• Jantana Sawekwan Nursing Science (Community Nurse Practitioner), Faculty of Public Health, Mahidol University
  • Kwanjai Amnatsatsue Department of Public Health Nursing, Faculty of Public Health, Mahidol University
  • Patcharaporn Kerdmongkol Department of Public Health Nursing, Faculty of Public Health, Mahidol University


Older Adults, Uncontrolled Hypertension, Self-Care Behavior, Continuing Care Program


Continuing care is a significant role of nurses in chronic disease management, particularly among community-dwelling older adults. This quasi-experimental two group pretest-posttest study was conducted to examine effects of a continuing care program for older adults with uncontrolled hypertension. Purposive sampling was used to select an experimental group (n=30) and a comparison group (n=30). The experimental group received a 6-week continuing care program using the Chronic Care Model (CCM) for self-management support and as a clinical information system of multiple activities. These included health education, enhancing motivation and practical skills for selfcare, continuing selfcare behavioral support, monitoring BP and follow-up from the data center, transfer of community health data to follow and to make appropriate self-care behavior adjustments, and support by telephone follow-up, consultation and feedback. The comparison group received regular care. From January to March 2018, data were collected by the researcher using questionnaires before and after the intervention. Analysis included independent and paired t-test.

Results show that the experimental group reported a significantly higher mean score of self-care behavior and lower blood pressure than the comparison group and after the program (p < 0.001).

Results suggest that a continuing care program can provide patients with skills training and expertise for health behavior practice. Family and community settings can give recognition to health problems and motivate action to support self-care behavior of hypertensive patients.


Download data is not yet available.


Prasartkul P, editors. Situation of the elderly 2016. Nakorn Pathom: Printery; 2017.

Buranakitjaroen P. Essential hypertension. Bangkok: Hmochaoban; 2010.

Prakongsai P. Thailand Health Profile 2011-2015. Nonthaburi: Ongkansongkhor-thahanphansuek; 2016.

Buranakitjaroen P, Sitthisook S, Wataganara T, Ophascharoensuk V, Bunnag P, Roubsanthisuk W, Puavilai W, et al. Thai Hypertension Society: Guidelines in the Treatment of Hypertension [Internet]. 2015 [cited 16 May 2016]. Available from: http://www.thaihypertension.org/guideline.html.

Prasartkaew N, Terathongkum S, Maneesriwongkul W. The Effect of a Home Visit and Telephone Follow-up Program on Health Beliefs and Blood Pressure in Persons with Uncontrolled Hypertension. Journal of Public Health 2012; 42(3): 19- 31. (in Thai)

Thamnamsin K. Effects of self-care promoting program on self-care behavior among older adults with uncontrolled hypertension in Bangkok. Master of Nursing Science Program in Community Nurse Practitioner of Public Health, Bangkok: Mahidol University; 2015.

Seesawang J, Thongtaeng P, Yodthong D. Effectiveness of Self-Management Supportive Program among Hypertensive Older People. Ramathibodi Nursing Journal 2014; 20(2): 179-92. (in Thai)

Thatsaeng B, Lasuka D, Khampolsiri T. Effects of a Self-management Supporting Program on Self-management Behaviors and Blood Pressure among Elders with Hypertension. Nursing Journal 2012; 39(4): 124-37. (in Thai)

Srivanichakorn S, Yana T, Chalordate B. Situation of Primary Care System in Thailand 2011. Nakorn Patho: Saha Phatthana Phaisan; 2011.

Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J &Bonomi A. Improving chronic illness care: translating evidence into action. Health Affairs (Millwood) 2001; 20(6): 64–78.

Petsirasan R. Effects of a multicomponent proactive nursing program on blood pressure control at a 6-month follow-up among hypertensive older persons in community. The degree of doctor of philosophy program in nursing science Faculty of Nursing, Bangkok: Chulalongkorn University; 2011.

Jewpattanakul Y, Reungthongdee U, Tabkeaw T. The Effect of the Arm Swing Exercise with Family Participation Program on Exercise Behavior in Elderly with Essential Hypertension. Journal of Nursing Science 2012; 3(2): 46-57. (in Thai)

Tantirithisak T. Clinical Practice Guidelines: Dementia. Bangkok: Thana place; 2014.

Jitapunkul S. Principles of geriatric medicine. chulalongkorn university; 2001.

Orem DE, Taylor SG, Renpenning KM. Nursing: concepts of practice. St. Louis: Mosby; 2001.

Wongputtakham S, Boonchuang P, Panya P. Effects of Self-management on Health Behaviors and Blood Pressure Among Hypertensive Patients. Nursing Journal 2009; 36(3): 125-36. (in Thai)

Park YH, Chang H, Kim J, Kwak JS. Patient‐tailored self‐management intervention for older adults with hypertension in a nursing home. Journal clinical nursing 2013; 22: 710-22

Churproong S, Khampirat B, Ratanajaipan P, Tattathongkom P. The Effect of the Arm Swing on the Heart Rate of Non-Athletes. J Med Assoc. 2015; 98(4): S79-S86.

Boonchun N, Ucharattana P, Punsakd W, Meehardsai N. Effects of an Empowerment Program on Self-care Agency for Elders with Hypertension. Journal of Nursing Science 2011; 29 (Suppl 2): 93-102. (in Thai)

Kantaradusdi-Triamchaisri S. Practicing. SKT Meditation Healing Exercise: Metaphysic Therapy. Bangkok: Ongkansongklorthahanphansuek; 2008.

Dusek JA, Hibberd PL, Buczynski B, Chang BH, Dusek KC, Johnston JM, et al. Stress management versus lifestyle modification on systolic hypertension and medication elimination: a randomized trial. The journal of alternative and complementary medicine 2008; 14(2):129-38.

Nuibandan A, Vachprasi R, Siripituptum D. Effect of prayer on stress of nursing student of Prince of Songkla University. Songklanagarind Journal of Nursing 2009; 29(3): 1-15. (in Thai)

Bosworth HB, Powers BJ, Olsen MK, McCant F, Grubber J, Smith V, et al. Home blood pressure management and improved blood pressure control: results from a randomized controlled trial. Archives of internal medicine 2011; 171(13): 1173-1180.

Pulawit T, Junjira S. Lived Experience of Thai Older People Living with Hypertension. Journal of The Royal Thai Army Nurses 2014; 15(3): 287-95. (in Thai)

Sumonta H, Noppawan P, Chularuk K. Case Study: Behaviors, Problems, and Barriers of Blood Pressure Control in Persons with Severe Hypertension in a Community. Ramathibodi Nursing Journal 2013; 19(1): 129-42. (in Thai)

Imoun S, Kotruchin P, Techaatik P, Mitsungnern T. Effectiveness of a Praying Therapy for Blood Pressure Control of Hypertensive Patients. Journal of Nursing and Health Care 2015; 33(2): 44-9. (in Thai)

Chibsamanboon P, Suttineam U. Effects of the Somporn Kantaradusdi -Triamchaisri technique 2 (SKT 2) on blood pressure levels and biochemical markers. Journal of Boromarajonani College of Nursing Bangkok 2013; 29(2): 122-33. (in Thai)

Nantsupawat R, Junmahasathien S, Phumvitchuvate L, Charuwatcharapaniskul U, Chareonsanti J, Keitlertnapha P, et al. Development of Community Health System by the People for the people: Case Study of Chisathan District. Nursing Journal 2012; 39(2): 146-156. (in Thai)

Hajjar IM, Dickson B, Blackledge JL, Lewis P, Herman J, Watkins KW. A multidisciplinary management program in primary care to improve hypertension control and healthy behaviors in elderly patients. Journal of the American Geriatrics Society 2007; 55(4): 624-6.

Figar S, Galarza C, Petrlik E, Hornstein L, Rodríguez Loria G, Waisman G, et al. Effect of Education on Blood Pressure Control in Elderly Persons: A Randomized Controlled Trial. American Journal of Hematology 2006; 19(7): 737-43.



How to Cite

Sawekwan, J. ., Amnatsatsue, K., & Kerdmongkol, P. (2020). EFFECTS OF A CONTINUING CARE PROGRAM FOR OLDER ADULTS WITH UNCONTROLLED HYPERTENSION. Journal of Public Health Nursing, 33(1), 152–170. Retrieved from https://he01.tci-thaijo.org/index.php/phn/article/view/241804



Research Articles