Ajani Khairulnissa, Gowani Ambreen, Gul Raisa, Petrucka Pammla
School of Nursing, Aga Khan University, Karachi, Pakistan.
School of Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
Int J Gen Med. 2021 Mar 25;14:1023-1032. doi: 10.2147/IJGM.S297770. eCollection 2021.
Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan.
This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban cosmopolitan setting within Karachi Pakistan. Four hundred and two patients were screened using the H-SCALE questionnaire, while socio-demographic predictors of self-care and level of knowledge of hypertension were identified using a study-specific checklist. Self-care was assessed against six clinical domains including medication adherence, diet, weight management, physical activity, and abstinence from alcohol.
Participants were recruited from the two largest tertiary care hospitals in Karachi. Good knowledge about hypertension, including its causes, management, and complications was reported by 4.47% of the participants. Highest levels of self-care adherence were found for abstinence from alcohol (100%), smoking cessation (83.33%), and medication compliance (71.89%), whereas lowest levels were found for diet (27.11%), and physical activity (24.88%). In terms of predictors for self-care, age, male gender, and self-checking of blood pressure at home, followed by the level of education were the most common predictors for each self-care behavior in the given population.
Overall knowledge of self-care for hypertension is sub-optimal among hypertensive patients in Pakistan which is reflected in their behaviors. There is a need to introduce healthcare educational programs in Pakistan which can improve self-care behaviors of hypertensive individuals and potentially reduce the prevalence of associated cardiovascular diseases and its complications.
在全球范围内，高血压是主要的非传染性疾病，也是心血管疾病最强的预测因素。为了减轻和预防与高血压相关的并发症，自我护理行为的调整已被证明至关重要。在本研究中，我们根据美国预防、检测、评估与治疗高血压联合委员会第七次报告中规定的六个临床自我护理水平，对巴基斯坦卡拉奇特定样本的高血压患者进行了研究，并分析了这些水平的预测因素。
本研究报告了一项序贯混合方法研究的横断面调查，该研究评估了居住在巴基斯坦卡拉奇一个国际化城市环境中的高血压患者的自我护理水平。使用H-SCALE问卷对402名患者进行了筛查，同时使用特定研究清单确定自我护理的社会人口学预测因素和高血压知识水平。针对六个临床领域评估自我护理情况，包括药物依从性、饮食、体重管理、体育活动和戒酒。
参与者来自卡拉奇两家最大的三级护理医院。4.47%的参与者报告对高血压及其病因、管理和并发症有良好的了解。自我护理依从性最高的是戒酒（100%）、戒烟（83.33%）和药物依从性（71.89%），而最低的是饮食（27.11%）和体育活动（24.88%）。在自我护理的预测因素方面，年龄、男性性别、在家自测血压以及教育水平是该特定人群中每种自我护理行为最常见的预测因素。
巴基斯坦高血压患者对高血压自我护理的总体知识水平欠佳，这在他们的行为中有所体现。巴基斯坦需要引入医疗保健教育项目，以改善高血压患者的自我护理行为，并有可能降低相关心血管疾病及其并发症的患病率。
