A Blood Pressure Management Protocol Based on the Transtheoretical Model: Designing and Effectiveness Evaluation

Abstract

Background. Hypertension is one of the most important public health challenges in the world, and self-care is an essential part of hypertension treatment. The present study aimed to investigate the effectiveness of a blood pressure management protocol based on the transtheoretical model on improving self-care, self-efficacy, and health-related quality of life in patients with hypertension. Methods. This mixed-methods study consisted of two stages that were conducted in Tabriz Health centers in 2022-2023. The first stage was concerned with designing a blood pressure management protocol based on the transtheoretical model. The second stage was centered on a randomized controlled trial (RCT) to evaluate the effectiveness of the designed protocol on increasing self-care, self-efficacy, and health-related quality of life. Thus, 60 people with hypertension were included in the study and were randomly divided into two experimental and control groups. Data was collected via relevant questionnaires in the pre-test stage, immediately after the training (baseline), 2 months after the training in the post-test stage, and 4 months after the training in the follow-up stage. ANCOVA (repeated measures) statistical test was used to evaluate the effect of the intervention at different times. Results. In the patients of the experimental group, the designed protocol sustainably increased the dimensions of self-care over time. Also, this protocol was effective in increasing self-efficacy and health-related quality of life dimensions in the patients of the experimental group. This increase was not observed for the variables of self-efficacy, self-care, and quality of life in the control group. Conclusion. The greatest effect of training based on the transtheoretical model was on the patients’ self-care. Furthermore, with the passage of time in the presentation of education, the effect of the intervention decreased. Therefore, it can be concluded that holding short training sessions continuously to stabilize the behavior change of patients with hypertension is necessary.

Keywords

• hypertension
• transtheoretical model
• self-care
• self-efficacy
• quality of life