Effects of Self-efficacy for Disease Self-management Promoting Program on Disease Control Behaviors, Blood Pressure Level, and Quality of Life among People with Hypertension: A Longitudinal Study

Abstract

The purpose of this clinical trial was to determine the effects of a Self-efficacy for disease self-management promoting program on disease control behavior, blood pressure level, and quality of life among people with hypertension in long-term period. Subjects were 255 hypertensive patients who had health insurance and lived in Pathumthani province and the near area, who came for follow-up visit at Kukot Medical Center, Lumlookka 21 branch, and Zeer Rangsit branch, Lumlookka subdistrict, Pathumthani province. They were randomly assigned to the experimental and control group using simple random sampling technique. The experimental group received the treatment from the family medicine team using the treatment guideline of the Royal College of Physicians of Thailand and home health care by the nurses from health promotion department, and the Self-efficacy for disease self-management promoting program. The control group received the treatment from the family medicine team using the treatment guideline of the Royal College of Physicians of Thailand and home health care by the nurses from health promotion department. The research instruments composed of the Self-efficacy for disease self-management promoting program and the patients manual; living well with chronic disease. Data were collected using the sphygmomanometer, the disease control behavior questionnaire and SF-36, Thai version questionnaire. The Cronbach’s alpha coefficient were .91 and .93, respectively. The research implementation and data collection were conducted from June 2009 to July 2010. Data were analyzed using frequency, percentage, mean, standard deviation, independent t-test, Chi-square test, repeated measure ANOVA, and multiple comparisons by Bonferroni method.

Results revealed that: 1) at 6-month after entering the program, the experimental group had statistically significant higher score of disease control behaviors and quality of life than baseline (p < .05) and had no statistically significant difference in systolic and diastolic blood pressure level compared to baseline; 2) at 12-month after entering the program, the experimental group had no statistically significant different score of disease control behaviors, quality of life, and systolic blood pressure than baseline; whereas the experimental group had statistically significant lower level of diastolic blood pressure than baseline (p < .05); 3) at 6-month after entering the program, the experimental group had statistically significant higher score of disease control behaviors and quality of life (p < .001 and p < .05, respectively), and had statistically significant lower diastolic blood pressure level than the control group (p < .05); whereas the systolic blood pressure level was not different; and 4) at 12-month after entering the program, the experimental group had statistically significant higher score of disease control behaviors and quality of life (p < .001), and had statistically significant lower diastolic blood pressure level than the control group (p < .05); whereas the systolic blood pressure level was not different.

Results suggested that the reinforcement strategies for disease control and factor influencing blood pressure in long term period study should be considered.