Predictores de conductas de autocuidado entre pacientes hipertensos con escasos conocimientos en salud, con base en un modelo de creencias sobre la salud en el distrito de Bushehr, al sur de Irán / Factors Predicting Self-Care Behaviors among low health literacy hypertensive patients based on Health Belief Model in Bushehr district, south of Iran

Azam Larki, Mahnoush Reisi, Rahim Tahmasebi

Resumen


Antecedentes: La hipertensión es un importante reto de salud pública a nivel mundial, que puede tener consecuencias muy graves. La estrategia más importante para controlar la presión arterial y mantenerla en un rango óptimo es el cumplimiento de las conductas de autocuidado por parte del paciente. El objetivo de este estudio fue determinar los factores que influyen en el cumplimiento de dichas conductas entre los pacientes hipertensos con pocos conocimientos sobre salud, basándose en un modelo de creencias respecto a la salud.

Métodos: Se realizó un estudio transversal entre 152 pacientes hipertensos con un nivel bajo de conocimientos sobre salud durante julio y agosto de 2017. Los pacientes con conocimientos limitados sobre salud se identificaron mediante cuestionarios S-TOFHLA. Los datos se recogieron utilizando la escala H para evaluar las conductas de autocuidado y, HK-LS para evaluar su conocimiento sobre la hipertensión. Se aplicó un cuestionario elaborado por el investigador para recoger datos acerca de los constructos relativos al modelo de creencias sobre la salud. Los datos se analizaron con la versión 22 del SPSS mediante un análisis de regresión logística múltiple.

Resultados: La edad media (±SD) de los participantes fue de 56.86 (8.7). El mejor cumplimiento de las conductas de autocuidado estaba relacionado con la abstención en el consumo de alcohol (78,9%) y el consumo de tabaco (55,9%), y el cumplimiento más bajo se relacionó con una dieta baja en sal (5,3%) y con el uso adecuado de medicamentos (9,2%). La eficacia auto-percibida se asoció con todas las conductas de autocuidado, excepto con los regímenes de medicación. Hubo una asociación significativa entre la susceptibilidad percibida respecto a las complicaciones derivadas de la hipertensión y la adherencia, tanto a una dieta baja en sal (OR = 3,47) como a la conducta de no fumar (OR = 1,10). Los individuos con más complicaciones graves percibidas (OR = 1,82), exhibieron una adherencia significativamente mayor a sus regímenes de medicación en comparación con los de menos complicaciones percibidas. Los beneficios y obstáculos percibidos no se asociaron significativamente con ninguno de los dos tipos de conductas de autocuidado de la hipertensión.

Conclusión: Parece que en el diseño y la implementación de programas educativos para aumentar la eficacia auto-percibida entre los pacientes, promover sus creencias sobre la susceptibilidad y la gravedad percibida en relación a las complicaciones derivadas de la hipertensión, puede ser útil para mejorar la adhesión a conductas de autocuidado entre los pacientes con bajos conocimientos de salud.

Palabras clave: Conductas de autocuidado; alfabetización sanitaria; Hipertensión; Irán

Abstract

Background: Hypertension is an important worldwide public-health challenge, which can lead to very serious consequences. The most important strategy for controlling blood pressure and maintaining it in the optimal range is patient compliance with self-care behaviors. The aim of this study was to determine the factors influencing adherence to self-care behaviors among low health literacy hypertensive patients based on health belief model.
Methods: A cross-sectional study was conducted among 152 hypertensive patients with low health literacy during July and August 2017. Patients with limited health literacy were identified by S-TOFHLA questionnaires. The data were collected using H-scale for assessing self-care behaviors and, HK-LS for assessing knowledge of hypertension. A researcher made questionnaire was applied for collecting data of health belief model constructs. Data were analyzed by SPSS version 22 with using multiple logistic regression analyses.
Results: The mean (±SD) age of participants was 56.86(8.7). The best compliance with self-care behaviors was related to lack of alcohol (78.9%) and tobacco use (55.9%), and the lowest was related to low salt diet (5.3%) and proper use of drugs (9.2%). Perceived self-efficacy was associated with all self-care behaviors except medication regimens. There was a significant association between perceived susceptibility about hypertension complications and adherence to both low-salt diet (OR = 3.47) and non-smoking Behavior (OR = 1.10). Individuals who had more perceived severity (OR = 1.82), had significantly greater adherence to their medication regimens compared to those who had less perceived severity. Perceived benefits and barriers were not significantly associated with either type of hypertension self-care behaviors.
Conclusion: It seems that designing and implementation of educational programs to increase self-efficacy of patients and promote their beliefs about perceived susceptibility and severity of complications, may be usefulness of the results in order to improve self-care behaviors among low health literacy hypertensive patients.
Keywords: Self-Care Behaviors; health literacy; Hypertension; Iran

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