Impact on blood pressure control of a six month intervention project

The aim of this study is to evaluate the impact of a six-month structured education programme on blood pressure (BP) control in patients with uncontrolled hypertension. All patients attending the Specialist Hypertension Clinic, University Hospital of the West Indies (UHWI), between January 4 and March 29, 1999, with blood pressure >140/90 mmHg (n=80), were randomly divided into Group 1, cases (n=42) and Group 2, controls (n=38). A 40-item pretested questionnaire, administered at the baseline and final visits of both groups, elicited demographic, lifestyles and knowledge data. Group 1 attending monthly structured interventions for six months. Except for diastolic blood pressure among male controls, disatolic blood pressure and systolic blood pressure were significantly reduced at the end of the intervention period (p < 0.01). Knowledge improved among the male patients (p < 0.01). Among the female patients, acitivity scores were significantly increased (p < 0.01), weight ( p < 0.05) and BMI (p < 0.05) were significantly reduced. There were no differences in these variables among the controls. This intervention had a benefit in blood pressure control.(Au)

Impact on blood pressure control of a six-month intervention project

OBJECTIVE: to evaluate the impact of a structured education programme on blood pressure (BP) control in patients with uncontrolled hypertension. METHODS: All patients attending the Specialist Hypertension Clinic, University Hospital of the West Indies, Kingston, Jamaica, between January 4 and March 29,1999, with blood pressure > 140/90 mmHg (n = 80), were randomly divided into Group 1, cases (n = 42) and Group 2, controls (n =38). Group 1 attended monthly structured intervention programmes for six months: blood pressure and weight monitoring, video presentations, group and individual counselling. A 40-item pre-tested questionnaire, administered at the baseline and final visits of both groups, elicited demographic, lifestyle and knowledge data. Both groups kept their usual clinic appointments. RESULTS: Except for diastolic blood pressure among male controls, diastolic blood pressure and systolic blood pressure were significantly reduced at the end of the intervention period (p < 0.01). Knowledge improved significantly among the male patients (P<0.01). Among the female cases, activity scores were significantly increased (p<0.01), weight (p<0.05) and body mass index (p<0.05) were significantly reduced. There were no differences in these variables among the controls. CONCLUSION: This intervention may have a benefit in blood pressure control.(Au)

Impact of a six-month intervention project on blood pressure control: preliminary report

OBJECTIVES: To describe the characteristics of uncontrolled hypertensive clients attending the specialist hypertension clinic at the University Hospital of the West Indies. To evaluate the effect of a six-month structured education programme on blood pressure (BP) control in these clients. METHOD: All clients attending the clinic between January 4 and March 29, 1999, with blood pressure >140/90 mmHg (n=80), were divided into Group 1, cases (n=42) and Group 2, controls (n=38). Blood pressure (BP), weight (wt), height (ht), waist (W) and hip (H) circumferences were measured and Body Mass Index (BMI) and W/H ratio calculated. Group 1 attended monthly structured interventions: BP and wt monitoring, videos, group and individual counselling for six months. A 40 item pretested questionnaire, administered to both groups, collected demographic, lifestyle, knowedge and medication data at baseline and at the end of six months. RESULTS: Mean BMI for men was 27.2 (95 percent CI, 25.7-29.6); mean BMI for women was 30.9 (95 percent CI, 26.1-35.7). Although the majority of both men and women recognized diet, inactivity and overweight as contributing to high blood pressure. Reported medication compliance was good with a mean of only 4 days missed per month. In men, there were associations between BMI and WWHR, p<0.05, BMI and diastolic BP and a negative association between BMI and activity level, p<0.05. Following the intervention, BP was reduced overall, p<0.01, except for diastolic BP in male controls. Knowledge improved among the male cases p<0.01. In the female cases activity scores were higher, p<0.001; Wt and BMI, were lower than at baseline, p<0.05. There was no difference in these variables among the controls. CONCLUSION: Structured education and monitoring interventions with personalised counselling in life style management and weight reduction may be an important part of therapy for clients.(Au)

Topical use of Papaya in chronic skin ulcer therapy in Jamaica

The objective of the study was to determine the prevalence of the use of the fruit (papaya) or Carica papaya as topical ulcer dressings by registered nurses in the Spanish Town Hospital (STH), Kingston Public Hospital (KPH) and the University Hospital of the West Indies (UHWI), Jamaica. A ten-item pre-tested self-administered questionnaire was distributed to 285 randomly selected registered nurses at the UHWI, KPH and STH. There was a 72 percent response rate. The prevalence of topical papaya use among the respondents was 75 percent. Comments from the users of papaya suggested that topical application of the unripe fruit promoted desloughing, granulation and healing and reduced odour in chronic skin ulcers. It was cost effective. Papaya was considered to be more effective than other topical applications in the treatment of chronic ulcers. There was some difficulty in preparation of the fruit and occasionally a standardised procedure but there were no reports of wound infection from its use. Papaya is widely used by nurses as a form of dressing for chronic ulcers and there is need for standardisation of its preparation and application.(Au)

Profile of uncontrolled hypertensive patients attending the specialist hypertension clinic, University Hospital of the West Indies

The purpose of this study was to describe the knowledge of hypertension, its management anthropometric measurements, blood pressure (BP), medication use, and current lifestyles of patients with persistent hypertension attending the Specialist Hypertension Clinic at UHWI from January to March 1999. Patients (n=80) who had a baseline systolic BP > 140mmHg and/or a diastolic BP > 90 mmHg were invited to participate in the study. BP, height, weight, waist/hip ratios (WHR) were calculated. A 40 item pretested questionnaire eliciting demographic data, level of activity, dietary habits, knowledge of hypertension, medication compliance, use of alternative medicines, and substance use was administered to each participant. Mean BMI for men was 27.65 (95 percent CI 17.8, 37.5); mean BMI for women was also 30.89 (95 percent CI 18.5, 43.3). In men there was an association between BMI and WHR, r=0.62, P < 0.05, an association between BMI and diastolic BP and a negative association between BMI and activity level, r=-0.42, P < 0.05. Although the majority of both men and women were classified as obese, only 7 percent of men and 12 percent of women recognized diet and overweight as contributing to high blood pressure. Reported diets tended to be high in fat, salt and meats and low in vegetables and fruits; the majority of the participants were sedentary. Medication compliance was good, with a mean of only four days of medications missed per month. These findings suggest that to lower blood pressures in this population, the use of nonpharmacologic therapy involving lifestyle changes such as improved diet, weight loss and increased physical activity will be important.(AU)

Knowledge about causes, effects, attitudes towards and experiences with violent acts among students in secondary schools, Jamaica

Violence is an important public health problem in Jamaica and the world over. Adolescents are an important group with reference to victims and perpetrators of violence. In this project a comparison of adolescents knowledge, attitude towards and experiences with violent acts between a rural and an urban secondary school is presented. There is little or no differences between the two schools and this is consistent in all areas of the study. A prevalence rate of 20 percent for violence is present among students in both schools and students have indicated that they would more frequently show violence towards friends, relatives and classmates. Students are more experienced with witnessing of fights, murders, stabbing and gun shot wounds. Suggestions for violence prevention include; counselling, church attendance, participation in neighbourhood watch and avoidance of conflict. There is need for programmes aimed at violence prevention to be implemented and should adopt a multisectoral approach. The family as the basic unit of society must also be given due consideration in any programme aimed at prevention of violence (AU)