Developing Nursing Practice Processes for Managing Patients with Uncontrolled Hypertension Through Motivational Interviewing at Thali Hospital, Loei Province

Abstract

Background: Incorporating the principles of Motivational Interviewing (MI) into nursing practice facilitates the management of blood pressure and mitigates the risk of complications in patients with uncontrolled hypertension.                                       

Methods: This research and development study sought to formulate a nursing action process for managing patients with uncontrolled hypertension through MI at Tha Li Hospital, Loei Province. The study was grounded in the systems theory framework and integrated a four-phase nursing process: Phase 1—Problem and Needs Analysis; Phase 2—Design and Development; Phase 3—Implementation; and Phase 4—Evaluation and Improvement. The sample comprised 10 professional nurses, selected via purposive sampling, and 40 patients with uncontrolled hypertension, chosen through simple sampling. Research instruments included a self-care behavior record form, a Motivational Interviewing conversation record form, a blood pressure monitoring form, nurse group discussion guidelines, and a satisfaction and acceptance assessment form. The quality of these tools was validated by five experts, resulting in a Content Validity Index (CVI) of 0.83–0.90 and a reliability score of 0.84. Qualitative data were analyzed using content analysis, while quantitative data were examined using descriptive statistics, paired t-test, and Chi-square test. 

Results: The study identified that the developed nursing action process encompassed a manual and activities employing MI across six stages: providing feedback, supporting decision-making responsibility, offering advice, presenting options, expressing empathy, and enhancing potential. Furthermore, patients exhibited a high level of self-care behavior (M = 4.14, SD = 0.35), with a statistically significant difference at the .05 level, and the rate of blood pressure control increased to 80.00%. The nurse group reported the highest levels of satisfaction and acceptance (M = 4.62, SD = 0.25).                   

Conclusion: The integration of motivational interviewing (MI) within the nursing action process is well-suited for implementation in chronic disease clinics. Its continued promotion is recommended to sustainably enhance the quality of patient care.