Relationships between Hypertension knowledge, Self-efficacy, Treatment beliefs and Self-management behaviors among uncontrolled hypertension patients in Da Nang city, Vietnam*


  • Tran Thi My Khon Kaen University
  • Nonglak Methakajanasak Faculty of Nursing, Khon Kaen University, Thailand
  • Huynh Van Minh Hue University of Medicine and Pharmacy, Hue city, Viet Nam


uncontrolled hypertension, self-management behaviors, self-efficacy, hypertension knowledge, treatment beliefs, Vietnam


This descriptive research aimed to investigate level of self-management behaviors (SMBs) and its relationships with selected factors among patients with uncontrolled hypertension in Da Nang, Vietnam. A total of 85 eligible patients were surveyed using a demographic data questionnaire, the hypertension fact knowledge questionnaire (HFQ), the self-efficacy for managing chronic disease 6-item scale (SEMCD 6), the beliefs about medicines questionnaire (BMQ)-specific, and the hypertension self-management behavior questionnaire (HSMBQ). The reliability index of the HFQ, SEMCD 6, BMQ, HSMBQ were 0.95, 0.73, 0.93 and 0.73, respectively. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient. The results revealed that self-management behaviors of participants were at moderate level (2.37± 0.54). Only 17.6 % of the participants had self-management behaviors at high level. A statistically significant correlation was found between SMBs, and hypertension knowledge (r=0.617, p<0.01) and self-efficacy (r=0.675, p<0.01). The results implied that in order to promote self-management behavior of patients, health care providers should place emphasis on improvement of knowledge and self-efficacy.


Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation 2016;134(6):441-50.

Quoc CT, Van BL, Anh TN, Van TV, Minh QN, Yang SH, et al. Associated factors of hypertension in women and men in Vietnam: A cross-sectional study. Int J Environ Res Public Health 2019;16(23):4714.

Van MH, Viet NL, Sinh CT, Hung PN, Mong NNT, Hung NV, et al. Blood pressure screening during the May Measurement Month 2017 programme in Vietnam-South-East Asia and Australasia. Eur Heart J Suppl 2019; 21(Suppl D):127-9.

Hoa N, Ich TD, That TT. Prevalence trend of hypertension and risk factors of cardiovascular disease among people aged 25 and older in Da Nang city between 2011 and 2015. Vietnam Journal of Preventive Medicine 2017;27(8):55.

Nguyen TPL, Nguyen TBY, Nguyen TT, Vinh HV, Le HH, Schuiling-Veninga CCM, et al. Direct costs of hypertensive patients admitted to hospital in Vietnam’ a bottom-up micro-costing analysis. BMC Health Services Research 2014;14(1):514.

Son PT, Quang NN, Viet NL, Khai PG, Wall S, Weinehall L, et al. Prevalence, awareness, treatment and control of hypertension in Vietnam-results from a national survey. Journal of Human Hypertension 2012;26(4):268-80.

World Health Organization. A global brief on hypertension : silent killer, global public health crisis: World Health Day 2013 [Internet]. 2013 [cited 2020 May 3]. Available from:

Hien HA, Tam NM, Tam V, Derese A, Devroey D. Prevalence, awareness, treatment, and control of hypertension and its risk factors in (Central) Vietnam. International Journal of Hypertension 2018;6326984:1-13. Available from:

Hoang VM, Tran QB, Vu THL, Nguyen TKN, Kim BG, Pham QN, et al. Patterns of raised blood pressure in Vietnam: Findings from the WHO STEPS survey 2015. Int J Hypertens 2019;1219783:1-7. Available from:

Ha DA, Goldberg RJ, Allison JJ, Chu TH, Nguyen HL. Prevalence, awareness, treatment, and control of high blood pressure: A population-based survey in Thai Nguyen, Vietnam. PLoS One 2013;8(6):e66792.

Qu Z, Parry M, Liu F, Wen X, Li J, Zhang Y, et al. Self-management and blood pressure control in China: A community-based multicentre cross-sectional study. BMJ Open 2019; 9(3):e025819.

Akhter N. Self-management among patient with hypertension in Bangladesh [Thesis]. Hat Yai: Prince of Songkla Univ; 2010.

Intarakamhang U, Sutipan P, Kittipichai W, Macaskill A. Effects of self-management program on healthy lifestyle behaviors among elderly with hypertension. The Journal of Behavioral Science 2018;13(2):38-50.

Maciejewski ML, Bosworth HB, Olsen MK, Smith VA, Edelman D, Powers BJ, et al. Do the benefits of participation in a hypertension self-management trial persist after patients resume usual care? Circ Cardiovasc Qual Outcomes 2014;7(2):269-75.

Ding W, Li T, Su Q, Yuan M, Lin A. Integrating factors associated with hypertensive patients' self-management using structural equation modeling: a cross-sectional study in Guangdong, China. Patient Prefer Adherence 2018;12:2169-78.

Penaloza-Ramos MC, Jowett S, Mant J, Schwartz C, Bray EP, Sayeed Haque M, et al. Cost-effectiveness of self-management of blood pressure in hypertensive patients over 70 years with suboptimal control and established cardiovascular disease or additional cardiovascular risk diseases (TASMIN-SR). Eur J Prev Cardiol 2016;23(9):902-12.

Babaee Beigi MA, Zibaeenezhad MJ, Aghasadeghi K, Jokar A, Shekarforoush S, Khazraei H. The effect of educational programs on hypertension management. Int Cardiovasc Res J 2014;8(3):94-8.

Truong PV, Jullamate P, Piphatvanitcha N. Factors related to self-management behaviours in hypertensive older adults in Haiduong province, Vietnam. Journal of Nursing and Health Sciences 2016;10(3):56-64.

Ilkafah I, Titi Iswanti A, Nurul Anugrah R. Analysis of factors related to self management behavior (SMB) in hypertensive patients. Paper presented at 8th international nursing conference on education, practice and research development in nursing (INC);Surabaya, Indonesia; 2017.

Udlis KA. Self-management in chronic illness: concept and dimensional analysis. Journal of Nursing and Healthcare of Chronic Illness 2011;3(2):130-9.

Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health 1999;14(1):1-24.

MacInnes J. Relationships between illness representations, treatment beliefs and the performance of self-care in heart failure: a cross-sectional survey. Eur J Cardiovasc Nurs 2013;12(6):536-43.

Niriayo YL, Ibrahim S, Kassa TD, Asgedom SW, Atey TM, Gidey K, et al. Practice and predictors of self-care behaviors among ambulatory patients with hypertension in Ethiopia. PLoS One 2019;14(6):e0218947.

Pangman VC, Sloan J, Guse L. An examination of psychometric properties of the mini-mental state examination and the standardized mini-mental state examination: implications for clinical practice. Appl Nurs Res 2000;13(4):209-13.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA 2003;289(19):2560-72. doi: 10.1001/jama.289.19.2560.

Hulley SB. Designing clinical research. 3rded. Philadelphia: Lippincott Williams & Wilkins; 2007.

Cohen J. A power primer. Psychol Bull 1992;112(1):155-9.

Cha ES, Kim KH, Erlen JA. Translation of scales in cross-cultural research: Issues and techniques. J Adv Nurs 2007;58(4):386-95.

Saleem F, Hassali MA, Shafie AA, Atif M, Ul Haq N, Aljadhey H, el al. Disease related knowledge and quality of life: A descriptive study focusing on hypertensive population in Pakistan. South Med Rev 2012;5(1):47-52.

Lorig KR, Holman H. Self-management education: History, definition, outcomes, and mechanisms. Ann Behav Med 2003;26(1):1-7.

Lin CC, Anderson RM, Chang CS, Hagerty BM, Loveland-Cherry CJ. Development and testing of the diabetes self-management instrument: A confirmatory analysis. Res Nurs Health 2008;31(4):370-80.

James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311(5):507-20.

Flynn SJ, Ameling JM, Hill-Briggs F, Wolff JL, Bone LR, Levine DM, et al. Facilitators and barriers to hypertension self-management in urban African Americans: Perspectives of patients and family members. Patient Prefer Adherence 2013;7:741-9.

Jandeekaewsakul P, Watthayu N, Suwonnaroop N. Factors predicting self-management behavior among patients with uncontrolled essential hypertension. Nursing Science Journal of Thailand 2018;36(1):31-43.

Anh DTT, Shih YW, Miao NF, Liao YM, Chuang YH, Chang HJ, et al. Differences of self-management in controlling blood pressure between patients with hypertension and healthy people in Vietnam. POJ Nursing Practice & Research 2017;1(1):1-8.

WHO. Human resources for health country profiles: Viet Nam [Internet]. 2016 [cited 2020 May 3]. Available from

Long Y, Li LW. "How would we deserve better?" Rural-urban dichotomy in health seeking for the chronically ill elderly in China. Qual Health Res 2016;26(12):1689-704.

Huda S, Amatayakul A, Karuncharernpanit S. Factors associated with self-care management among adult people with hypertension in Jepara, central java, Indonesia. the 3rd annual conference of the Asian network for public opinion research (ANPOR) Bangkok, Thailand; 2015.

Lee JE, Han HR, Song H, Kim J, Kim KB, Ryu JP, et al. Correlates of self-care behaviors for managing hypertension among Korean Americans: A questionnaire survey. Int J Nurs Stud 2010;47(4):411-7.

Warren-Findlow J, Seymour RB, Brunner Huber LR. The association between self-efficacy and hypertension self-care activities among African American adults. J Community Health 2012;37(1):15-24.

Yoo H, Kim CJ, Jang Y, You M. Self-efficacy associated with self-management behaviours and health status of South Koreans with chronic diseases. International Journal of Nursing Practice 2011;17(6): 599-606.

Bandura A. Health promotion by social cognitive means. Health Education & Behavior 2004;31(2):143-64.

Cea-Calvo L, Marin-Jimenez I, de Toro J, Fuster-RuizdeApodaca MJ, Fernandez G, Sanchez-Vega N, et al. Association between non-adherence behaviors, patients' experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions. Curr Med Res Opin 2020; 36(2): 293-300.

Lemay J, Waheedi M, Al-Sharqawi S, Bayoud T. Medication adherence in chronic illness: do beliefs about medications play a role? Patient Prefer Adherence 2018;12:1687-98.




How to Cite

My TT, Methakajanasak N, Minh HV. Relationships between Hypertension knowledge, Self-efficacy, Treatment beliefs and Self-management behaviors among uncontrolled hypertension patients in Da Nang city, Vietnam*. JNSH [Internet]. 2020 Dec. 26 [cited 2024 Apr. 15];43(4):59-71. Available from:



Research Article