@2024 Afarand., IRAN
ISSN: 2383-2150 Journal of Education and Community Health 2020;7(4):303-310
ISSN: 2383-2150 Journal of Education and Community Health 2020;7(4):303-310
The Role of Education in Promoting Self-Care Behaviors in Patients with Hypertension: An Application of the PRECEDE Model
ARTICLE INFO
Article Type
Original ResearchAuthors
Abedi M. (1)Borhani M. (*1)
Rahimzadeh H. (1)
Hoseini Z.S. (3)
(1) Health Management and Social Development Research Center, , Golestan University of Medical Sciences, Gorgan, Iran
(3) Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur , Iran
Correspondence
Article History
Received: March 15, 2020Accepted: June 9, 2020
ePublished: December 20, 2020
ABSTRACT
Aims
Hypertension is one of the most common chronic health problems worldwide and self-care behaviors are an important part of managing blood pressure in these patients. Therefore, the present study was conducted to determine the effect of educational intervention based on the PRECEDE model on the promotion of self-care behaviors of patients with hypertension.
Materials & Methods This randomized controlled trial was performed among 102 patients with hypertension who were selected by multi-stage cluster sampling in 2018. Data collection tools included demographic information and a standard questionnaire based on the PRECEDE model constructs which were completed by interview. The experimental group participated in 4 training sessions. Questionnaires were collected before and 3 months after the educational intervention from the participants of the experimental and control groups. Data were analyzed in SPSS 19 software using Chi-square, independent t-test, paired t-test, and linear regression.
Findings The results showed that knowledge, attitude and enabling factors predicted 20% of the variance of self-care behaviors of patients with hypertension before the educational intervention. After the educational intervention, the mean scores of all structures of the PRECEDE model were statistically significant between the experimental and control groups (p<0.05), except for the enabling factors (p>0.05). Also, the mean score of self-care behaviors 3 months after the educational intervention in the experimental group was significantly increased compared to the control group (p<0.05).
Conclusion Increasing the average of self-care behavior in patients undergoing educational intervention indicates the effective role of education in the use of self-care behaviors. Proper planning for educational interventions based on the PRECEDE model as well as providing the necessary structures is necessary to facilitate the realization of self-care behaviors in patients with hypertension.
Materials & Methods This randomized controlled trial was performed among 102 patients with hypertension who were selected by multi-stage cluster sampling in 2018. Data collection tools included demographic information and a standard questionnaire based on the PRECEDE model constructs which were completed by interview. The experimental group participated in 4 training sessions. Questionnaires were collected before and 3 months after the educational intervention from the participants of the experimental and control groups. Data were analyzed in SPSS 19 software using Chi-square, independent t-test, paired t-test, and linear regression.
Findings The results showed that knowledge, attitude and enabling factors predicted 20% of the variance of self-care behaviors of patients with hypertension before the educational intervention. After the educational intervention, the mean scores of all structures of the PRECEDE model were statistically significant between the experimental and control groups (p<0.05), except for the enabling factors (p>0.05). Also, the mean score of self-care behaviors 3 months after the educational intervention in the experimental group was significantly increased compared to the control group (p<0.05).
Conclusion Increasing the average of self-care behavior in patients undergoing educational intervention indicates the effective role of education in the use of self-care behaviors. Proper planning for educational interventions based on the PRECEDE model as well as providing the necessary structures is necessary to facilitate the realization of self-care behaviors in patients with hypertension.
CITATION LINKS
[1]Shayesteh H, Mirzaei A, Sayehmiri K, Qorbani M, Mansourian M. Effect of education intervention on lifestyle of patients with hypertension among the rural population of Lorestan Province. J lifestyle Med. 2016;6(2):58-63.
[2]Brunner LS. Brunner & Suddarth’s textbook of medical-surgical nursing. 1st Volume. Philadelphia: Lippincott Williams & Wilkins; 2010.
[3]Mojahedi MJ, Hami M, Shakeri MT, Hasani MH, Ahadi M. The Prevalence and related risk factors of hypertension in young adults in Mashhad Hypertension in young adults. Med J Mashhad Univ Med Sci. 2015;58(5):252-7.
[4]Yazdanpanah L, Shahbazian H, Shahbazian H, Latifi SM. Prevalence, awareness and risk factors of hypertension in southwest of Iran. J Ren Inj Prev. 2015;4(2):51-6.
[5]Barik D, Arokiasamy P. Rising health expenditure due to non-communicable diseases in India: an outlook. Front Pub Health. 2016;4:268.
[6]Eghbali-Babadi M, Feizi A, Khosravi A, Sarrafzadegan N. The effect of training on knowledge, attitude, and practice in patients with hypertension; The application of the expanded chronic care model: A clinical trial study. Iran Red Crescent Med J. 2018;20(5):e61693.
[7]Karimi M, Clark AM. How do patients’ values influence heart failure self-care decision-making?: A mixed-methods systematic review. Int J Nurs Stud. 2016;59:89-104.
[8]Babaei-Sis M, Ranjbaran S, Mahmoodi H, Babazadeh T, Moradi F, Mirzaeian K. The effect of educational intervention of life style modification on blood pressure control in patients with hypertension. J Educ Community Health. 2017;3(1):12-9. [Persian]
[9]Shojaeezadeh D, Sharifirad G, Tol A, Mohajeri Tehrani MR, Alhani F. Effect of empowerment model on distress and diabetes control in patients with type 2 diabetes. 2012;1:38-47. [Persian]
[10]Saffari M, Shojaezadeh D, Ghofranipour F, Heydania A, Pakpor Hajiagha A. Health Education & pomotion: Theories, models & methods. Tehran: ASARE SOBHAN; 2012. [Persian]
[11]Azizzadeh Pormehr A, Shojaezadeh D. The effects of educational intervention for anxiety reduction on nursing staffs based on PRECEDE-PROCEED model. Health Educ Health Promot. 2019;7(3):119-23.
[12]Khani Jeihooni A, Kashfi SM, Kooshkghazi SZ, Kashfi SH. Effectiveness of a training program based in PRECEDE Model on fruit and vegetable consumption among female students. Int J Pediatr. 2017;5(10):5935-44.
[13]Green L, Kreuter M. Health promotion planning: An educational and ecological approach. 4th Edition. New York: McGraw-Hill; 2005.
[14]Hosseini F, Farshidi H, Aghamolaei T, Madani A, Ghanbarnejad A. The impact of an educational intervention based on PRECEDE-PROCEED model on lifestyle changes among hypertension patients. Iran J Health Educ Health Promot. 2014;2(1):17-27. [Persian]
[15]Omidi S, Farmanbar R, Mokhtarpour S. The effect of educational intervention based on PRECEDE-PROCEED model on promoting traffic safety behaviors in primary schools students of Tabriz in 2014. J Educ Community Health. 2016;2(4):48-56. [Persian]
[16]Bacha D, Abera H. Knowledge, attitude and self-care practice towards control of hypertension among hypertensive patients on follow-up at St. Paul's Hospital, Addis Ababa. Ethiop J Health Sci. 2019;29(4):421-30.
[17]Ramezankhani A, Pooresmaeili A, Rakhshandehrou S, Khodakarim S. The effect of education on knowledge, attitude and preventive behaviors of high blood pressure based on group discussion in women 20-49 years old, Islamshahr city. Razi J Med Sci. 2017;24(155):11-9. [Persian]
[18]Girija M, Kokilavani N. Effectiveness of structured teaching programme on knowledge, attitude and practice among patients with hypertension. Asian J Nurs Educ Res. 2014;4(1):136-9.
[19]Aghamolaei T, Hosseini F, Farshidi H, Madani A, Ghanbarnejad A. The impact of an educational intervention based on PRECEDE-PROCEED model on lifestyle of hypertension patients. J Hypertens. 2015;33:e4.
[20]Solhi M, Shabani Hamedan M, Salehi M. The effect of educational intervention based on PRECEDE-PROCEED Model on the life quality of women-headed households covered by Tehran Welfare Organization. Iran J Health Educ Health Promot. 2017;4(4):259-70. [Persian]
[21]Sanjari S, MohammadiSoleimani MR. The impact of education on the prevention of vaginal infection based on the PRECEDE-PROCEED model. J Rafsanjan Univ Med Sci. 2017;16(4):338-52. [Persian]
[22]Hlaing PH, Sullivan PE, Chaiyawat P. Application of PRECEDE-PROCEED Planning model in transforming the clinical decision making behavior of physical therapists in myanmar. Front Pub Health. 2019;7:114.
[23]Liao CD, Lin LF. Application Precede-Proceed health promotion model to enhance the implementation and execution rate of the treatment staff wash their hands. J Oslo Univ Med Sci. 2014;41(1):1-5.
[24]Mirtz TA, Thompson MA, Greene L, Wyatt LA, Akagi CG. Adolescent idiopathic scoliosis screening for school, community, and clinical health promotion practice utilizing the PRECEDE-PROCEED model. Chiropr Osteopat. 2005;13:25.
[25]Tabasinejad N, Ahmadi Tabatabaei SV, Khanjani N, Mohseni M. Predicting of Factors influencing physical activity in women for the prevention of osteoporosis according the Precede Model. J Health Based Res. 2015;1(2):155-66. [Persian]
[26]Salinero-Fort MA, Carrillo-de Santa Pau E, Arrieta-Blanco FJ, Abanades-Herranz JC, Martín-Madrazo C, Rodés-Soldevila B, et al. Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus. BMC Pub Health. 2011;11:267.
[27]Khani Jeihooni A, Hatami M, Zarei S, Safdar S, Maleki Z, Akbarzadeh Z. Investigating the Effect of educational program based on precede model on the consumption of fruits and vegetables in high school girl students of Fasa city. J Fasa Univ Med Sci. 2017;7(3):361-70. [Persian]
[28]Shayesteh H, Mansoriyan M, Mirzaie A, Sayehmiri K. Survey of the effect of educational intervention on the nutrition physical activity and stress management of patients with hypertension among the rural population of Aligoudarz county of Lorestan province in 2015. J Ilam Univ Med Sci. 2016;24(2):54-62. [Persian]
[29]Liu S, Tanaka R, Barr S, Nolan RP. Effects of self-guided e-counseling on health behaviors and blood pressure: Results of a randomized trial. Patient Educ Couns. 2020;103(3):635-41.
[2]Brunner LS. Brunner & Suddarth’s textbook of medical-surgical nursing. 1st Volume. Philadelphia: Lippincott Williams & Wilkins; 2010.
[3]Mojahedi MJ, Hami M, Shakeri MT, Hasani MH, Ahadi M. The Prevalence and related risk factors of hypertension in young adults in Mashhad Hypertension in young adults. Med J Mashhad Univ Med Sci. 2015;58(5):252-7.
[4]Yazdanpanah L, Shahbazian H, Shahbazian H, Latifi SM. Prevalence, awareness and risk factors of hypertension in southwest of Iran. J Ren Inj Prev. 2015;4(2):51-6.
[5]Barik D, Arokiasamy P. Rising health expenditure due to non-communicable diseases in India: an outlook. Front Pub Health. 2016;4:268.
[6]Eghbali-Babadi M, Feizi A, Khosravi A, Sarrafzadegan N. The effect of training on knowledge, attitude, and practice in patients with hypertension; The application of the expanded chronic care model: A clinical trial study. Iran Red Crescent Med J. 2018;20(5):e61693.
[7]Karimi M, Clark AM. How do patients’ values influence heart failure self-care decision-making?: A mixed-methods systematic review. Int J Nurs Stud. 2016;59:89-104.
[8]Babaei-Sis M, Ranjbaran S, Mahmoodi H, Babazadeh T, Moradi F, Mirzaeian K. The effect of educational intervention of life style modification on blood pressure control in patients with hypertension. J Educ Community Health. 2017;3(1):12-9. [Persian]
[9]Shojaeezadeh D, Sharifirad G, Tol A, Mohajeri Tehrani MR, Alhani F. Effect of empowerment model on distress and diabetes control in patients with type 2 diabetes. 2012;1:38-47. [Persian]
[10]Saffari M, Shojaezadeh D, Ghofranipour F, Heydania A, Pakpor Hajiagha A. Health Education & pomotion: Theories, models & methods. Tehran: ASARE SOBHAN; 2012. [Persian]
[11]Azizzadeh Pormehr A, Shojaezadeh D. The effects of educational intervention for anxiety reduction on nursing staffs based on PRECEDE-PROCEED model. Health Educ Health Promot. 2019;7(3):119-23.
[12]Khani Jeihooni A, Kashfi SM, Kooshkghazi SZ, Kashfi SH. Effectiveness of a training program based in PRECEDE Model on fruit and vegetable consumption among female students. Int J Pediatr. 2017;5(10):5935-44.
[13]Green L, Kreuter M. Health promotion planning: An educational and ecological approach. 4th Edition. New York: McGraw-Hill; 2005.
[14]Hosseini F, Farshidi H, Aghamolaei T, Madani A, Ghanbarnejad A. The impact of an educational intervention based on PRECEDE-PROCEED model on lifestyle changes among hypertension patients. Iran J Health Educ Health Promot. 2014;2(1):17-27. [Persian]
[15]Omidi S, Farmanbar R, Mokhtarpour S. The effect of educational intervention based on PRECEDE-PROCEED model on promoting traffic safety behaviors in primary schools students of Tabriz in 2014. J Educ Community Health. 2016;2(4):48-56. [Persian]
[16]Bacha D, Abera H. Knowledge, attitude and self-care practice towards control of hypertension among hypertensive patients on follow-up at St. Paul's Hospital, Addis Ababa. Ethiop J Health Sci. 2019;29(4):421-30.
[17]Ramezankhani A, Pooresmaeili A, Rakhshandehrou S, Khodakarim S. The effect of education on knowledge, attitude and preventive behaviors of high blood pressure based on group discussion in women 20-49 years old, Islamshahr city. Razi J Med Sci. 2017;24(155):11-9. [Persian]
[18]Girija M, Kokilavani N. Effectiveness of structured teaching programme on knowledge, attitude and practice among patients with hypertension. Asian J Nurs Educ Res. 2014;4(1):136-9.
[19]Aghamolaei T, Hosseini F, Farshidi H, Madani A, Ghanbarnejad A. The impact of an educational intervention based on PRECEDE-PROCEED model on lifestyle of hypertension patients. J Hypertens. 2015;33:e4.
[20]Solhi M, Shabani Hamedan M, Salehi M. The effect of educational intervention based on PRECEDE-PROCEED Model on the life quality of women-headed households covered by Tehran Welfare Organization. Iran J Health Educ Health Promot. 2017;4(4):259-70. [Persian]
[21]Sanjari S, MohammadiSoleimani MR. The impact of education on the prevention of vaginal infection based on the PRECEDE-PROCEED model. J Rafsanjan Univ Med Sci. 2017;16(4):338-52. [Persian]
[22]Hlaing PH, Sullivan PE, Chaiyawat P. Application of PRECEDE-PROCEED Planning model in transforming the clinical decision making behavior of physical therapists in myanmar. Front Pub Health. 2019;7:114.
[23]Liao CD, Lin LF. Application Precede-Proceed health promotion model to enhance the implementation and execution rate of the treatment staff wash their hands. J Oslo Univ Med Sci. 2014;41(1):1-5.
[24]Mirtz TA, Thompson MA, Greene L, Wyatt LA, Akagi CG. Adolescent idiopathic scoliosis screening for school, community, and clinical health promotion practice utilizing the PRECEDE-PROCEED model. Chiropr Osteopat. 2005;13:25.
[25]Tabasinejad N, Ahmadi Tabatabaei SV, Khanjani N, Mohseni M. Predicting of Factors influencing physical activity in women for the prevention of osteoporosis according the Precede Model. J Health Based Res. 2015;1(2):155-66. [Persian]
[26]Salinero-Fort MA, Carrillo-de Santa Pau E, Arrieta-Blanco FJ, Abanades-Herranz JC, Martín-Madrazo C, Rodés-Soldevila B, et al. Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus. BMC Pub Health. 2011;11:267.
[27]Khani Jeihooni A, Hatami M, Zarei S, Safdar S, Maleki Z, Akbarzadeh Z. Investigating the Effect of educational program based on precede model on the consumption of fruits and vegetables in high school girl students of Fasa city. J Fasa Univ Med Sci. 2017;7(3):361-70. [Persian]
[28]Shayesteh H, Mansoriyan M, Mirzaie A, Sayehmiri K. Survey of the effect of educational intervention on the nutrition physical activity and stress management of patients with hypertension among the rural population of Aligoudarz county of Lorestan province in 2015. J Ilam Univ Med Sci. 2016;24(2):54-62. [Persian]
[29]Liu S, Tanaka R, Barr S, Nolan RP. Effects of self-guided e-counseling on health behaviors and blood pressure: Results of a randomized trial. Patient Educ Couns. 2020;103(3):635-41.