Determinants of Self-Care and Home-Based Management of Hypertension: An Integrative Review

Abstract

Introduction: Patients with hypertension should perform diverse self-care activities that incorporate medication adherence and lifestyle modification, such as no smoking or alcohol, weight reduction, a low-salt diet, increased physical activity, increased self-monitoring, and stress reduction, for effective management at home.

Aim: This systematic review assessed and synthesized the factors that are associated with self-care and home-based management of hypertension.

Methods: The search of the articles incorporated the population, intervention, comparison, and outcome (PICO) framework. The literature was searched in four databases (PubMed, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], Embase, and Web of Science) until 2022. The articles retrieved and searched from the reference list (531) were transported to EndNote version 20, and duplicates (19) were identified and removed to produce 512 titles. Following the eventual title, abstracts, and full-text screening, 13 articles were appropriate for this study. The narrative and thematic data analysis were used to analyze and integrate the data.

Results: The analysis showed five themes were associated with home-based self-care and blood pressure (BP) control among patients diagnosed with hypertension. These themes that emerged were (1) the prevalence of control of BP, (2) sociodemographic factors, (3) treatment-related factors, (4) knowledge of management, and (5) knowledge of the prevention of risk factors of hypertension. The demographic factors influencing home-based self-care for hypertension were gender, age, and socioeconomic status. In contrast, the treatment factors were duration of hypertension treatment, medication burden, and medication adherence. Other factors that influenced self-care were inadequate knowledge of BP management, follow-up care, and risk factors of hypertension.

Conclusion: Hypertension self-care interventions must incorporate individual, societal, and cultural perspectives in increasing knowledge and improving home-based hypertension management. Therefore, well-designed clinical and community-dwelling interventions should integrate personal, social, and cultural perspectives to improve behavior in the home management of hypertension by increasing knowledge and self-efficacy.

Keywords: adherence; care; home-based management; hypertension; self-care; treatment.