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https://tkuir.lib.tku.edu.tw/dspace/handle/987654321/122772
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| 题名: | A web-based self-care program to promote healthy lifestyles and control blood pressure in patients with primary hypertension: A randomized controlled trial |
| 作者: | Chen, Ting-Yu;Kao, Chi-Wen;Cheng, Shu-Meng;Chang, Yue-Cune |
| 关键词: | diet;hypertension;physical activity;self-care;self-efficacy;web-based;weight management |
| 日期: | 2022-06-08 |
| 上传时间: | 2022-06-14 12:10:19 (UTC+8) |
| 出版者: | Wiley |
| 摘要: | Background: Hypertension is a major risk factor for cardiovascular diseases, which
contributes to the worldwide mortality rate. Successful blood pressure control requires
adherence to medications and lifestyle modifications. However, motivating
patients with primary hypertension to change and sustain behaviors long-term
is
challenging. A web-based
self-care
program centered on self-efficacy
theory could
provide feedback for effective control of blood pressure.
Purpose: To examine the effect of a web-based
self-care
program for patients with
primary hypertension on cardiovascular risk-factors
(pulse pressure and lipids), self-efficacy,
and self-care
behaviors (medication adherence and lifestyle).
Design: A two-armed
randomized controlled trial with 3-month
and 6-month
follow-ups.
Setting and Participants: A total of 222 patients with primary hypertension were recruited
between February 2017 and August 2018 at a cardiology clinic of a medical
center in Taipei, Taiwan.
Methods: Eligible patients were randomized by permuted block randomization into
the intervention group (n = 111) and control group (n = 111). Patients in the intervention
group received a 6-month
web-based
self-care
program, based on the theory of
self-efficacy,
while patients in the control group received usual care. Baseline and outcome
measures (3 and 6 months) included self-efficacy,
evaluated with the Chinese
version of the 6-item
Self-Efficacy
for Managing Chronic Diseases (SEMC6), self-care,
using subscales of the Hypertension Self-Care
Activity Level Effects Scale (H-SCALE)
for lifestyle and medication adherence, and blood pressure and serum lipid data,
collected through web-based
self-reports
and chart review. Generalized estimating
equations evaluated the effects of the intervention.
Findings: At baseline, the control group had higher scores on the SEMC6, and lower
cholesterol (HDL) compared with the intervention group (t = −2.70, p < 0.05; and
t = 1.76, p < 0.05, respectively). Pulse pressure decreased significantly (β = −20.30,
95% CI −23.76, −16.83), and serum triglycerides and low-density
lipoprotein cholesterol
levels were significantly lower compared with controls at 6 months (all p < 0.001).
At 6 months, the intervention group had significantly higher mean scores for the
SEMC6 compared with the control group (β = 21.84, 95% confidence interval [CI]
19.25, 24.42) and H-SCALE
subscale for medication adherence, diet, weight management,
and physical activity compared with controls at 6 months (all, p < 0.001).
Conclusions and clinical relevance: The greatest benefit of this program was allowing
participants to immediately consult with the researchers about self-care
issues
via the website. Lifestyles vary from person to person; therefore, the individuality
of each participant was considered when providing feedback. We provided devising
interventions for participants that would increase their confidence in self-care
for
hypertension and ultimately achieve home blood pressure control. We encourage incorporating
this program into standard clinical care for patients with hypertension. |
| 關聯: | Journal of Nursing Scholarship |
| DOI: | 10.1111/jnu.12792 |
| 显示于类别: | [數學學系暨研究所] 期刊論文
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