Afshari Maryam, Gholamaliee Behzad, Kangavari Mehdi, Partoi Naser, Afshari Masomeh, Nazari Mohsen
Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Health Center of Tuyserkan, Hamadan University of Medical Sciences, Hamadan, Iran.
Community Health Equity Res Policy. 2022 Oct;43(1):21-29. doi: 10.1177/0272684X211004951. Epub 2021 Mar 29.
High blood pressure effects on patients' life. One of the problems in controlling blood pressure is lack of self-care. As a primary form of care, self-care is under patients' control and the patient's belief plays an important role in self-care behaviors. Using the Health Belief Model, this study aimed to determine the effect of educational program on self-care behaviors of rural patients afflicted with hypertension in Toyserkan city.
This study was a quasi-experimental research. It studied 100 hypertensive patients in four health centers in rural areas in Toyserkan city in 2019. The samples were simple random sampling among those people referred to the four health centers. Participants in the intervention group attended three training sessions, but the control group did not take part in any training program. The assessment was conducted in both groups before and after the intervention through personal interviews with patients. The questionnaire including the Health Belief Model and self-care behavior constructs was administered.
Perceived susceptibility, perceived severity, self-efficacy and self-care behavior constructs did not have significant statistical differences in terms of mean scores before intervention between the two groups, but after intervention, there were statistically significant differences between the two groups. Examining the model factor in predicting self-care in the intervention group showed that the perceived severity and self-efficacy constructs had the highest predictive power.
The results showed that planning and intervention based on HBM, as the models that were used in education and health promotion could be effective in achieving better performance and attitude of patients suffering from hypertension and their self-care. Also, special mention is needed to health care providers to improve self-care training in patients with high blood pressure.
高血压影响患者生活。控制血压的问题之一是缺乏自我护理。作为护理的主要形式，自我护理由患者掌控，患者的信念在自我护理行为中起着重要作用。本研究采用健康信念模型，旨在确定教育项目对托伊塞尔坎市农村高血压患者自我护理行为的影响。
本研究为准实验研究。2019年，对托伊塞尔坎市农村地区四个健康中心的100名高血压患者进行了研究。样本是从转诊到这四个健康中心的人群中简单随机抽取的。干预组的参与者参加了三次培训课程，而对照组未参加任何培训项目。通过与患者进行个人访谈，在干预前后对两组进行评估。采用了包括健康信念模型和自我护理行为结构的问卷。
在干预前，两组在感知易感性、感知严重性、自我效能感和自我护理行为结构的平均得分方面没有显著统计学差异，但干预后，两组之间存在统计学显著差异。对干预组预测自我护理的模型因素进行检验表明，感知严重性和自我效能感结构具有最高的预测能力。
结果表明，基于健康信念模型进行规划和干预，作为教育和健康促进中使用的模型，可能有助于高血压患者获得更好的表现和态度以及自我护理。此外，需要特别提醒医疗保健提供者改善高血压患者的自我护理培训。
