Effect of a goal attainment nursing program on self-management and blood pressure control in high-risk hypertensive patients in a primary care unit

Abstract

© 2019 Faculty of Medicine Siriraj Hospital, Mahidol University. Objective: To determine the effects of goal attainment in nursing programs among hypertensive patients who are at high-risk to cardiovascular disease. Methods: A quasi-experimental study was conducted in a primary care unit setting. Eligible participants included hypertensive patients aged 35 years and above with poorly controlled blood pressure and accompanying risk factors for cardiovascular disease. Seventy-eight participants were divided evenly into two groups via simple random sampling. The experimental group participated in a 10-week program consisting of small group education/demonstration sessions focused on goal setting and self-management behavior. These participants also received a follow-up phone call and text messages that served as reminders/reinforcements. The control group received routine care only, which included appropriately consultation with health care providers. Results: The proportion of participants who achieved optimal blood pressure control (SBP < 140 mmHg) in the experimental group (80.6%) was greater than the control group (44.1%) (p-value < 0.05). In addition, the systolic blood pressure of the experimental group (x 131.33 mmHg, S.D. 12.09) was significantly lower than that of the control group (x 142.96 mmHg, S.D. 15.77) (p-value < 0.05). The mean scores for self-management behavior were significantly higher in the experimental group (x 106.14, S.D. 14.43) than the control group (x 83.21, S.D. 8.17) (p-value < 0.05). Conclusion: The goal attainment nursing program targeting behavior modification through empowerment was effective in improving self-management behavior among hypertensive patients at high risk for cardiovascular disease. Thus, this program can be applied to patients with uncontrolled chronic diseases.