Effectiveness of INOSEL program consisting of Integrative Nursing and Omaha System for older women feeling loneliness: a randomised controlled trial.

OBJECTIVES: To evaluate the effectiveness of an intervention combining Integrative Nursing and Omaha System on physical, mental, social, spiritual health of older women living with high level of loneliness. The second aim was to determine the effect of Omaha System interventions on knowledge, behaviour and status scores. METHODS: A randomised controlled trial was conducted with 69 older women feeling loneliness (INOSEL n = 36, control n = 33 groups). INOSEL group received group-based and person-centered intervention and control group received routine care. RESULTS: INOSEL and control groups showed an improvement in loneliness score. The decrease in loneliness score and level was higher in the INOSEL group. The physical activity, health status perception, social support, social inclusion, well-being, and spirituality scores increased in the INOSEL group. INOSEL group experienced an increase in the knowledge, behaviour and status. DISCUSSION: INOSEL program, a theoretical structure, reduced loneliness and positively affected women's health. IMPLICATIONS FOR PRACTICE: Health professionals can use this program based on Integrative Nursing and Omaha System in nursing caring. CLINICAL TRIAL REGISTRATION: NCT03695133.

Effects of Transitional Care Model-Based Interventions for Stroke Patients and Caregivers on Caregivers' Competence and Patient Outcomes: Randomized Controlled Trial.

This study evaluated the effectiveness of the Transitional Care Model Stroke Turkey for stroke patients and caregivers as regards the competence of caregivers and patient outcomes. It is a parallel-group, assessor-blinded monocenter conducted with 126 participants in total (66 intervention included 33 stroke patients and 33 caregivers; 60 control groups included 30 stroke patients and 30 caregivers), between March and August 2018. The Transitional Care Model Stroke Turkey program lasts for 13 to 20 weeks. It includes a 12-week follow-up after discharge, a minimum of three hospital visits, one home visit, minimum 18 phone calls, and Web-based training. The intervention group exhibited better caregiver competence (13.48 ± 2.31), preparation for care (28.48 ± 4.74), and e-health literacy (34.42 ± 4.74) than the control group (respectively, 11.37 ± 2.48, 20.93 ± 7.10, 26.93 ± 8.53) ( P < .001). Emotional exhaustion and depersonalization increased in the control group, but remained the same in the intervention group. Personal accomplishment decreased in the intervention group, unlike in the control group. Within 12 weeks of discharge, five patients from the intervention group and seven patients from the control group were rehospitalized. There was no statistical difference between stroke patients in either group in terms of having previously used home healthcare services. The Transitional Care Model Stroke Turkey is a practical model for stroke patients transitioning from hospital to home.

Community-Dwelling Adults' Perceived Versus Actual Risk of Cardiovascular Disease, Body Mass Index, and Physical Activity Levels and Related Factors.

CONTEXT: The difference between actual and perceived risk levels shows distorted risk perception. Unrealistic perceptions of cardiovascular disease (CVD) risks and insufficient knowledge about CVD risk factors can not only hinder the adoption of a positive lifestyle change but also obstruct preventive efforts. OBJECTIVE: The aim of this study was to evaluate the concordance between perceived and actual risks, body mass index (BMI), and physical activity levels. DESIGN: This descriptive study included 522 community-dwelling adults in 2 different regions of Antalya/Turkey. The actual CVD risk level of the participants was determined using the "HeartScore program," actual body weight was determined according to BMI, and actual activity levels were found using the "International Physical Activity Questionnaire Short Form (IPAQ-SF)." The perceived risks were measured with the CVD Risk and Risk Factors Perception Determination Questionnaire. CVD Risk Factors Knowledge Level (CARRF-KL) Scale was used to calculate the participants' level of knowledge about the risk factors. RESULTS: There was no concordance between the participants' actual and perceived CVD risks. A below-average agreement was found between the participants' actual and perceived BMI levels. In terms of actual measurements, it was seen that slightly obese individuals have a realistic perception. There was a weak agreement between the actual and perceived physical activity levels of the adults. Knowledge about the CVD risk factors of adults does not affect the perception of CVD risk and BMI and physical activity. CONCLUSIONS: Adults have an optimistic risk perception regarding CVD risk, BMI, and physical activity levels. It may be beneficial to periodically assess actual risks to change skewed perceptions of CVD and risk factors. These findings will inform the development of tailored intervention strategies and policies for these adults.

The Healthcare Environment Survey: A multicountry psychometric evaluation of nurses' job satisfaction.

AIM: To evaluate the properties of a reduced-item Healthcare Environment Survey measuring nurses' job satisfaction across eight countries. BACKGROUND: There is currently no rigorously tested international measure of nurses' job satisfaction that can be used internationally to improve the nurse work environment. METHODS: Nursing staff from 11 hospitals in eight countries participated in this study. The original 57-item, 11-facet Healthcare Environment Survey was evaluated for reliability, validity, and measurement invariance: Cronbach's alpha was used to test for reliability; construct, discriminate, and convergent testing were used to test validity; and invariance testing including configural, metric, and scalar tests were used to study measurement invariance between the countries. RESULTS: 2,046 nursing staff completed the survey. Reliability was established for all six subscales and the combined composite score. Both validity and measurement invariance were supported in every test conducted. An excellent model fit was found for the final 19-item, 6-facet Healthcare Environment Survey that explained 82% of the variance of nurses' job satisfaction. CONCLUSIONS: Findings suggest the instrument is an efficient measure of nurses' job satisfaction across multiple countries. Longitudinal testing for invariance will be needed to ensure the model remains a good fit. Testing more countries will also verify model fit. IMPLICATIONS FOR NURSING: The instrument can be used to measure nurse job satisfaction globally. IMPLICATIONS FOR NURSING POLICY: The instrument can be used to assess interventions to improve the social (patient, unit manager, and coworker) and technical (professional rewards, autonomy, and professional growth) aspects of nurse job satisfaction.

Effect of Telehealth Interventions on Blood Pressure Control: A Meta-analysis.

The aim of this study was to find out the effects of telehealth interventions on blood pressure control by conducting a meta-analysis. Six databases were used. The literature review covered the period between December 1, 2020, and January 26, 2021. The meta-analysis was conducted by comprehensive Meta-Analysis Software version 2.2. Categorical variables were analyzed by odds ratios at a confidence interval of 95%. In data formatting and analysis, independent groups (sample size, P value); independent groups (mean, SD); Cohen's d, SE; and paired groups (N, P value) were used. The bias risk was assessed based on the Revised Cochrane Risk-of-Bias Tool for Randomized Trials. Total sample size including 22 studies was 11 120. It was determined that interventions performed through telehealth applications had a significant effect on blood pressure control (odds ratio = -0.14; 95% confidence interval = -0.20 to -0.08; P < .001). In telehealth applications, blood pressure values decreased more when the application was performed through a Web site (-0.31; 95% confidence interval = -0.49 to -0.13), duration of the intervention was 12 months or shorter (-0.18; 95% confidence interval = -0.28 to -0.010), stroke developed in case of hypertension (-0.31, 95% confidence interval = -0.76 to 0.12), and the study was conducted in the Far East countries (-0.24; 95% confidence interval = 0.40 to -0.07). Interventions with telehealth applications are effective in blood pressure management. PROSPERO ID: CRD42021228536.

Nursing students' experiences of health screening in rural areas of southern Turkey: a qualitative study.

INTRODUCTION: Individuals in rural areas live with healthcare disadvantages relating to, for example, access to health institutions, necessary treatments, and healthcare professionals during medical emergencies. The aim of this study was to explore the experiences, beliefs and attitudes of nursing students to identify advantages and disadvantages of health screening in several rural areas in rural Turkey. METHODS: Health screening practices with senior nursing students were conducted in six rural areas. A qualitative descriptive study was performed using thematic analysis of open-ended responses to a web-based survey of 34 students aged 18 years and over. This study was conducted in March and April 2020. RESULTS: The practices of nursing students in rural areas included measuring vital signs, body mass index calculation, blood glucose and cholesterol measurement, depression screening, cancer screening and health education. Students undertook various health screening practices in rural health care including colorectal cancer screening, evaluation of scales used in diabetes and depression risk. Characteristics referred to by student nurses as part of public health nursing roles were protector, advocate, supporter, caregiver, coordinator, collaborator, educator, counsellor, researcher, therapist, case manager, leader and care provider. The main themes generated related to student emotions, feedback of screening participants to nursing students, positive nursing characteristics, advantages and disadvantages of doing health screening in rural areas, benefits of working with health professionals to nursing student education, and feedback for nursing educators and researchers. CONCLUSION: Participants recognised their emotions, and the benefits and advantages of health screening practices, and disadvantages were determined across the themes. Health services should be planned by taking these experiences into account in health screenings to be carried out in rural areas.

The effect of lifestyle physical activity in reducing cardiovascular disease risk factors (blood pressure and cholesterol) in women: A systematic review.

Cardiovascular diseases (CVD) are the most important cause of death in older women. Although there is strong evidence in the literature that moderate lifestyle physical activity (PA) is effective in modifiable CVD risk factors, there is limited evidence demonstrating which activities are effective in women. This systematic review was conducted to evaluate the effect of lifestyle PA interventions on CVD risk factors in women. Various databases were searched for English articles from 2000 to 2019. Eight articles met the selection criteria. It is recommended to use different combinations of interventions including moderate PA, to reduce CVD risk factors in women.

Is home parenteral nutrition safe for cancer patients? Positive effects and potential catheter-related complications: A systematic review.

PURPOSE: Total Parenteral Nutrition began to be applied frequently in the houses of patients starting from the 1990s and is stated in literature as Home Parenteral Nutrition (HPN). The purpose of this review is to answer the question of whether or not HPN is safe for cancer patients. METHODS: Searches were conducted in Cochrane, CINAHL, PubMed, Springer, Google Scholar, and the Web of Science databases. RESULTS: The 1,949 articles were accessed in the total, and 20 articles have been included in the review. In the studies being evaluated, it can be determined that HPN has influenced the quality of life, performance status, and the nutrition level of cancer patients positively. Most frequently seen complications were infections relating to the catheter, the mechanical obstruction in the catheter and venous thrombosis. For each 1,000 days with HPN or a catheter, infections in the interval of 0.05 and 3.08, mechanical problems in the interval of 0.07 and 2.13, and thrombosis in the interval of 0.05 and 0.20 were determined. CONCLUSIONS: While HPN influenced quality of life, nutrition, and the personal performance of cancer patients positively, the rate of complications is at a level that can be managed at home.

A comparative study on perception of body weight of women from different socioeconomic levels.

The purpose of the study was to evaluate perception of body weight (PBW) of women who live in two different regions of the Antalya provincial center in Turkey with different socioeconomic status (SES) and whose ages range from 50 to 65. A cross-sectional survey was conducted. Association with PBW was investigated using multiple logistic regression analyses; correct PBW of women in middle SES was 0.28 times more than those in upper-middle and upper SES. Health professionals should take unemployed women with high body mass index and low SES as a target group.

Cultural sensitivity levels of university students receiving education in health disciplines.

Medical and nursing students are expected to be more competent in terms of being acquainted with different cultures and approaching culturally, compared to many other disciplines. This descriptive study was designed to evaluate the cultural sensitivity levels of nursing and medical students and the affecting factors. One hundred and eleven nursing and 164 medical students were included in the study. The data were collected by using a questionnaire questioning the variables that were thought to affect the cultural sensitivity of students and the intercultural sensitivity scale. According to results of the study; it was observed that university students receiving education in the fields of medicine and nursing had good cultural sensitivity levels and those interacting with people from other cultures and speaking a foreign language had significantly higher cultural sensitivity levels (p < 0.05). According to these results, it was thought that it would be useful to develop plannings aimed at increasing the language proficiency in university curriculums and abroad experience opportunities of students, and to design qualitative studies based on interviews and observations aimed at examining the factors affecting the intercultural sensitivity.

Evaluation of Quality, Content, and Use of the Web Site Prepared for Family Members Giving Care to Stroke Patients.

This study was designed to evaluate the quality, content, usability, and efficacy of a Web site prepared for the purpose of improving the caregiving capability of family members who provide care for stroke survivors at home. The DISCERN score for the Web site was found to be 4.35 over 5. The first section that assesses reliability of the Web site was 4.38 over 5; mean score of the second section that measures the quality of the provided information on treatment/care options was 4.30, and mean score of the third section that gives a general evaluation of the material was 4.1. The Web site content achieved an average score of 3.47 over 4 after evaluation by experts. The Web site system usability score was found to be 79.4 over 100. The Web site was utilized mostly for exercises in bed (76.3%; n = 29), use of medications, and patient safety (68.4%; n = 26). It was determined that those who were younger and employed and had no previous experience of nursing any patient utilized relatively more from the section of patient nutrition and oral care and married family caregivers from the body hygiene section. The Web site quality and content were judged to be good and reliable to use. The Web site was efficiently used by caregivers.

Psychometric features of an assessment instrument with likert and dichotomous response formats.

OBJECTIVE: To assess the psychometric properties of a Likert-formatted assessment instrument after altering the responses to a dichotomous format. DESIGN AND SAMPLE: This methodological study used a 15-item instrument to obtain data from 183 participants who responded in both Likert and dichotomous formats. Response sets from each format were compared. MEASURES: Each response set underwent factor analysis, Kuder-Richardson 20, Cronbach's α coefficient, item-total correlation, and parallel form equivalence tests. RESULTS: Factor loads of the instrument varied between .362 and .754 when responses were Likert-formatted and between .370 and .713 when responses were dichotomous. The Cronbach's α coefficient with Likert-formatted responses was .858; the Kuder-Richardson 20 coefficient of the dichotomous responses was .827. Parallel form equivalences were significant at the level of r = .753. CONCLUSIONS: The instrument had valid results when either Likert or dichotomous responses were obtained.

Complementary and alternative approaches used by parents of children with epilepsy on epilepsy management.

The aim of this study was to determine the complementary and alternative approaches used by parents of children with epilepsy on epilepsy management. This descriptive study included a total of 304 parents of children with epilepsy aged between 0 and 18years evaluated at the Pediatric Neurology Clinic of Akdeniz University Hospital in Turkey between January and May 2013. Data were collected by using a questionnaire developed by the researchers. It was determined that all the parents use complementary and alternative approaches for their children with epilepsy, and the most common approaches are praying (99.3%); keeping their children away from the effects of smoking (79.8%); feeding their children walnuts (79.6%), butter (59.2%), and bone marrow (58.6%); providing their children with good quality sleep (58.6%); and enabling their children to play games (51%). The approaches commonly applied during seizures include praying (96.2%), comforting their children in their arms and showing affection (55.6%), waiting for seizures to finish at home (45.7%), and laying children on their side (41.1%). Of parents, 98% stated that alternative approaches enable them to control their child's seizures, 100% said that alternative approaches have no adverse effect, and 98.4% stated that they will continue to use these approaches. The children's approaches to cope with epilepsy included looking after pets (72.7%), listening to music (70.1%), watching television (64.5%), playing games (55.3%), praying (51%), and spending time with friends (48.7%). Most of the approaches used by parents and children with epilepsy for the management of illness are determined to consist of complementary approaches that may contribute to management of epilepsy. Knowing the approaches of parents and children with epilepsy that could adversely affect disease management is important for educating parents and children to avoid these potentially harmful interventions.

Development of family health nursing certificate program for Turkey: Delphi study.

BACKGROUND: There are 26,252 family medicine units and the same number of family health workers in Türkiye. However, the educational standards and professional identities of these employees differ from international definitions. OBJECTIVES: The aim of the study was to create a draft Family Health Nursing Certificate Program using the Delphi consensus technique. METHODS: The study was conducted both online and face to face from 15 March to 25 May 2022. The research encompassed academic nurses working in the field of family health nursing and family health workers working in family health centres in Türkiye. Two rounds of the Delphi survey were undertaken. The first was completed by 38 experts and the second by 35 experts. Definition, title, education level, duties, and responsibilities of the family health nurse, along with consensus regarding the necessary certification, screening, follow-up and practices among family health nurses, were evaluated for the draft Family Health Nursing Certificate Program. The criteria for consensus on Likert-type questions were a width value of 1.50 and a percentage agreement of 75 %. RESULTS: Consensus was reached at rates of 84.5 % and 62.2 % on the items in the first and second rounds, respectively, with rates of 89.2 % and 45 % on the Likert-type questions. At the end of the survey rounds, an 85.6 % consensus was reached on all topics and an 85.9 % consensus was reached on the Likert-type questions. CONCLUSIONS: The Family Health Nursing Certificate Program drafted by consensus can be used for nurses working in family health centers in Türkiye, to guide educational proficiency and standardization. It may also be used as a comprehensive guide in countries other than Türkiye.

Effects of the Omaha System- and HeartScore®-Based Impaired-Risk Perception Reduction Program on the Risk Perception of Individuals Aged 50-65 Years: A One-Group Pre-Test-Post-Test Study.

PURPOSE: This study evaluates the impact of interventions in the Omaha System and HeartScore®-based program to reduce impaired-risk perception. DESIGN: and setting: This study utilized a one-group pre-test-post-test design. SUBJECTS: The program was conducted among participants aged over 50 years from different social settings. INTERVENTION: The program had three parts: a briefing on HeartScore® recommendations, Omaha System interventions, and referral to a doctor. MEASURES: HeartScore® determined cardiovascular disease (CVD) risk, body mass index (BMI) was calculated from height and weight, and the International PA Questionnaire evaluated physical activity (PA) levels. Self-assessment was used to perceived CVD risk, BMI, and PA. ANALYSIS: We used the Wilcoxon signed-rank test to compare the pre-test and post-test scores of the Omaha System, the problem rating scale (PRS) subscales and McNemar test to measure changes in CVD risk perception, BMI, and PA level. RESULTS: 310 high-risk individuals out of 522 had impaired perception of their CVD risk. Only 201 responded to follow-up phone calls. Interventions based on HeartScore® and Omaha System improved CVD risk and PA perceptions (P < .001) but not BMI. The program significantly increased knowledge, status, and behavior scores (P < .001). After participating, 39% saw a cardiologist, and 57.2% saw a family physician within six months to reduce impaired risk perception. CVD risk perception increased to the actual level after the intervention, mostly in the group with low education level. CONCLUSIONS: The program using the Omaha System and HeartScore® can help middle-aged individuals better understand their risk of cardiovascular disease.

Impaired perception of cardiovascular risk and health literacy in individuals with high cardiovascular diseases risk from different socioeconomic levels in Antalya, Turkey.

BACKGROUND: This study aimed to determine how the frequency of impaired perception of cardiovascular disease (CVD) risk is correlated with health literacy in individuals with high CVD risk in two regions with different socioeconomic levels. METHODS: A descriptive study was conducted. The Systematic Coronary Risk Estimation, recommended by the European and Turkish Cardiology Societies, provides recommendations based on individuals' actual CVD risk levels. According to the Systematic Coronary Risk Estimation, participants suffering from diseases were identified as high and very high risk. The perception of risk was determined by subjectively assessing the risk level of the individuals. The European Health Literacy Survey Questionnaire was used. The Mann-Whitney U test, Chi-squared test and Spearman's correlation analysis were used to analyse the data. We also conducted a logistic regression analysis to identify factors contributing to impaired perception of CVD risk. RESULTS: A total of 384 individuals, aged between 40 and 70years (with a mean age of 58.35±8.33years), were included in the study. These individuals had a high risk of CVD and were registered to family health centres from two different socioeconomic levels. Out of the 384 participants, 201 individuals belonged to the lower socioeconomic level region and 183 individuals belonged to the higher socioeconomic level region. A total of 61.7% of the participants with high CVD risk had an impaired perception of CVD risk. The health literacy level of 59.9% of individuals was either inadequate or problematic. The health literacy score of participants with impaired risk perception (29.59±9.07) was lower than those with correct risk perception (35.83±10.94; P <0.001). Factors that affected the perception of CVD risk included age, education level, working status, occupation, a family history of CVD, the CVD risk assessment by health professionals and the recommendation of health professionals to individuals for CVD screening. CONCLUSIONS: It is necessary for health care professionals to make risk assessments and perform interventions to improve health literacy to raise the awareness of individuals with high CVD risk on their actual risk.

The Effect of the Breast Cancer Risk Reduction Program on Women With High Breast Cancer Risk in Terms of Their Participation in Screening and Their Health Beliefs and Behavior: A Study Protocol for a Randomized Controlled Trial.

BACKGROUND: First-degree biological relatives of individuals with breast cancer have a higher risk of breast cancer. OBJECTIVE: The purpose of this study was to create a protocol for evaluating the effect of the Breast Cancer Risk Reduction Program (BrCaRRP) on the participation of women at risk in screening and on their health beliefs and risk reduction behaviors. METHODS: The research was planned as a single-site, single-blind randomized controlled experimental study with a parallel group. Participants will be assigned to intervention and control groups using the Stratified Permuted Block Randomization method. The BrCaRRP will be applied to the intervention group within the theoretical framework of the Health Belief Model and the Health Promotion Model. The BrCaRRP is a 12-week program that encompasses 6 meetings, the first being face-to-face and the others via phone. Multidisciplinary experts calculated the content validity index of BrCaRRP as being 0.954 (high); its weighted kappa statistic is 0.70 (high). RESULTS: The difference in the likelihood of participation in breast cancer screening between the BrCaRRP and control groups will be evaluated after the interventions. Findings will be presented in terms of our hypotheses. CONCLUSIONS: The BrCaRRP is a nurse-led program based on the Health Belief Model and the Health Promotion Model. The BrCaRRP has high content validity and interrater reliability. IMPLICATIONS FOR PRACTICE: This protocol can be tested as an intervention in a randomized controlled study.

The Profile of Caring: An Internationally Tested Model to Assess and Support Nurses During Pandemic.

The psychological impact of the COVID-19 pandemic on nurses, and subsequent increases in turnover, have been extensively documented. This article examines a profile of nurses which included (1) the degree to which direct-care nurses are caring for themselves, (2) the degree to which their manager acts in a caring way, (3) the degree to which nurses have clarity about their professional role and about how the system works, and (4) the degree to which nurses are satisfied with essential social and technical dimensions of their jobs, to help understand how some of the critical internal states and working relationships of nurses fit together as a model. To test the model, authors used structural equation modeling with a 35-item measurement tool in three countries (Russia, Serbia, and Turkey; n = 984), replicating a recent 8-country study. Results revealed a good model fit, similar to the original study, despite statistically significant differences in mean scores between the countries studied. Good model fit with a second group of countries, despite differences in mean scores, suggests that results from both studies can be used for a global conversation about how caring, clarity, and job satisfaction in nursing relate to one another. These results provide evidence that health facilities should study variables such as caring for self, caring by the unit or department manager, clarity of role and system, and job satisfaction to learn about, recover, and monitor nurses' health and experience of work as they emerge from the pandemic.

The effect of the odor of breast milk on the time needed for transition from gavage to total oral feeding in preterm infants.

PURPOSE: The aim of this study was to investigate the effect of the application of the odor of breast milk in preterm infants during gavage feeding on the period of transition to total oral feeding. DESIGN: This prospective experimental study was performed on a total of 80 preterm infants: 40 infants in the study group and 40 in the control group. METHODS: This experimental study was performed in eastern Turkey at the Neonatal Intensive Care and Premature Unit of a university hospital between September 2007 and December 2008. The demographic data were collected via a questionnaire, and an intervention and follow-up table was prepared by the researcher based on relevant literature. The study was approved by the local institution, and written informed consent was obtained from all parents. FINDINGS: The findings of the study indicated that the preterm infants who were stimulated by the odor of breast milk during gavage feeding transitioned to oral feeding 3 days earlier than control subjects. Moreover, the mean hospitalization time of these infants was 4 days shorter. CONCLUSIONS: The results show that stimulation with breast milk odor is an effective method for decreasing transition of preterm infants from gavage to oral feeding. CLINICAL RELEVANCE: Nurses can train mothers to pump their breast milk, stimulate their infants with the odor of their breast milk, and feed it to their infants in the premature unit. This may lead to a quicker transition to oral feeding.

The effect of patient education and home monitoring on medication compliance, hypertension management, healthy lifestyle behaviours and BMI in a primary health care setting.

AIM: The aim of this study was to determine the effect of anti-hypertensive patient-oriented education and in-home monitoring for medication adherence and management of hypertension in a primary care setting, by providing education on healthy lifestyle behaviours and medication adherence. BACKGROUND: Hypertension is the third most common cause of death worldwide. Prevalence of hypertension in Turkey is approximately 30% in the general population and 45-50% in population over 50. DESIGN: Randomised controlled study. METHODS: This study conducted in Turkey used a study group comprised of 120 subjects (40 Group A, 40 Group B, 40 controls), all previously diagnosed with hypertension and who started medication therapy at least one year prior to start of study. The study was conducted between February-November 2006 at public primary health care facilities and homes of the study participants. Participants in Group A and B received a total of six monthly education sessions, four times during clinic visits and two home visits. Medication adherence education for Groups A and B and education about healthy lifestyle behaviours for Group B were administered in a structured and individualised format. The control group was routinely monitored in health care facilities. RESULTS: Healthy lifestyle behaviours and perception of self-efficacy regarding medication adherence showed improvement after education sessions in Groups A and B. Systolic and diastolic blood pressures of subjects in Group A and B showed a significant decrease compared with those of the control group; the blood pressure decrease in Group B was greater than in Group A. CONCLUSION: Nurses play an important role in uncontrolled hypertension detection and can improve medication adherence and healthy lifestyle behaviours. RELEVANCE TO CLINICAL PRACTICE: Patient education medication adherence alone and in combination with healthy lifestyle behaviour teaching is an effective tool for blood pressure reduction in the hypertensive population in primary health care settings.