Factors related to self-care activities among Cambodian adults with hypertension

Abstract

This study aimed to investigate the factors related to self-care activities among Cambodian adults with hypertension. A comparative correlational research design was used. Using convenience sampling, 297 participants aged 18 to 64 years diagnosed with hypertension for at least 6 months were recruited from the outpatient departments of three hospitals in Phnom Penh, Cambodia. The questionnaire included demographic characteristics, hypertension knowledge, self-efficacy, perceived susceptibility, perceived severity, and self-care activities related to hypertension. Data analysis was conducted using SPSS 23.0 with descriptive statistics, t-test, ANOVA, and correlation coefficient. The results are as follows. 1. The mean age of the participants was 61.05 ± 8.93 years. Most were female (74.4%), married (67.7%), Buddhist (93.0%), and living in the province (64.3%) and had no or primary school level education (63.0%). The participants had been diagnosed with hypertension for 2.68 ± 1.92 years. 2. The mean score for hypertension knowledge was 15.04 ± 3.47, self-efficacy was 29.81 ± 8.06, perceived susceptibility was 12.91 ± 2.44, perceived severity was 15.28 ± 2.37, and self-care activities was 109.86 ± 24.01. 3. Hypertension knowledge differed by education level (F = 5.17, p < .01); post hoc analysis revealed that participants who had secondary education had the highest level of knowledge followed by those who had primary school education and no education. 4. Self-efficacy differed significantly according to age (t = 3.71, p = .01), level of education (F = 4.38, p < .01), and living area (t = −3.13, p < .01). Tukey's post hoc analysis revealed that participants in their 50s had higher self-efficacy than participants older than 69. Participants who had secondary education had the highest level of self-efficacy followed by those with primary school education and no education. Participants living in rural areas had a significantly higher level of self-efficacy than those in Phnom Penh. 5. Self-care activities were positively correlated with hypertension knowledge (r = .21, p < .001) and self-efficacy (r = .20, p < .001). In this study, when the level of knowledge and self-efficacy increased, participants’ engagement in self-care activities increased. Therefore, providing nursing interventions to increase knowledge and self-efficacy for adults with hypertension in Cambodia might aid their engagement in self-care activities. In Cambodia, with limited access to health care, public health nurses could play significant roles in delivering tailored intervention for adults with hypertension. ;연구의 목적은 캄보디아, 성인 고혈압 환자들의 자가관리 활동 관련 요인을 조사하기 위함이다. 1. 연구 설계는 상관관계연구였고, 참여자는 편의 추출에 의한 297명이었다. 연구참여자는 캄보디아 프놈펜의 3개 종합 병원 외래를 방문한 18-64세의 고혈압 진단받은 지 6개월 이상 경과된 환자들이었다. 질문지는 인구학적 특성(9문항), 고혈압 관련 지식(22문항), 자기 효능감(5문항), 인지된 민감성과 심각성(8문항) 및 자가관리 활동(29문항) 등 73문항으로 구성되었다. 자료의 분석은 SPSS 23.0을 사용하여 서술적통계, t-test, ANOVA, 및 상관계수를 구하였다. 연구결과는 다음과 같다. 2. 연구 참여자의 평균 연령은 61세였는데, 그들 중 여성이 74.4%, 기혼자가 67.7%, 무학이나 초등학교 졸업자가 63.3%, 93.3% 가 불교였고, 농촌 거주자는 64.3% 였다. 고혈압으로 진단 받은 후 평균 경과 기간은 2.68년이었다. 3. 평균 고혈압 관련 지식점수는 15.04(0-22범위), 자기효능감은 29.81(1-50범위), 인지된 심각성은 15.28(1-40범위), 자가관리 활동은 109.86(0-203범위) 이었다. 4. 고혈압관련 지식점수는 교육기간집단에 따라 차이가 있었는데, 사후검정 결과 중학교 졸업 군이 초등학교 졸업 군이나 무학 군보다 유의하게 높았다(F=5.17, p<.01). 자기 효능감 점수는 50대 연령군이 69세 이상 군보다 유의하게 높았고(t=3.71, p=.01) 중학교 졸업군이 초등학교 졸업군이나 무학 군보다 유의하게 높았고(F=4.38, p<.01), 농촌거주자가 프놈펜 거주자군 보다 유의하게 높았다 (t=-3.13, p<.01). 5. 자가관리 활동 점수와 고혈압관련 점수는 낮지만 유의한 상관관계를 보였고(r=.21, p<.001), 또한 자기효능감과도 낮지만 유의한 상관관계를 보였다(r=.21, p<.001). 그러므로, 이상의 결과를 근거로 캄보디아 성인 고혈압환자들의 자가관리 수준을 높이기 위한 간호중재로는 고혈압 관련 지식을 높이고 자기효능감을 높이기 위한 간호전략이 우선되어야 할 필요가 시사되었다.