School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
BMJ Open. 2023 Jun 20;13(6):e070244. doi: 10.1136/bmjopen-2022-070244.
To determine the prevalence and associated factors of self-care behaviours among people with hypertension in the Kathmandu district of Nepal.
Cross-sectional study.
Municipalities of Kathmandu district, Nepal.
We enrolled 375 adults aged ≥18 years with a minimum 1-year duration of hypertension using multistage sampling.
We used the Hypertension Self-care Activity Level Effects to assess self-care behaviours and collected data through face-to-face interviews. We conducted univariate and multivariable logistic regression analyses to determine the factors associated with self-care behaviours. The results were summarised as crude and adjusted ORs (AORs) with 95% CIs.
The adherence to antihypertensive medication, Dietary Approach to Stop Hypertension (DASH) diet, physical activity, weight management, alcohol moderation, and non-smoking were 61.3%, 9.3%, 59.2%, 14.1%, 90.9%, and 72.8%, respectively. Secondary or higher education (AOR: 4.42, 95% CI: 1.11 to 17.62), Brahmin and Chhetri ethnic groups (AOR: 3.30, 95% CI: 1.26 to 8.59) and good to very good perceived health (AOR: 3.96, 95% CI: 1.60 to 9.79) were positively associated with DASH diet adherence. Males (AOR: 2.05, 95% CI: 1.19 to 3.55) had higher odds of physical activity. Brahmin and Chhetri ethnic groups (AOR: 3.44, 95% CI: 1.63 to 7.26) and secondary or higher education (AOR: 4.70, 95% CI: 1.62 to 13.63) were correlates of weight management. Secondary or higher education (AOR: 2.47, 95% CI: 1.16 to 5.29), body mass index ≥25 kg/m (AOR: 1.83, 95% CI: 1.04 to 3.22) and income above the poverty line (AOR: 2.24, 95% CI: 1.08 to 4.63) were positively associated with non-smoking. Furthermore, Brahmin and Chhetri ethnic groups (AOR: 4.51, 95% CI: 1.64 to 12.40), males (AOR: 0.17, 95% CI: 0.06 to 0.50) and primary education (AOR: 0.26, 95% CI: 0.08 to 0.85) were associated with alcohol moderation.
The adherence to the DASH diet and weight management was particularly low. Healthcare providers and policymakers should focus on improving self-care by designing simple and affordable interventions for all patients with hypertension.
在尼泊尔加德满都地区确定高血压患者自我护理行为的流行情况及其相关因素。
横断面研究。
尼泊尔加德满都市区的直辖市。
我们采用多阶段抽样方法，纳入了 375 名年龄≥18 岁且高血压持续时间至少 1 年的成年人。
我们使用高血压自我护理活动水平效应量表评估自我护理行为，并通过面对面访谈收集数据。我们进行了单变量和多变量逻辑回归分析，以确定与自我护理行为相关的因素。结果以粗比值比（OR）和调整比值比（AOR）及其 95%置信区间（CI）表示。
高血压药物治疗、得舒饮食（DASH）、体力活动、体重管理、酒精适度和不吸烟的依从率分别为 61.3%、9.3%、59.2%、14.1%、90.9%和 72.8%。接受过中等或高等教育（AOR：4.42，95%CI：1.11 至 17.62）、婆罗门和切特里种姓（AOR：3.30，95%CI：1.26 至 8.59）和自我感知健康状况良好至非常好（AOR：3.96，95%CI：1.60 至 9.79）与 DASH 饮食的依从性呈正相关。男性（AOR：2.05，95%CI：1.19 至 3.55）体力活动的可能性更高。婆罗门和切特里种姓（AOR：3.44，95%CI：1.63 至 7.26）和中等或高等教育（AOR：4.70，95%CI：1.62 至 13.63）与体重管理相关。接受过中等或高等教育（AOR：2.47，95%CI：1.16 至 5.29）、体重指数≥25kg/m2（AOR：1.83，95%CI：1.04 至 3.22）和收入超过贫困线（AOR：2.24，95%CI：1.08 至 4.63）与不吸烟呈正相关。此外，婆罗门和切特里种姓（AOR：4.51，95%CI：1.64 至 12.40）、男性（AOR：0.17，95%CI：0.06 至 0.50）和小学教育（AOR：0.26，95%CI：0.08 至 0.85）与饮酒适度有关。
DASH 饮食和体重管理的依从性尤其低。医疗保健提供者和政策制定者应通过为所有高血压患者设计简单且负担得起的干预措施，重点改善自我护理。
