predict health beha0iors. =+ender1 2886L +eterson HBredo!1 3778>. The model is an attempt to depict the multifaceted natures of persons interacting !ith the en0ironment as they pursue health. &nli e a0oidanceDoriented models that rely upon fear or threat to health as moti0ation for health beha0ior1 the )+M has a competence or approachDoriented focus =+ender1 2886>. As cited by +ender in her theory of )ealth promotion1 nurses and community play a significant role to promote health on client. The assertions made in this theory further support the hypotheses made about health care pro0iders as important sources of interpersonal influence to clients and health educationEs significance to the promotion of health and therefore reducing the morbidity of hypertension. Therefore this supports the idea that health education can be of great help in promoting health in patients !ith hypertension. The model focuses on follo!ing three areas. "ndi0idual characteristics and e.periences1beha0iorDspecific cognitions and affect and beha0ioral outcomes. The )ealth +romotion Models theory loo s at steps in !hich a person can pursue better health or ideal health. To achie0e that1 the )ealth +romotion Model ta es into consideration indi0idual characteristics and e.periences1 beha0ior specific cognitions and affect and beha0ioral outcomes of a person. *0ery analysis is used to determine the best methods for attaining impro0ed health1 enhanced functional ability and better @uality of life. The factors that are del0ed into in the )ealth +romotion Model are predominantly an indi0idualEs lifestyle1 mindset1 psychological health1 social and cultural aspects as !ell as biological factors. $nce e0ery bit of information is -ot do!n1 there is a set of actions1 functional as !ell as beha0ioral1 that are recommended for the indi0idual. Any such action !ould meet !ith certain barriers in its !ay. Steps are ta en to counter such pre0enti0e barriers !hich might cause disruption in abiding by the )ealth +romotion Model. The )ealth +romotion Model is a uni@ue approach to attain good health and to lead a good1 balanced life. *0ery indi0idual irrespecti0e of age can benefit from the )ealth +romotion Model. At e0ery stage of the de0elopment cycle1 beha0ioral changes1 amends to lifestyles and progress of good health is noted do!n to ascertain the further course of steps necessary.

Health Education: Its Effectiveness 8 | P a g e Health Education )ealth education1 defined as the transference of health information from healthcare pro0iders to patients1 !as a component of many inter0entions =Connell1 +. et al 3779>. *ducational inter0entions in hypertensi0e patients are efficacious in hypertension management and can ma e a ma-or contribution to impro0ement in the patientsE healthy lifestyle beha0iors1 medication adherence1 and blood pressure =)acihasanogMlu1 R.et al.3722>. )ealth education has the potential to help indi0iduals maintain and impro0e their health1 pre0ent disease1 and reduce healthDrelated ris beha0iors = Jann1 L. et al3775>.)ealth education for hypertensi0e patients is rele0ant for success in controlling blood pressure =Aparecida1M.et al.377?>. *mpo!ering clients to ta e control of their health and to ma e decisions about their health are regarded as fundamental aspects of health education =Leung1 C.M.1 et.al.377:>. )ealth education1 the most commonly e0aluated inter0ention1 !as usually a necessary component for patient selfDmanagement1 family support1 and impro0ed B+ monitoring =Lu1 F. et al.3723>. *ducational acti0ities !ere designed to emphasiCe the mobiliCation of helpful resources surrounding the patient1 including help from other health professionals and pro0en public health inter0entions =)udmon1J. et al.3722>. )ealth a!areness is preceded by full access to information and education as a !ay to ma e indi0iduals and communities capable of greater control o0er their o!n !ellness1 !hich is an essential goal in public health1 especially on the primary health care le0el =Ribeiro1A.1et al.3722>. +oor health literacy and unhealthy lifestyles1 compounded by lac of a!areness of hypertension1 are part of the cause. =Gafar1T.et al.3778>. "n +enderEs health promotion model1 education enables the patient to understand hypertension better1 its complications1 effects of regular medication adherence on the control of blood pressure and the role of their o!n beha0ior in blood pressure control =$dusola1A.$.et al.3722>. *ducational inter0entions in hypertensi0e patients are efficacious in hypertension management and can ma e a ma-or contribution to impro0ement in the patientsE healthy lifestyle beha0iors1 medication adherence1 and blood pressure =)acihasanogMlu1 R.et al.3722>. Training of hypertensi0e patients has a profound effect on blood pressure control and it moti0ates patients to change lifestyle ris factors1 namely to lose !eight1 and increases the patients Nphysical acti0ity le0el1 thereby decreasing the patientsE blood pressure =(leischmann1*.) et al1 377;>. )ealth no!ledge1 attitude and beha0ior rele0ant to pre0ention and control of hypertension and C/% at the population le0els !as remar ably enhanced or impro0ed through health education or promotion.=Chen1G.et al.3775>. )ypertensi0e indi0iduals !ho are educated about the importance of their medication and about the conse@uences of not ta ing the prescribed drug dosage sho! better compliance !ith prescribed drug regimen than those !ho are not thus educated. =Saounatsou1M.et al.3722>. +opular education promotes community empo!erment by increasing indi0idualsE and communitiesE a!areness of their capacity and pro0iding a frame!or and strategies through !hich participants can identify and resol0e problems.=<iggins1#.et al.3779>.

Health Education: Its Effectiveness

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This !ill in effect impro0e the general lifestyle of the population as most participants had great health concern =Jofi1 G.3722>. There are many factors that affect patientsE perspecti0es on health education. These include the scarcity of continuity of care1 recei0ing conflicting health education messages1 access to the facility in terms of transport1 accessibility of information in terms of language and communication !ith health professionals as !ell as cultural beliefs. =+ar er et al. 3723>The nurseDled empo!ermentDbased inter0ention has the potential to impro0e selfDmanagement beha0ior1 the le0el of empo!erment1 and metabolic syndrome ris factors in hypertensi0e patients =Chan1A.J.et al.3723>. A multifactorial inter0ention including patient education impro0ed blood pressure control compared !ith pro0ider education alone.=Roumie1C.et al.3776>. Ad0ice is one of many !ays to help hypertensi0e indi0iduals to initiate and maintain healthy lifestyles.=Jim1M.et al.3727>. Lifestyle modifications such as healthy eating and increased physical acti0ity are an integral part of impro0ing blood pressure control =Rigsby1B.3722>. )ealthy lifestyle suggestions or modifications included smo ing cessation1 moderate drin ing1 physical acti0ity1 a0oiding o0er!eight and obesity1 and nutritional instructions emphasiCing a reduction in salt and fat inta e. =Goanna Briggs "nstitute.3727>. The researchers hypothesiCed that the greater health education and a!areness especially on management of hypertension1 the greater the chance of the patient to manage hypertension thereby decreasing blood pressure. Hypertension )ypertension is a modern dayEs epidemic and it is becoming a public health emergency !orld!ide1=Singh1S.et al.3723>.The documented association bet!een hypertension and impaired cogniti0e function may pro0ide additional incenti0e to treat aging populations. )ealth beha0ior models illustrate !hy hypertension and other chronic diseases cannot be controlled solely through the clinicianOpatient relationship =Truncali1 A. et al 3727>. %ifferent factors ha0e been associated !ith an inade@uate control of hypertension I+atientDrelated factorsI therapeutic adhesion1 age1 lifestyle =alcoholism1 sedentarism>1 bodyDmass inde.1 number of 0isits to the doctor during the past year1 the understanding of their condition1 among others.=(ernandeC1R.et al.3778> and patient reticence about reporting symptoms from medication side effects during pro0ider 0isits is significantly correlated to ameliorable and pre0entable ad0erse drug e0ents1 $0erDtheD counter =$TC> medications1 supplements1 and alcohol all interact !ith antihypertensi0e and contribute to poor B+ control.=#eafsey1+.G.et al.3727>.These factors can be influenced by other factors1 such as patient interactions !ith clinicians1 commercial influences1 and patient participation in treatment decisions =Roumie1 C. et al 3776>. Ade@uate control of blood pressure in patients !ith hypertension is of paramount importance in pre0enting the occurrence of cardio0ascular complications =<ang1L.et al.3776>. Measuring blood pressure and encouraging lifestyle changes !ere fre@uently

Health Education: Its Effectiveness 1! | P a g e deli0ered ser0ices and are important in blood pressure management.=Monay1/.et al.3727>.Lifestyle modifications such as healthy eating and increased physical acti0ity are an integral part of impro0ing blood pressure control=Rigsby1B.3722>. )ypertension1 as an antecedent to multiple forms of morbidity1 is of central importance to nursing as nurses and ad0anced practice nurses can ha0e a direct impact on pre0ention1 early detection1 and treatment for those !ith hypertension.=Luc y1%.et al.3722>. "n a rural area1 a comprehensi0e programme of hypertension management at primary healthcare le0el can be implemented successfully and benefit se0ere hypertensi0e =#guyen1 '.#.et1al.3727>. There is a gro!ing body of e0idence sho!ing that hypertension is more pre0alent !ith increasing urbaniCation1 !hich has led to sedentarism1 less healthy diets1 increased alcohol consumption and higher body !eights. =+ires1G. et al.372?>. Many patients belie0e that hypertension is intermittent and can be best treated !ith nonDpharmacological therapies such as stress relief or home remedies =Bennett1).1 Laird1J.1 et al.3778>. )ypertension remains a ma-or public health problem and contributing to e.cess morbidity1 mortality1 and indirect and direct healthcare costs =%eSimone1 M.*.et al.3779>. The pre0alence and under treatment of hypertension coupled !ith its potentially lifeD threatening conse@uences underscore the urgent need to strengthen clinical efforts to manage hypertension and help patients achie0e and sustain target measures. =(ernandeC1S.et al.3779>. +atientsE poor medication adherence1 poor beliefs about )T# and its treatment and the failure of health care pro0iders to initiate or intensify drug therapy for patients !ere barriers to B+ control.=Fhao1P. et al. 372?>. )esearch Simulacrum/ )esearch #aradigm HEALTH E&U!ATIO" H0#E)TE"SIO"

(ETHO&S )esearch &esign This study uses e.perimental design !hich consists of :7 respondents1 the half of the group !ill be the inter0ention group and the other half !ill be the control group. "n inter0ention group1 they !ill be gi0en a health education about management1pre0ention and complications of hypertension. And a pretest and post test design !ill be used to determine the difference in their blood pressure. Locale of the Study

Health Education: Its Effectiveness 11 | P a g e Control group Community people diagnosed !ith hypertension and also !ith maintenance medication The location is !ithin the 0icinity of Tuguegarao City. *.perimental group Community people diagnosed !ith hypertension and !ith maintenance medication The location is !ithin the 0icinity of Tuguegarao City.

Su-1ects/#articipants +articipants for this study !ere the patients !ho are diagnosed !ith )ypertension that reside !ithin the locale. The samples !ill be composed of :7 )ypertensi0e patients. The indi0iduals !ho !ill be @ualified for this study !ill be must first inter0ie! for the profile data. 3: of the group !ill be the e.perimental group and !ill be gi0en a health education on the management of hypertension and 3: !ill be the control group for the repeated monitoring of Blood pressure. All respondents must be able to communicate easily and cooperate !ith researchers and !ho did not ha0e any disease or condition =e.g. diabetes mellitus1 heart failure1 renal impairment>. /aluing the clientEs autonomy1 the respondents must indulge in the study on their o!n !ill not force nor bribed. 2*hat3s the inclusion criteria.4 &ata 'athering Instrument 2Including &ata (easures4 A sphygmomanometer !ill be used to measure blood pressure !hile the indi0idual !as seated and resting for fi0e minutes !ith the arm held at heart le0el. And prior to the ta ing of blood pressure the patient should not ha0e drun coffee or tea and alcoholic be0erages1 smo e cigarette or tobacco1 and other factors that may alter the result of the blood pressure. The first measurement !as ta en in any part of the arm and !ill be recorded. &ata 'athering #rocedure #re5 E6perimental Stage

Health Education: Its Effectiveness 12 | P a g e The community must permit the study to ta e place and Barangay officilas1 and concerned citiCens !ill be properly notified. The indi0iduals !ho are @ualified for the study !ill be inter0ie!ed first for their history and profile for baseline data. The researchers !ill measure their blood pressure using sphygmomanometer. E6perimental Stage There !ere t!o group of respondents1 the control group and e.perimental group. "n the e.perimental group1 each patient !as met through home 0isits and !ill be gi0en health education about the different management of hypertension. Their blood pressure !ere recorded for baseline =+retest>. And for the control group1 they !ere not health educated but initial blood pressure !ere ta en for baseline. (ollo! up 0isits !ere done and blood pressure also !ere ta en for both groups. =post Otest>. A health education program !as to be done before the follo! up 0isits for the inter0ention group. There !ill be indi0idualiCed education1 by gi0ing pamphlet and the content of this material !as e.plained and discussed to participants in their o!n dialect for better understanding. The pamphlet material !as translated in tagalog language and the conte.t !as outlined regarding the topic of hypertension =!hat is hypertension1 its causes1 complications1 and signs and symptoms>1 dietary approaches to stop hypertension =%AS)>1 importance of restriction of alcohol consumption1 significance of !eight loss and benefits of ha0ing physical acti0ity 1 and the effects and side effects of hypertensi0e medications. #ost5 E6perimental Stage &ata Analyses (re@uency counting and percentage !ill be used to describe the profile of the respondents. TDtest for "ndependent sample !ill be applied to determine the difference in the decrease of blood pressure before and after gi0ing of health education on the inter0ention group. )ESULTS &IS!USSIO" !O"!LUSIO" )E!O((E"&ATIO"S/LI(ITATIO"S

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