Research in Community and Public Health Nursing (지역사회간호학회지)

Korean Academy of Community Health Nursing (한국지역사회간호학회)
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Practice-based Evidence for Health Promotion in Underserved Clients with Hypertension in Primary Health Care Settings

  • Hong, Woi-Hyun (College of Medicine, Chungbuk National University, Graduate School of Health Science Business Convergence, Medical Research Information Center)
  • Received : 2015.09.26
  • Accepted : 2015.12.18
  • Published : 2015.12.31
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Abstract

Purpose: The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. Methods: Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. Results: The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). Conclusion: This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.

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References

  1. Grover SA, Coupal L, Kaouache M, Lowensteyn I. Preventing cardiovascular disease among Canadians: What are the potential benefits of treating hypertension or dyslipidemia? Canadian Journal of Cardiology. 2007;23(6):467-473. http://dx.doi.org/10.1016/S0828-282X(07)70786-9
  2. Kokubo Y, Kamide K, Okamura T, Watanabe M, Higashiyama A, Kawanishi K, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease in a Japanese urban cohort: The Suita study. Hypertension. 2008;52(4):652-659. http://dx.doi.org/10.1161/HYPERTENSIONAHA.108.118273
  3. Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M, et al. Prevalence of hypertension in the US adult population: Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension. 1995;25(3): 305-313. http://dx.doi.org/10.1161/01.HYP.25.3.305
  4. Domino FJ. Improving adherence to treatment for hypertension. American Family Physician. 2005;71(11):2089-2090.
  5. Writing Group of the PREMIER Collaborative Research Group. Effects of comprehensive lifestyle modification on blood pressure control. The Journal of the American Medical Association. 2003;289(16):2083-2093. http://dx.doi.org/10.1001/jama.289.16.2131
  6. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206-1252. http://dx.doi.org/10.1161/01.HYP.0000107251.49515.c2
  7. U.S. Department of Health and Human Services. The seventh report of the joint national committe on prevention, detection, and treatment of high blood pressure. JNC 7. National high blood pressure education program. Washington, DC: National Institute of Health, National Heart, Lung, and Blood Institute. U.S. Department of Health and Human Services; 2003 December. Report No.: 03-5233.
  8. Svetkey LP, Erlinger TP, Vollmer WM, Feldstein A, Cooper LS, Appel LJ, et al. Effect of lifestyle modifications on blood pressure by race, sex, hypertension status, and age. Journal of Human Hypertension. 2005;19(1):21-31. http://dx.doi.org/10.1038/sj.jhh.1001770
  9. Svetkey LP, Simons-Morton DG, Proschan MA, Sacks FM, Conlin PR., Harsha D, et al. Effect of the dietary approaches to stop hypertension diet and reduced sodium intake on blood pressure control. Journal of Clinical Hypertension. 2004;6(7):373-381. http://dx.doi.org/10.1111/j.1524-6175.2004.03523.x
  10. Hong WH. Evidence-based nursing practice for health promotion in adults with hypertension in primary settings [dissertation]. [Wisconsin]: University of Wisconsin-Milwaukee; 2007. 226 p.
  11. American Diabetes Association. Hypertension management in adults with diabetes. Diabetes care. 2004;27:S65-S76. http://dx.doi.org/10.2337/diacare.27.2007.S65
  12. Malloch K, Porter-O'Grady T. A new age for practice: Creating the framework for evidence. In: Malloch K, editor. Introduction to evidence-based practice in nursing and health care 2nd ed. Sudbury, MA: Jones and Bartlett; 2010. p. 115-207.
  13. Lundeen SP, Friedbacher BE. The automated community health information system (ACHIS): A relational database application of the omaha system in community nursing centers. In: Grobe S, Pluter-Wenting E, editors. Nursing informatics: An international overview for nursing in a technological era. New York: Elsevier; 1994. p. 23-31.
  14. Martin KS. The omaha system: Application for community health nursing. Philadelphia: Saunders Company; 1992. 258 p.
  15. Martin KS. The omaha system: A key of practice, documentation, and information management. Philadelphia: Elsevier Saunders; 2005. 484 p.
  16. Martin KS, Norris J, Leak GK. Psychometric analysis of the problem rating scale for outcomes. Outcomes Management for Nursing Practice. 1999;3(1):20-25.
  17. Bosworth HB, Olsen MK, Gentry P, Orr M, Dudley T, McCant F, et al. Nurse administered telephone intervention for blood pressure control: a patient-tailored multifactorial intervention. Patient Education and Counseling. 2005;57(1):5-14. http://dx.doi.org/10.1016/j.pec.2004.03.011
  18. Bosworth HB, Olsen MK, Goldstein MK, Orr M, Dudley T, McCant F, et al. The veterans' study to improve the control of hypertension (V-STITCH): Design and methodology. Contemporary Clinical Trials. 2005;26(2):155-168. http://dx.doi.org/10.1016/j.cct.2004.12.006
  19. Hong WH, Lundeen SP. Using ACHIS to analyze nursing health promotion interventions for vulnerable populations in a community nursing center: A pilot study. Asian Nursing Research. 2009;3(3):130-138. http://dx.doi.org/10.1016/S1976-1317(09)60024-4
  20. Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: A cross-sectional study. BMJ Open. 2013;3 (8):e003423. http://dx.doi.org/10.1136/bmjopen-2013-003423
  21. Blaha MJ, Kusz KL, Drake W, Elasy TA. Hypertension prevalence awareness, treatment and control in North Nashville. Tennessee Medicine. 2006;99(4):35-37.
  22. Rubin HJ, Rubin IS. Qualitative interview. The auto hearing data. Thousand Oaks: Sage; 1995. 385 p.