Self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City administration, Eastern Ethiopia: A multi-center cross-sectional study

Abstract

IntroductionHypertension is a silent killer that causes serious health issues in all parts of the world. Hypertension is a risk factor for cardiovascular disease, stroke, and kidney disease. Self-care practices have been identified as an important component of hypertension management. Despite the government's commitment and the interventions of various stakeholders, the burden of hypertension and its sequel remain unabated. A recent study showed that hypertension self-care practices play a vital role in controlling and managing high blood pressure, even though there is poor self-practice among hypertensive patients in Ethiopia. Therefore, this study assessed the level of self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City Administration, Eastern Ethiopia.MethodsHospital-based cross-sectional study was conducted from June 15 to July 15/2021 among 415 adult hypertensive patients on follow-up. The participants were selected using systematic sampling. Hypertension Self-Care Activity Level Effects (H-SCALE) was used to collect data through face-to-face interviews. The SPSS version 24 was used for analysis. Logistic regression analyses were done to determine the association between the outcome and independent variables. For multivariate logistic regression models, variables having a P < 0.25 during bivariate analysis were candidates. The strength of the association was estimated using AOR and 95% CI. The level of statistical significance was declared at a p < 0.05.ResultsThis study revealed that 52% (95% CI, 48.2–58%) had good level of self-care practices. Formal education (AOR = 3.45, 95% CI: 2.1–4.85), good knowledge about hypertension (AOR = 1.5, 95% CI: 1.17–2.1) 1.5, abstain from chewing khat (AOR = 2.01, 95% CI: 1.44–3.94), strong social support (AOR= 1.9, 95% CI: 1.16–3.1), and absence of depression (AOR = 2.03, 95% CI: 1.43–3.92) were statistically associated with a good level of self-care practices.ConclusionsThis study pointed out that about half of the participants had a good level of self-care practices. Formal education, good knowledge about hypertension, abstaining from khat chewing, good social support, and absence of depression showed associations with a good level of self-care practices. Therefore, public health interventions on hypertension self-care practices, and strengthening non-communicable diseases control programs are vital. Moreover, the provision of targeted education to patients can improve disease knowledge and self-care practices.

Unveiling the Nexus: Depressive Symptoms and Medication Adherence in Hypertensive Patients’ Self-care: A Systematic Review

“…The main characteristics of the included studies are presented in Table 1 included. Of the 18 studies published from 2002 to 2022, nine were conducted in the USA ( 32 – 40 ), two in Korea ( 41 , 42 ), and one study each was conducted in Mexico ( 43 ), Pakistan ( 44 ), China ( 45 ), Ethiopia ( 46 ), Ghana ( 47 ), Germany ( 48 ), and the UK ( 49 ). The predominant study design was cross-sectional, present in the majority of studies ( 32 , 35 , 39 – 47 , 49 ), while two were RCTs ( 34 , 38 ), two were cohort studies ( 33 , 36 ), one involved baseline cross-sectional analyses derived from an RCT ( 37 ), and one was a retrospective study ( 48 ).…”

“…In 12 studies ( 32 , 35 – 39 , 41 , 43 – 45 , 47 , 49 ) the majority of the participants were females, one study reported an equal gender distribution ( 48 ) and one study exclusively involved male participants ( 34 ). Fourteen studies ( 32 – 39 , 41 – 46 ) provided data on mean age of the participants, which varied from 41.7 ( 34 ) to 75.0 years ( 36 ).…”

“…A total of 10 different instruments were used to evaluate depressive symptoms (Table 1). Specifically, the Patient Health Questionnaire-9 items (PQ9) was used in two studies ( 37 , 46 ), the Geriatric Depression Scale (GDS) in two ( 32 , 42 ), the Beck Depression Inventory (BDI) in two ( 33 , 39 ), the Center for Epidemiological Studies Depression Scale (CES-D) in five ( 34 , 36 , 38 , 41 , 49 ), the Hospital Anxiety and Depression Scale (HADS) in two ( 43 , 45 ), and one study each utilized the Kim Depression Scale for Korean Americans (KDSKA) ( 35 ), the DSM-IV Composite International Diagnostic Interview (DIA-X-CIDI) ( 48 ), the Depression Anxiety Stress Scale (DASS) ( 47 ), the Depression Symptom Inventory ( 40 ), and the Aga Khan University Anxiety and Depression Scale (AKU-ADS) ( 44 ).…”

“…Regarding the measurement of medication adherence self-care, 12 different instruments were employed (Table 1), including the Hypertension Self-Care Activity Level Effects (H-scale) ( 46 ), Beliefs about Medicines Questionnaire (BMQ) ( 32 ), Hill Bone Compliance to High Blood Pressure Therapy Scale ( 34 , 35 , 39 ), Medication Adherence Self-Efficacy Scale-Short Form (MMAS) ( 36 , 42 , 44 , 47 ), Reported Adherence to Medications scale (RAM) ( 49 ), Medication Adherence Self-Efficacy Scale Self-care (MASES) ( 38 ), Behavior Questionnaire ( 41 ) and Blood Pressure Self-Care scale ( 32 ). Five studies ( 37 , 40 , 43 , 45 , 48 ) utilized self-report questionnaires, and one study ( 33 ) involved enrollment and follow-up visits.…”

Self-care practices and associated factors among hypertensive patients attending at public hospital in Hawassa city, Sidama region, Ethiopia, 2023: Facility-based cross-sectional study

“…To avoid having high blood pressure the practice of self-care for hypertension is crucial. Self-care is the intentional, proactive decision and capacity of individuals, families, and communities to actively participate in health promotion and protection, disease prevention, and illness and disability management, either with or without the assistance of a healthcare provider (4). Additionally, by enhancing the self-care behaviors of hypertensive patients, the resulting morbidities, life-threatening complications, and hypertension-related deaths can be decreased (11).…”