Levels and Predictors of Self-Care Among Patients with Hypertension in Pakistan

Abstract

Khairulnissa Ajani,1 Ambreen Gowani,1 Raisa Gul,1,2 Pammla Petrucka3 1School of Nursing, Aga Khan University, Karachi, Pakistan; 2School of Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan; 3College of Nursing, University of Saskatchewan, Saskatoon, CanadaCorrespondence: Khairulnissa AjaniAga Khan University School of Nursing, P.O. Box 3500, Stadium Road, Karachi, PakistanEmail [email protected]: Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan.Methods: This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban cosmopolitan setting within Karachi Pakistan. Four hundred and two patients were screened using the H-SCALE questionnaire, while socio-demographic predictors of self-care and level of knowledge of hypertension were identified using a study-specific checklist. Self-care was assessed against six clinical domains including medication adherence, diet, weight management, physical activity, and abstinence from alcohol.Results: Participants were recruited from the two largest tertiary care hospitals in Karachi. Good knowledge about hypertension, including its causes, management, and complications was reported by 4.47% of the participants. Highest levels of self-care adherence were found for abstinence from alcohol (100%), smoking cessation (83.33%), and medication compliance (71.89%), whereas lowest levels were found for diet (27.11%), and physical activity (24.88%). In terms of predictors for self-care, age, male gender, and self-checking of blood pressure at home, followed by the level of education were the most common predictors for each self-care behavior in the given population.Conclusion: Overall knowledge of self-care for hypertension is sub-optimal among hypertensive patients in Pakistan which is reflected in their behaviors. There is a need to introduce healthcare educational programs in Pakistan which can improve self-care behaviors of hypertensive individuals and potentially reduce the prevalence of associated cardiovascular diseases and its complications.Keywords: hypertension, self-care management, cross-sectional study, Pakistan

Keywords

• hypertension
• self -care management
• cross-sectional study
• pakistan