Adherence to lifestyle modifications and its associated factors in hypertensive patients
Amrita Dhakal, Takma K.C., Mahesh Neupane
Abstract
AIMS AND OBJECTIVES: To find out the adherence to lifestyle modifications and its associated factors in hypertensive patients. BACKGROUND: Low adherence to lifestyle modifications leads to poor therapeutic effectiveness, decreased quality of life, poor health outcomes and increased health care costs. Various factors play an important role in determining the adherence level varying among the different cultural, social and national contexts. DESIGN: A cross-sectional analytical research design was carried out. METHODS: Information from 264 patients with hypertension was collected at the Outpatient Department of Manmohan Cardiothoracic, Vascular and Transplant Center, Kathmandu. A standard tool of WHO Steps Survey Questionnaire and Hypertension Fact Questionnaire was used for data collection. Chi-square test and binary logistic regression were used for analysis using SPSS 16. RESULT: The overall adherence to lifestyle modifications was determined as 20.8% with the adherence rate being lowest up to 30.3% for adequate intake of fruits and vegetables. Likewise, 52.5% of patients had average knowledge of hypertension management. Age (p = .021), education (p = .001), occupation(p = .026), household income (p = .007) and family history(p = .011) had statistically significant association with the level of adherence. Younger age (AOR = 1.85 CI = 0.79-4.33) remained as the independent predictor of high adherence to lifestyle modifications. The study followed the STROBE checklist for reporting cross-sectional study. CONCLUSION: This study identified that adherence to lifestyle modification is low in older patients. More effective lifestyle modification counselling and educational approaches focusing on the older age groups as well as considering educational level, occupation, family income and family history of hypertension are required to improve their level of adherence. RELEVANCE TO CLINICAL PRACTICE: Nurses are frequently acquainted with the hypertensive patients in hospitals where they need to provide health teaching on lifestyle modifications. This study identifies the factors that need to be considered while counselling the hypertensive patients.