Examining the Effect of the Training Program by Using the Health Belief Model in Performing Self-Care Behaviors of Rural Patients Having High Blood Pressure
Restricted accessResearch articleFirst published online October, 2022
Examining the Effect of the Training Program by Using the Health Belief Model in Performing Self-Care Behaviors of Rural Patients Having High Blood Pressure
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.
Methods
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.
Results
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.
Conclusion
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.
Makarov LM, Komolyatova VN, Kupriyanova OA, et al. National Russian guidelines on application of the methods of Holter monitoring in clinical practice. Russ J Cardiol 2014; 28: 6--71.
2.
NagayaTYoshidaHTakahashiH, et al. Resting heart rate and blood pressure, independent of each other, proportionally raise the risk for type-2 diabetes mellitus International. Int J Epidemiol2010; 39: 215–222.
3.
Sotodeh AslNNeshat-DustHKalantariM, et al. Comparison of effectiveness of two methods of hope therapy and drug therapy on the quality of life in the patients with essential hypertension. J Clin Psychol2010; 2: 27–34 (In Persian).
4.
Jekel JamesFKatz DavidL.Epidemiology, biostatistics and preventive medicine. 2nd ed. New York: Saunders Company, 2001.
5.
WangYWangQJ.The prevalence of pre hypertension and hypertension among adults according to the new joint national committee guidelines, new challenges of the old problem.Arch Int Med2004; 164: 2126–2134.
6.
DelavariAHorriNAlikhaniS, et al. Prevalence of hypertension in Iranian urban and rural populations aged over 20 years in 2004. J Mazandaran Univ Med Sci2007; 17: 79–86 (In Persian).
7.
CalhounDJonesDTextorS, et al. Resistant hypertension: diagnosis, evaluation, and treatment a scientific statement from the American Heart Association Professional Education Committee of the council for high blood pressure research.Hypertens J2008; 51: 1403–1419.
8.
HopmanWMHarrisonMBCooH, et al. Associations between chronic disease, age and physical and mental health status. Chronic Dis Can2009; 29: 108–116. PMID:19527569
9.
AhmadiAHasanzadehJRajaeifardA.To determine the relative factors on hypertension in Kohrang, Chaharmahal & Bakhtiari province. Iran J Epidemiol2008; 4: 19–25 (In Persian).
10.
CollierSR.Sex differences in the effects of aerobic and anaerobic exercise on blood pressure and arterial stiffness.Gend Med2008; 5: 115–123.
11.
DabghmaneshMHMostafaviHZareN.Blood pressure levels, risk factors and hypertension control status in adult. J Hormozghan Univ Med Sci2007; 11: 41–49 (In Persian).
12.
ChobanianAVBakrisGLBlackHR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. J Am Med Assoc2003; 289: 2560–2571.
13.
PickeringTG.Why are we doing so badly with the control of hypertension? Poor compliance is only part of the story.J Clin Hypertens2001; 3: 179–182.
14.
BaghianimoghadamMAivaziSMzloomySS, et al. Factors in relation with self- regulation of hypertension, based on the model of goal directed behavior in Yazd city.J Med Life2011; 15; 30–35.
15.
GargJPElliottWJFolkerA, et al. Resistant hypertension revisited: a comparison of two university-based cohorts. Am J Hypertens2005; 18: 619–626.
16.
ChodoshJ.Meta analysis: chronic disease self management programs for older adults. Ann Intern Med2005; 143: 412–427.
17.
Allah VerdipoorH. Passing through traditional health education towards theory oriented health education.Health Promot Educ J2005; 1: 75–79 (In Persian).
18.
BeckerMH.The health belief model and personal health behavior. Health Educ Monogr1974; 2: 324–473.
19.
GlanzKRimerBKViswanathK.Health behavior and health education: Theory, re-searches, and practice. 4th ed.San Francis-Co: John Wiley & Sons, 2008, pp. 24–40.
20.
KhazaeiZRajabfardiZHatamiH, et al. Factors associated with end stage renal disease among hemodialysis patients in Tuyserkan City in 2013. PSJ2014; 13: 33–41 (in Persian).
21.
SharafkhaniNKhorsandiMShamsiM, et al. The effect of an educational intervention program on the adoption of low back pain preventive behaviors in nurses: an application of the health belief model. Glob Spine J2016; 6: 29–34.
22.
PirzadehAMazaheriMA.The effect of education on women's practice based on the health belief model about pap smear test. Int J Prev Med2012; 3: 585.
23.
BaratiMDarabiDMoghimbeigiA, et al. Self-regulation behaviors of hypertension and related factors among hypertensive patients. J Fasa Univ Med Sci2011; 3: 60–66 (in Persian).
24.
LeeHHoPSWangWC, et al. Effectiveness of a health belief model intervention using a lay health advisor strategy on mouth self-examination and cancer screening in remote aboriginal communities: a randomized controlled trial.Patient Educ Counsel2019; 102: 2263–2269.
25.
JorvandRGhofranipourFHaeri MehriziA, et al. Evaluating the impact of HBM-based education on exercise among health care workers: the usage of mobile applications in Iran.BMC Public Health2020; 20: 546.
26.
KamranAAhariSSBiriaM, et al. Determinants of patient’s adherence to hypertension medications: application of health belief model among rural patients.Ann Med Health Sci Res2014; 4: 922–927.
27.
PanelliRGallagherLKearnsR.Access to rural health services: research as community action and policy critique.Soc Sci Med2006; 62: 1103–1114.
28.
HazaveheiMMMoeiniBDashtiS, et al. Assessing related factors with regulation of hypertension in rural hypertension patients in Hamadan: Applying Health Belief Model (HBM). Hamadan: Hamadan University of Medical Sciences, 2013 (in Persian).
29.
SamavatTNaderi AsiabarZ.National program for prevention and control hypertension. 1th ed. Tehran: Seda Press, 2002 (in Persian).
30.
ParkSChangSChungC.Effects of a cognitionemotion focused program to increase public participation in Papanicolaou smear screening. Pub Health Nurs2005; 22: 289–298.
31.
TwinSHolroydEFabrizioC, et al. Increasing knowledge about and uptake of cervical cancer screening in Hong Kong Chinese women over 40 years. Hong Kong Med J2007; 13: 116–120.
32.
SadeghiRMohseniMKhanjaniN.The effect of an educational intervention according to hygienic belief model in improving care and controlling among patients with hypertension. J Rafsanjan Univ Med Sci2014; 13: 383–394.
33.
SharifiradGHazaveheiSMohabiS.The effect of educational program based on health belief model on diabetic foot care. Int J Dia iDeve Countries2007; 27: 18–23.
34.
KamranASadeghieh AhariSBiriaM, et al. Determinants of patient's adherence to hypertension medications: application of health belief model among rural patients. Ann Med Health Sci Res2014; 4: 922–927.
35.
CherkzyAKochakiGBadelehM, et al. The effect of education on nurse’s staff knowledge attitude and practice toward hypertension. J Gorgan Univ Med Sci2007; 9: 43–48 (in Persian).
36.
DijkstraAOkkenVNiemeijerM, et al. Determinants of perceived severity of hypertension and drug-compliance in hypertensive patients.Cardiovasc Hematol Disord Drug Targets2008; 8: 179–184.
37.
SharifiradGEntezariMHKamranA, et al. The effectiveness of nutritional education on the knowledge of diabetic patients using the health belief model. J Res Med Sci2009; 14: 1–6.
38.
ChaoyangLUngerJSchusterD, et al. Youths' exposure to environmental tobacco smoke (ETS): associations with health beliefs and social pressure. Addict Behav2003; 28: 39–53.
39.
RimandoM.Perceived barriers to and facilitators of hypertension management among underserved African American older adults.Ethn Dis2015; 25: 329–336.
40.
SimsekogluOLajunenT.Social psychology of seat belt use: a comparison of theory of planned behavior and health belief model. Trans Res Part F Traffic Psycho Behav2008; 11: 181–191.
41.
AbediPHuanSKendaaM, et al. Effect of lifestyle changes on health belief model on cardiovascular risk factors in postmenopausal women in Ahwaz. Invest Sanity Sys2011; 7: 127–137 (in Persian).
42.
AvciIA.Factors associated with breast self examination practices and beliefs in female workers at a Muslim community.Eur J Oncol Nurs2008; 12: 127–133.
43.
Kauric-KleinZPetersRMYarandiHN.Self-efficacy and blood pressure self-care behaviors in patients on chronic hemodialysis.West J Nurs Res2017; 39: 886–905.
44.
SwaimRBarnerJBrownC.The relationship of calcium intake and exercise to osteoporosis health beliefs in post menopausal women. Res Soc Admin Pharm2008; 4: 153–163.
45.
SharifabadMTonekaboniR.Social support and self-care behaviors in diabetic patients referring to Yazd diabetes research center.Tabib-e-Shargh2008; 24: 43–49 (in Persian).
