Exploring factors associated with hypertension self‐care in primary care: The role of nurse education levels and patient‐related factors

• Published in: International journal of nursing practice Vol. 30; no. 5; p. e13208
• Main Authors: Suwanno, Jom, Phonphet, Chennet, Mayurapak, Chidchanog, Ninla‐aesong, Putrada, Thaimwong, Ladda
• Format: Journal Article
• Language: English
• Published: Richmond Wiley Subscription Services, Inc 01.10.2024
• Subjects: Adequacy; Aging; Attribution; Clinical outcomes; Clinical research; Clinical training; Clinical trials; Computerized medical records; Health education; Health records; Higher education; Hypertension; Nurses; Obesity; Observational studies; Overweight; Patients; Primary care; Self care; Sociodemographics
• ISSN: 1322-7114; 1440-172X; 1440-172X
• DOI: 10.1111/ijn.13208

Abstract Aim To explore the association between nurse education levels and patient‐related factors with hypertension self‐care. Background Although self‐care development is recognized as a healthcare provider–patient encounter, the attribution of nurse education level to hypertension self‐care is not well addressed. Design A cross‐sectional study. Methods Hypertensive patients from 15 primary care facilities were sampled, and self‐care was assessed using the Self‐Care of Hypertension Inventory version 2.0, with standardized scores ≥70 indicating adequate self‐care. Data on patient‐related factors were obtained from electronic health records, self‐reports and laboratory tests, while nurse education levels were categorized as standard (baccalaureate‐prepared) or higher (post‐baccalaureate specialty). Results A total of 1493 participants were included in this study, with a median age of 66 years and 77.7% being female. Approximately 10% of participants had adequate self‐care, and 66% received care from higher educated nurses. The study showed the relation between nurse education levels and the self‐care of the patients. Adequate hypertension self‐care was significantly associated with higher educated nurse providers and patient‐related factors, including intermediate to higher education, non‐overweight/obese and the absence of age‐related comorbidities. Conclusions Hypertensive patients who had been provided care by higher educated nurses and their favourable sociodemographic, lower cardiometabolic risk and no concomitant disease were more likely to demonstrate adequate self‐care. Summary statement What is already known about this topic? Improving hypertension self‐care requires attention to both patient‐related and healthcare‐related factors. Clinical trial studies have established the effectiveness of nurse‐enhanced hypertension self‐care. There is currently a lack of evidence regarding the impact of nurse‐related factors, such as nurse education level, on hypertension outcomes in routine primary care practice and observational studies. What this paper adds? We confirmed that patient‐related factors, such as having intermediate to higher education, being non‐overweight/obese and not having aging‐related comorbidities, were associated with better hypertension self‐care. Patients who received care from higher educated nurses demonstrated better hypertension self‐care. The implications of this paper: To enhance hypertension self‐care, clinicians should prioritize individuals who have low levels of education, are overweight/obese and have aging‐related comorbidities. Preparing nurses with advanced competence through higher education could be a viable approach to improving hypertension outcomes in primary care settings.