Outcomes of a Self and Family Management Support Program in Balinese Older People with Uncontrolled Hypertension: A Quasi-Experimental Study

Abstract

Hypertension is highly prevalent and is difficult to control among older people worldwide, including in Indonesia, which is the setting for this study. Family involvement in self-management is crucial to controlling hypertension. This quasi-experimental study aimed to evaluate the effects of a self and family management support program for blood pressure control on health outcomes over time among Balinese older people with uncontrolled hypertension. One hundred and forty-one dyads of older people and their caregivers from three primary health centers in Mengwi, Bali province, Indonesia, were included in this study. The participants were categorized into the experimental group (n = 70) or control group (n = 71) using random assignment for their locations and then recruited with matching by age and gender. The experiment group received the Self and Family Management Support Program plus usual care for 12 weeks, while the control group received only usual care. Outcomes of the program were measured at baseline, 4 weeks, 8 weeks, and 12 weeks from baseline by the Hypertension Knowledge Scale, the Self-Management Behavior Questionnaire, the Hypertension Quality of Life Questionnaire, and sphygmomanometers. Data analysis utilized descriptive statistics, chi-square test, independent samples t-test, Mann-Whitney U test, Friedman test, and Wilcoxon signed-rank test. The findings indicated that the experimental group’s knowledge about hypertension, self-management behavior, systolic and diastolic blood pressure, and health-related quality of life significantly improved over time compared to the control group. These findings demonstrate the program’s benefits in improving blood pressure control in older people and enhancing their quality of life. Nurses can apply this intervention to coach older people and encourage family caregivers to support them. However, further testing should be conducted in various settings before the program is widely used.