Introduction
Hypertension is one of the major global health issues and is commonly referred to as high blood pressure due to the feature of arterial blood pressure elevation. Hypertension, which is also a chronic condition is usually diagnosed when a person’s blood pressure remains above 140/90 mmHg after three blood pressure measurements (Hu, Li & Arao, 2013). Globally, twenty-six percent of the entire adult population is estimated to be living with hypertension. Some regions of the world such as Europe tend to have a higher level of hypertension reaching up to forty-five percent of the region’s population. There is no known specific cause of hypertension as the condition is believed to be multi-factorial. Hu et al. (2013), argues that the risk of the disease tends to rise with aging and dietary inclinations. Hypertension can result as a secondary complication of various conditions such as kidney failure, obesity, and hyperthyroidism.
Hypertension is relevant to the nursing profession given that it has led to the development of evidence-based care modalities for chronic conditions. The listing of hypertension as a global health issue has resulted in the development of nursing knowledge aimed at the standardization of nursing care across different regions. The nursing profession has also benefited further as a consequence of the development of patient education in an attempt to ensure that hypertensive patients can live with the condition. Nursing has also been impacted as a result of the interdisciplinary approach that is adopted in the management of hypertension (Hedari, Shahbazi & Aliakbari, 2012). Hypertension research has also contributed to the growth of the body of knowledge within the nursing profession.
The number of persons living with hypertension in the USA is not different from the global scenario with data showing that the rate of emergency department visits is rising significantly as a result of hypertension. The diagnosis of hypertension in the USA is consistent with international standards. Given that hypertension is a chronic condition nursing management is mainly focused on the control of disease through medication (Li, Wallhagen & Froelicher, 2010). As such, there are numerous concerns regarding the adherence to hypertensive medication among hypertensive patients in the USA. In the USA, the focus on the management of hypertensive takes the approach of group study on multiple groups. It is assumed that behavioral aspects that have an impact on the control of the condition vary with each cluster (Li et al., 2010).
In Iran, hypertension is also listed as one of the major health systems concerns. The standards of diagnosing hypertension in Iran are aligned with global standards. Given the rise in an aging population in Iran, the country has also witnessed an increase in the number of persons who live with hypertension (Hedari, et al., 2012). The control of blood pressure among hypertensive patient is important in Iran and as such the nursing research has focused on this area. The knowledge of nurses on how to manage hypertension is a critical area as evidenced in the literature (Hedari, et al., 2012). Nurses have a role in the management of hypertension given the contribution of patient education in ensuring that patients comply with the provided medication regimen.
Study
Study 1: Nursing research Study in the USA
Li, W., Wallhagen, M., & Froelicher, E. (2010). Factors predicting blood pressure control in older Chinese immigrants to the United States of America. Journal of Advanced Nursing, 66 (10), 2202–2212.
Purpose
The study aimed at evaluating the factors that predict the control of blood pressure in a population of elderly Chinese immigrants to the USA. The paper focuses on the role of demographic characteristics in the blood pressure of the study population. The study also evaluates the role of medication-related aspects and adherence to medication in controlling blood pressure among elderly Chinese immigrants (Li et al., 2010). The role of knowledge level in controlling blood pressure among Chinese immigrants is also evaluated.
Participants
The study participants included a sample of ninety Chinese immigrants living in the United States. The participants were chosen from a population of Chinese immigrants aged sixty-five years and above during the period from 2006 to 2007.
Methods
The study adopted a longitudinal design where the participants were followed up for three months. The researchers measured the baseline variables, and the same measurements were repeated at different intervals during the research process. The study applied a multiple linear regression analysis to carry out an evaluation of the seven variables on blood pressure. Each of the seven variables was evaluated independently to yield more accurate data.
Findings
The provision of a high number of prescribed medications and the reduction in adherence levels was good predictor of systolic blood pressure levels. According to Li et al. (2010), being a male Chinese-immigrant in the United States accompanied by reduced levels of medication adherence was associated with an increase in the diastolic blood pressure of the participants. The study found out that when designing interventions for hypertension among Chinese Immigrants, it is important to include an education component as it positively impacts the control of blood pressure.
Study 2: Nursing Research Study (Non-USA)
Hedari, M., Shahbazi, S., & Aliakbari, F. (2012). Determining the awareness of nurses regarding the basis of blood pressure control. International Journal of Nursing Education, 4 (2), 206-208.
Purpose
The study aimed at evaluating the level of awareness among nurses on the principles that are applied in the control of blood pressure. It is critical for nurses to have the clinical skills of measuring blood pressure, but most importantly, nurses should be able to measure blood pressure and interpret the findings correctly.
Participants
The study participants included a sample of eighty-five nurses who were drawn from a population of nurses who were working in Valiasr Hospital in Borujen, Iran.
Methods
The study adopted a descriptive-analytic design. The researcher collected data from the participants using two different questionnaires namely a demographic information questionnaire and a primary information questionnaire. The primary questionnaire focused on the issues related to blood pressure control (Hedari, et al., 2012). The study carried out data analysis using several statistical tests, the Chi-square test as well as the direct T-test.
Findings
The study found out there is minimal awareness of basic principles of blood pressure control among nurses in Iran. Nurses with the highest awareness level were rated at fifty-eight percent level of knowledge (Hedari, et al., 2012). The level of knowledge among nurses practicing in the general wards was higher as compared to the nurses in specialized wards.
Study 3
Hu, H., Li, G., & Arao, T. (2013). Prevalence rates of self-care behaviors and related factors in a rural hypertension population: A questionnaire survey. International Journal of Hypertension, 13 (10), 89-93.
Purpose
The study aimed at investigating the self-care associated behaviors among hypertensive patients in a rural setting who had access to primary care (Hu et al., 2013).
Participants
The study participants included a sample 318 hypertensive patients drawn from a population of hypertensive patients in a rural area of China. The target population was the comprised of persons who visited a community health clinic seeking health care (Hu et al., 2013).
Methods
The study adopted a cross-sectional survey design. Participants were recruited through the provision of questionnaires aimed at assessing self-care behaviors at the clinic level. The study applied a logit regression model to analyze the association between variables related to self-care and the control of blood pressure.
Results
The findings of the study indicated that persons who adhered to their medication schedule were more likely to experience a longer duration of hypertension disease. Older hypertensive patients were more likely to engage in self-directed blood pressure monitoring. The study revealed that newly diagnosed patients of a younger age had relatively low self-care behaviors. According to Hu et al. (2013), the tendency of adopting self-care behaviors decreased even further if the hypertensive patient was of the male gender.
Study 4
Grobler, L., Roets, L., & Joubert, G. (2005). Nurses’ knowledge of and attitude towards exercise as a treatment method for hypertensive patients. South African Journal of Physiotherapy, 61 (2), 11-14.
Purpose
The study sought to evaluate the level of knowledge among nurses working in the primary health care set up regarding the use of exercise as a method of controlling hypertension. The study also sought to evaluate the attitude of nurses on the same issue.
Participants
The study participants included a sample of forty-three nurses drawn from a population of sixty-seven nurses working in Bloemfontein clinics.
Methods
The study adopted a descriptive design with the forty-three participants completing structured questionnaires. The questionnaires were designed to evaluate the knowledge level among the nurses regarding exercise being used as a treatment method for hypertensive patients. The researchers also carried out focus group discussions with an aim of evaluating the nurses’ attitude on the use of exercise to treat hypertensive patients.
Findings
The study revealed that nurses lack adequate knowledge to prescribe confidently exercise as a treatment modality for hypertensive patients. The study findings indicate that nurses required more information and were even willing to present exercise classes (Grobler, Roets & Joubert, 2005). According to the findings, there was a need to develop a training program for the nurses on the subject matter to boost the work of controlling blood pressure.
Conclusion
Hypertension is a chronic illness that requires the adoption of measures that can lead to the control of blood pressure. As such, there is a need to evaluate multiple factors that can be applied to ensure that the control of blood pressure is achieved among the hypertensive patients. The measures applied in controlling the blood pressure can be either driven by the patients or the healthcare providers, particularly nurses (Grobler et al., 2005). When designing blood control measures, it is important that to consider the patient-related factors that could hinder the process. It is also important to ensure that nurses are well versed in the management of blood pressure given the critical role they play in the process.
References
Grobler, L., Roets, L., & Joubert, G. (2005). Nurses’ knowledge of and attitude towards exercise as a treatment method for hypertensive patients. South African Journal of Physiotherapy, 61 (2), 11-14.
Hedari, M., Shahbazi, S., & Aliakbari, F. (2012). Determining the awareness of nurses regarding the basis of blood pressure control. International Journal of Nursing Education, 4 (2), 206-208.
Hu, H., Li, G., & Arao, T. (2013). Prevalence rates of self-care behaviors and related factors in a rural hypertension population: A questionnaire survey. International Journal of Hypertension, 13 (10), 89-93.
Li, W., Wallhagen, M., & Froelicher, E. (2010). Factors predicting blood pressure control in older Chinese immigrants to the United States of America. Journal of Advanced Nursing, 66 (10), 2202–2212.