Effects of mindfulness-based health education practice on health behaviors and quality of life among hypertensive patients: a quasi-experimental research
Keywords:
Quality of life, Health behaviour, Health education, Hypertension, Mindfulness practiceAbstract
Purpose – The purpose of this paper is to examine the effect of mindfulness practice on health behaviors and quality of life (QOL) among hypertensive patients.
Design/methodology/approach – A quasi-experimental research was designed by before, after and a follow-up phase (i.e. on the 0th, 6th and 12th weeks). Two primary health care units (PCU) were selected as control and experiment groups. Samples included patients 35–59 years old who had been diagnosed with stage I hypertension. Both groups received treatment according to standard hypertension guidelines. The experimental group was added as a drill for the purpose of a mindfulness-based health education (MBHE) practice that would emphasize behavior skills (in diet, exercise and mental function) and instill a feeling of adaptation to everyday life.
Findings – The total mean score of the prevention and promotional hypertension behaviors (PPHB), QOL, perceived in mindfulness (MF) and self-efficacy (SE) in the experiment group showed a significant statistical difference when compared to the control group in the 6th week in PPHB and SE (p < 0.001), QOL and MF ( p = 0.001). Similar results were found in the 12th week in PPHB, QOL, SE (p < 0.001) and MF (p = 0.023), respectively.
Research limitations/implications – However, finished implementation in experiment group, during the follow-up phase on the 12th week, ten participants in the control group were excluded (Figure 1). It may be no active intervention or as usual in the control group. Thus, the authors controlled missing data using intention-to-treat analysis comparison and the data distribution was successfully tested by a normality plot before the use of statistical data. Based on the results of this study, the following recommendations can be made: patients should practice in mindfulness in lifestyle modification continued for intensive skill practice over the long term in order to promote sustainability in behavior and in QOL.
Practical implications – Mindfulness trainer should drill and faith in the value of mindfulness corporation owner with patients learning all of the times; and for health practitioner, it should add MBHE for patients.
Social implications – Education institution should add mindfulness in educational programs all of graduates.
Originality/value – The mindfulness practice-based health education training should be in counterpart with modern medicine in order to promote sound health behaviors and an improved QOL for stage I hypertensive patients and to forestall cardiovascular and blood-pressure diseases.
References
2. Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol. 2006; 62(3): 373-86.
3. Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice. Boston, MA: Pearson; 2011.
4. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall; 1986.
5. The World Health Organization Quality of Life assessment [WHOQOL]. Position paper from the World Health Organization. Soc Sci Med. 1995 Nov; 41(10): 1403-9.
6. Abbott RA, Whear R, Rodgers LR, Bethel A, Coon JT, Kuyken W, et al. Effectiveness of mindfulness-based stress reduction and mindfulness-based cognitive therapy in Vascular disease: a systematic review and meta-analysis of randomised controlled trials. J Psychosom Res. 2014; 76(5): 341-51.
7. Centers for Disease Control and Prevention [CDC]. National center for chronic disease prevention and health promotion, division for heart disease and stroke prevention. A public health action plan to prevent heart disease and stroke fact sheet; 2016 [updated: 2016 June 1; cited 2018 May 26]. Available from: www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm
8. Sangprasert P, Palangrit S, Buranatrevedh S, Tiyoa N, Pattaraarchachai J. A systematic review of the effectiveness of mindfulness meditation and contemplation upon vascular disease patients. TMJ. 2018; 18(1): 79-92.
9. Cx V. Mindfulness in health education and health promotion: in handbook of research o adult and community health education: tools, trends and methodologies. Florida: Florida Atlantic University; 2014.
10. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESCJ). Hypertens. 2013 Jul; 31(7): 1281-357. doi: 10.1097/01.hjh.0000431740.32696.cc
11. Nyklicek I, Dijksman SC, Lenders PJ, Fonteijn WA, Koolen JJ. A brief mindfulness-based intervention for increase in emotional well-being and quality of life in Percutaneous Coronary Intervention (PCI) patients: the mindful heart randomized controlled trial. J Behv Med. 2014; 37(1): 135-44.
12. Seddon GM. The properties of Bloom’s taxonomy of educational objectives for the cognitive domain. Review of Educational Research. 1978; 48(2): 303-23.
13. Dale E. Audiovisual methods in teaching. 3rd ed. New York, NY: Dryden Press nd Holt, Rinehart & Winston; 1969.
14. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioural, and biomedical sciences. Behav Res Methods. 2007; 39(2): 175-91.
15. Sangprasert P, Buranatrevedh S, Pipatsatitpong D. The effectiveness of hypertensive management programs and social support in primary health care systems: preliminary study. Siriraj Med J. 2016; 68(6): 369-76.
16. Silpakit O, Silpakit C. A Thai version of mindfulness questionnaire: Srithanya Sati scale. East Asia Arch Psychiatry. 2014; 24(1): 23-9.
17. Ha Dinh TT, Bonner A, Clark R, Ramsbotham J, Hines S. The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: a systematic review. JBI Database System Rev Implement Rep. 2016 Jan; 14(1): 210-47. doi: 10.11124/jbisrir-2016-2296
18. Zou Y, Zhao X, Hou YY, Liu T, Wu Q, Huang YH, et al. Meta-analysis of effects of voluntary slow breathing exercises for control of heart rate and blood pressure in patients with cardiovascular diseases. Am J Cardiol. 2017 Jul 1; 120(1): 148-53. doi: 10.1016/j.amjcard.2017.03.247. Epub 2017 Apr 12.
19. Hughes JW, Fresco DM, Myerscough R, Dulmen VM, Carlson LE, Josephson R. Randomized controlled trial of mindfulness-based stress reduction for prehypertension. Psychosom Med. 2013 Oct; 75(8): 721-8. doi: 10.1097/PSY.0b013e3182a3e4e5
20. Cuddy ML. Treatment of hypertension: guidelines from JNC 7 (the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure 1). J Pract Nurs. 2005; 55(4): 17-21, 22-3.
21. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. DASHsodium collaborative research group. N Engl J Med. 2001 Jan 4; 344(1): 3-10.
22. Nejati S, Zahiroddin A, Afrookhteh G, Rahmani S, Hoveida S. Effect of group mindfulness-based stress-reduction program and conscious yoga on lifestyle, coping strategies, and systolic and diastolic blood pressures in patients with hypertension. J Tehran Heart Cent. 2015 Jul 3; 10(3): 140-8.
23. Siegel RD, Germer CK, Olendzki A. Mindfulness: what is it? Where did it come from? New York, NY: Springer; 2009.
24. Blom K, Baker B, How M, Dai M, Irvine J, Abbey S, et al. Hypertension analysis of stress reduction using mindfulness meditation and yoga: results from the HARMONY randomized controlled trial. Am J Hypertens. 2014 Jan; 27(1): 122-9. doi: 10.1093/ajh/hpt134.
Epub 2013 Sep 14.
25. Son JV, Nyklíček I, Pop VJ, Blonk MC, Erdtsieck RJ, Spooren PF, et al. The effects of a mindfulnessbased intervention on emotional distress, quality of life, and HbA(1c) in outpatients with diabetes (DiaMind): a randomized controlled trial. Diabetes Care. 2013 Apr; 36(4): 823-30. doi: 10.2337/dc12-1477. Epub 2012 Nov 27.
26. Black DS, O’Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med. 2015 Apr; 175(4): 494-501. doi: 10.1001/jamainternmed.2014.8081
27. Bakhshani NM, Amirani A, Amirifard H, Shahrakipoor M. The effectiveness of mindfulness-based stress reduction on perceived pain intensity and quality of life in patients with chronic headache. Glob J Health Sci. 2015 Aug 6; 8(4): 142-51. doi: 10.5539/gjhs.v8n4p142
28. Gimpel C, Scheidt CV, Jose G, Sonntag U, Stefano GB, Michalsen A, et al. Changes and interactions of flourishing, mindfulness, sense of coherence, and quality of life in patients of a mind-body medicine outpatient clinic. Forsch Komplementmed. 2014; 21(3): 154-62. doi: 10.1159/000363784. Epub 2014 Jun 18.
29. Williams H, Simmons LA, Tanabe P. Mindfulness-based stress reduction in advanced nursing practice: a nonpharmacologic approach to health promotion, chronic diseasemanagement, and symptomcontrol. J Holist Nurs. 2015 Sep; 33(3): 247-59. doi: 10.1177/0898010115569349. Epub 2015 Feb 11.
30. Fernros L, Furhoff AK, Wandell PE. Improving quality of life using compound mind-body therapies: evaluation of a course intervention with body movement and breath therapy, guided imagery, chakra experiencing and mindfulness meditation. Qual Life Res. 2008 Apr; 17(3): 367-76. doi: 10.1007/s11136-008-9321-x. Epub 2008 Mar 7.
