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1.
Medicine (Baltimore) ; 98(51): e18471, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31861026

RESUMO

This study aimed to compare the Hamilton anxiety rating/Hamilton depression rating (HAMA/HAMD) scale scores and blood pressure (BP) goal achievement associated with the use of valsartan-amlodipine single-pill combinations (SPCs) versus valsartan and amlodipine combination in adult hypertensive patients.A total of 476 hypertensive patients were randomly assigned into the SPC (valsartan-amlodipine) and control (valsartan and amlodipine combination) groups. All patients had an uncontrolled BP (160-179/100-109 mm Hg). BP goal was <140/90 mm Hg. Cox proportional hazards regression analysis was used to analyze the likelihood of HAMA/HAMD scales, SPCs, control group, and daily dosage number. Kaplan-Meier analysis was used to estimate the rates of BP goal achievement over time among the 2 groups.A total of 476 patients were included in the study, and 439 patients completed the follow-up and received the index drug therapy. There was a significant difference in BP between the 2 groups on days 28, 42, and 56. Patients who received SPCs had a significantly higher rate of BP goal achievement over time (P = .000). The average HAMD scores in the SPC and control groups were 5.54 and 5.49 and 6.06 and 6.21 on days 28 and 56, respectively. The average HAMA scores in the SPC and control groups were 7.41 and 7.13 and 7.90 and 8.01 on days 28 and 56, respectively. The means of HAMD and HAMA scores were 5.826 and 7.614, respectively. The higher the HAMA/HAMD scores, the lower was the BP goal achievement. The number of drugs taken by the patients was associated with the HAMA and HAMD scores. There was no significant difference between HAMA scores of patients taking 1 tablet daily (7.22 ±â€Š1.885) and those taking two-tablets daily (7.38 ±â€Š1.953) (P = .408). However, when these scores were compared to those of patients taking 4 tablets daily (8.08 ±â€Š2.285), a significant difference was observed (P = .000, P = .000).Hypertensive patients treated with valsartan-amlodipine SPCs were significantly more likely to achieve BP goal and have lesser HAMA/HAMD scores compared to patients treated with valsartan and amlodipine combination.


Assuntos
Combinação Anlodipino e Valsartana/uso terapêutico , Anti-Hipertensivos/administração & dosagem , Ansiedade/prevenção & controle , Depressão/prevenção & controle , Hipertensão/tratamento farmacológico , Combinação Anlodipino e Valsartana/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Feminino , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
2.
Vasc Health Risk Manag ; 15: 551-558, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31853180

RESUMO

Introduction: As hypertension is a chronic cardiovascular disease that contributes to a high proportion of morbidity and mortality worldwide, favorable knowledge is crucial to control it. Objective: The objective of this study was thus to assess knowledge and associated factors of blood pressure control among hypertensive patients at the chronic illness follow-up Clinic of the University of Gondar comprehensive-specialized hospital, Gondar, Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to April 2018. A systematic random sampling technique was used to select participants. Bi-variable and multivariable logistic regressions were done to assess the relationship between dependent and independent variables. The adjusted odds ratio with a 95% confidence interval was used to determine the presence and strength of association between covariates and the outcome variable. Results: A total of 404 participants took part in the study with a response rate of 97.3%. The overall good knowledge about blood pressure control was 51.7% (95% CI=46.3-56.8). Females were 3.79 (AOR= 3.79, 95% CI: (1.55, 9.28)) more knowledgeable about blood pressure control than males. In the multivariable analysis, the odds of being knowledgeable were 2.80 (AOR= 2.80, 95% CI (1.44, 5.46)), 8.05 (AOR=8.05, 95% CI (2.93, 22.10)), and 7.53 (AOR=7.53, 95% CI (2.52, 22.49)) for can read and write, secondary, preparatory and above education, respectively, compared to cannot read and write. Occupation was significantly associated with the knowledge of plod pressure control. For example, merchants 7.66 (AOR=7.66, 95% CI (3.01, 19.47)), government employee 6.33 (AOR=6.33, 95% CI (1.90, 22.07)), and self-employed 4.58 (AOR=4.58, 95% CI (1.80, 11.70)) times more likely to be knowledgeable than farmers, respectively. Participants with family history of hypertension were 2.36 (AOR=2.36, 95% CI (1.42, 3.92)) times more knowledgeable than their counterparts. Conclusion: In this study, knowledge of blood pressure control was lower compared to the finding of a study done at Bishoftu hospital, Ethiopia. But it is higher than studies in other African countries. Both pharmacological and non-pharmacological awareness is vital for blood pressure control.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Hospitais Universitários , Hipertensão/terapia , Ambulatório Hospitalar , Comportamento de Redução do Risco , Adulto , Idoso , Estudos Transversais , Escolaridade , Etiópia , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Ocupações , Fatores de Risco , Fatores Sexuais
3.
Rev Med Suisse ; 15(668): 1946-1949, 2019 Sep 23.
Artigo em Francês | MEDLINE | ID: mdl-31643156

RESUMO

High blood pressure is a major risk factor for cardiovascular disease, leading to a high and increasing rate of morbidity and mortality with our current lifestyle. This is therefore a real public health problem. About 20 % of refractory hypertension is caused by a poor drug intake. The new 2018 European recommendations for high blood pressure emphasize the importance of improving patients' therapeutic adherence. To achieve that, the general practitioner must promote a bio-psycho-social approach, targeted to patient empowerment and to develop multidisciplinarity with the other care providers. Concerning the medication, physicians are encouraged to use combination therapies in a single pill.


Assuntos
Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertensão/psicologia , Adesão à Medicação , Atenção Primária à Saúde , Combinação de Medicamentos , Humanos , Adesão à Medicação/psicologia
4.
Medicine (Baltimore) ; 98(39): e17287, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574848

RESUMO

Evidence suggests that mental health is associated with multiple factors such as physical activity, sedentary behavior, and physical function in older adults. The present study used latent profile analysis to identify classes of older adults based on their health profile among a representative sample of Korean older adults with hypertension. Differences in mental health between these classes were also examined.Seven hundred and sixty seven participants (mean age = 70.23, SD = 6.08; men 45.6%) were included in the analysis.There were 3 latent classes (class 1: a physically inactive lifestyle with low physical function and body perception; class 2: a physically moderate lifestyle with moderate physical function and low body perception; class 3: a physically active lifestyle with high physical function and body perception). According to class comparisons, older adults in class 3 had significantly lower anxiety/depression levels than classes 1 and 2. Older adults in class 3 had significantly lower stress levels than class 1.It is possible that among older adults, having a positive attitude of one's body shape may also be important for improving anxiety/depression along with having a physically active lifestyle and maintaining physical function.


Assuntos
Imagem Corporal/psicologia , Força da Mão , Hipertensão/psicologia , Postura Sentada , Caminhada , Idoso , Idoso de 80 Anos ou mais , Ansiedade/psicologia , Estudos Transversais , Depressão/psicologia , Exercício/psicologia , Feminino , Humanos , Hipertensão/fisiopatologia , Análise de Classes Latentes , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Percepção , República da Coreia , Estresse Psicológico/psicologia
5.
Rev Med Suisse ; 15(662): 1608-1613, 2019 Sep 11.
Artigo em Francês | MEDLINE | ID: mdl-31508912

RESUMO

After numerous years of research and development of effective anti-hypertensive drugs, it is regrettable to note that less than half of hypertensive patients reach the blood pressure targets that are known to reduce their cardiovascular risks and mortality. Poor adherence to treatment is one of the main causes of insufficient blood pressure control. Furthermore, non-adherence to anti-hypertensive therapy correlates with higher risks of cardiovascular events. The objective of health professionals is to identify non adherent patients and to offer them appropriate solutions to support their treatment self-management. Innovative approaches like using electronic pillboxes combined with an interprofessional medication adherence support program should allow a more appropriate and effective care.


Assuntos
Anti-Hipertensivos , Pressão Sanguínea/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Hipertensão/psicologia , Adesão à Medicação , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Humanos , Hipertensão/fisiopatologia
6.
Medicine (Baltimore) ; 98(37): e17101, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517840

RESUMO

BACKGROUND: Caregivers encounter serious and substantial challenges in managing hypertension in patients with subclinical or clinical borderline personality disorder (BPD). These challenges include therapeutic conflicts resulting from harmful drug-drug, and drug-disease interactions. Current guidelines provide no recommendations for concurrent psychotropic and antihypertensive treatment of hypertensive BPD patients who are at even greater cardiovascular risk. METHODS: We conducted a systematic literature review to assess the extent of available evidence on prevalence rates, cardiovascular risk factors, therapeutic conflicts, and evidence-based treatment recommendations for patients with co-occurring hypertension and BPD. Search terms were combined for hypertension and BPD in PubMed, MEDLINE, EMBASE, Cochrane, and PsycINFO databases. RESULTS: We included 11 articles for full-text evaluation and found a very high prevalence of hypertension and substantial cardiovascular risk in studies on co-occurring BPD and hypertension. However, we identified neither studies on harmful drug-drug and drug-disease interactions nor studies with treatment recommendations for co-occurring hypertension and BPD. CONCLUSIONS: Increased prevalence of hypertension in BPD patients, and therapeutic conflicts of psychotropic agents strongly suggest careful evaluation of treatment strategies in this patient group. However, no studies or guidelines recommend specific therapies or strategies to resolve therapeutic conflicts in patients with hypertension and BPD. This evidence gap needs attention in this population at high risk for cardiovascular disease.


Assuntos
Transtorno da Personalidade Borderline/complicações , Hipertensão/tratamento farmacológico , Psicotrópicos/efeitos adversos , Transtorno da Personalidade Borderline/tratamento farmacológico , Transtorno da Personalidade Borderline/psicologia , Interações de Medicamentos , Humanos , Hipertensão/psicologia , Prevalência , Psicotrópicos/uso terapêutico
7.
Pan Afr Med J ; 33: 27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384342

RESUMO

Introduction: In Nigeria, approximately 4.33 million adults suffer from hypertension and about a third of them do not adhere to prescribed medications. Depression has been reported to significantly predict poor medication adherence. The relationship between medication non-adherence and co-morbid depressive disorder in patients with hypertension has not been adequately explored in this environment. The study aimed to determine the prevalence of depression in patients with hypertension. The association between socio-demographic characteristics and presence of co-morbidity on medication adherence was also determined. Methods: A cross-sectional descriptive research design was adopted for the study. A socio-demographic questionnaire, the modified Morisky Medication Adherence Scale (MMAS), the Hamilton Rating Scale for Depression (HAM-D) and the Mini International Neuropsychiatric Interview (MINI), were administered to four hundred patients with hypertension attending medical out-patient clinic between August and September 2012. Results: About 43% (168) were aged 61 to 64 years the majority being females, with a female to male ratio of 1.63:1. The prevalence of comorbid depression was 22.8%, made up of mild (21.8%) and moderate (1.0%) depressive episodes only. Depression was commoner among females than males in a ratio of 3:1. A majority of the participants (96.8%) had high medication adherence; 2.8% and 0.4% had moderate and low adherence respectively. Depression was more among patients with good medication adherence. Conclusion: The occurrence of mild depressive disorder among hypertensives did not affect the level of medication adherence. Review of Antihypertensive drugs should also be done often to ensure patients are not likely to have depressive illness as a side effect of drugs used.


Assuntos
Anti-Hipertensivos/administração & dosagem , Depressão/epidemiologia , Hipertensão/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adulto , Anti-Hipertensivos/efeitos adversos , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Nigéria , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Fatores Sexuais , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
8.
Ethiop J Health Sci ; 29(4): 421-430, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447514

RESUMO

Background: Hypertension is the number one cardiovascular risk factor and the leading cause of mortality worldwide. It's the driver of the cardiovascular disease epidemic in Africa where it is a major, independent risk factor for heart failure, stroke and renal failure. There is no study to assess the level of knowledge of hypertension among hypertensive patients in our setup. The objective of this study was to assess knowledge, attitude and selfcare practice towards control of hypertension among hypertensive patients on follow up at our hospital. Methods: A total of 385 hypertensive patients who were on follow up at our hospital were randomly selected for interview. The Sociodemographic and relevant clinical data were extracted using a structured questionnaire. Operational definitions and Likert scale was used to compare the variables. Results: Only 48.6% of hypertensive patients participated in this study have good basic knowledge of hypertension, 47.8% of them have good attitude and only 39.5% of the study participants have good practice towards control of hypertension. Male sex, formal education and being urban resident are associated with better knowledge, attitude and self-care practice of hypertensive patients at our hospital. Conclusion: The result states that there is an inadequate knowledge about hypertension; as well attitude and self-care practice towards control of hypertension among our hypertensive patients is generally poor. Responsible bodies should focus on addressing such limitations of hypertensive patients. Attention should be given to hypertensive patients who are females, low educational level and those coming from rural.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/psicologia , Autocuidado , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Etiópia , Feminino , Hospitais Urbanos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Adulto Jovem
9.
JMIR Mhealth Uhealth ; 7(1): e12228, 2019 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-31344667

RESUMO

BACKGROUND: Mobile phone and tablet ownership have increased in the United States over the last decade, contributing to the growing use of mobile health (mHealth) interventions to help patients manage chronic health conditions like diabetes. However, few studies have characterized mobile device ownership and the presence of health-related apps on mobile devices in people with a self-reported history of hypertension. OBJECTIVE: This study aimed to describe the prevalence of smartphone, tablet, and basic mobile phone ownership and the presence of health apps by sociodemographic factors and self-reported hypertension status (ie, history) in a nationally representative sample of US adults, and to describe whether mobile devices are associated with health goal achievement, medical decision making, and patient-provider communication. METHODS: Data from 3285 respondents from the 2017 Health Information National Trends Survey were analyzed. Participants were asked if they owned a smartphone, tablet, or basic mobile phone and if they had health apps on a smartphone or tablet. Participants were also asked if their smartphones or tablets helped them achieve a health-related goal like losing weight, make a decision about how to treat an illness, or talk with their health care providers. Chi-square analyses were conducted to test for differences in mobile device ownership, health app presence, and app helpfulness by patient characteristics. RESULTS: Approximately 1460 (37.6% weighted prevalence) participants reported a history of hypertension. Tablet and smartphone ownership were lower in participants with a history of hypertension than in those without a history of hypertension (55% vs 66%, P=.001, and 86% vs 68%, P<.001, respectively). Participants with a history of hypertension were more likely to own a basic mobile phone only as compared to those without a history of hypertension (16% vs 9%, P<.001). Among those with a history of hypertension exclusively, basic mobile phone, smartphone, and tablet ownership were associated with age and education, but not race or sex. Older adults were more likely to report having a basic mobile phone only, whereas those with higher education were more likely to report owning a tablet or smartphone. Compared to those without a history of hypertension, participants with a history of hypertension were less likely to have health-related apps on their smartphones or tablets (45% vs 30%, P<.001) and report that mobile devices helped them achieve a health-related goal (72% vs 63%, P=.01). CONCLUSIONS: Despite the increasing use of smartphones, tablets, and health-related apps, these tools are used less among people with a self-reported history of hypertension. To reach the widest cross-section of patients, a mix of novel mHealth interventions and traditional health communication strategies (eg, print, web based, and in person) are needed to support the diverse needs of people with a history of hypertension.


Assuntos
Telefone Celular/estatística & dados numéricos , Computadores de Mão/estatística & dados numéricos , Hipertensão/psicologia , Propriedade/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Adulto , Idoso , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos/epidemiologia
10.
Trials ; 20(1): 414, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288854

RESUMO

BACKGROUND: Only one-third of hypertensive patients achieve and maintain blood-pressure control. This is attributed to low treatment adherence and has a negative impact on clinical outcomes. Adherence is multidimensional and involves aspects both related to patient characteristics and to the chronic nature of the disease. In this context, motivational interviewing has been proposed as an approach to foster patients' motivations to change their behavior for the benefit of their own health, thus providing more lasting behavioral changes. DESIGN AND METHODS: Single-center, parallel, randomized controlled trial with outcome-assessor blinding. This study will select adult patients (n = 120) diagnosed with hypertension who receive regular follow-up in a specialized outpatient clinic. Patients will be randomly allocated across two groups: the intervention group will have appointments focused on motivational interviewing, while the control group will have traditional appointments. Patients will be monitored face-to-face, once monthly for six months. The primary outcomes will be a reduction of at least 8 mmHg in systolic blood pressure and changes in mean blood pressure measured by 24-h ambulatory blood pressure monitoring. Secondary outcomes include improvement of adherence to a low-sodium diet, adherence to self-care behaviors, regular use of antihypertensive medications, increase or maintenance of physical activity, weight reduction, evaluation of changes in daytime sleepiness, and cessation of smoking. DISCUSSION: This study shows an intervention strategy that will be tested and, if effective, warrant replication in monitoring of other chronic diseases. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02892929 . Registered on 24 August 2016.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Adesão à Medicação , Entrevista Motivacional , Comportamento de Redução do Risco , Autocuidado , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Dieta Hipossódica , Exercício , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Sono , Fatores de Tempo , Resultado do Tratamento , Perda de Peso , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-31277210

RESUMO

Purpose: Hypertension is a major risk factor for cardiovascular diseases and stroke, and it requires lifelong medication. This study aimed to investigate the factors impacting on Health-Related Quality of Life (HRQoL) among hypertensive patients in Chongqing, China, and to provide evidence-based strategies to improve their HRQoL. Methods: This cross-sectional survey was conducted in Chongqing, China. Of 600 randomly selected patients, 586 patients agreed to participate and 567 patients completed the survey. A SF-36 (Medical Outcomes Study (MOS) Short Form Health Survey questionnaire) that included eight domains: physical functioning, role limitations due to physical problems, body pain, general health, vitality, social function, role limitations due to emotional problems, and mental health was used to measure HRQoL. Linear regressions were used; each domain of HRQoL was measured in the stratification of sex. Results: Self-perceived relatively low economic burden caused by hypertension and regular physical activity had a positive impact on HRQoL (p < 0.05) for both men and women. For women, younger age was associated with higher scores of measuring physical functioning and body pain. Living with more than three family members had a positive impact on domains, including physical functioning. Emotional self-regulation had a positive association with women's mental health. Alcohol use for men was associated with higher scores in physical and mental health measures, and emotional self-regulation showed some positive impact on general health. Conclusion: Perceived economic burden caused by hypertension was the most common factor impacting on patients' HRQoL. Female patients were more susceptible when compared to male patients. Health intervention strategies need to be further explored and adapted to the context of improving HRQoL for patients who suffer from hypertension and other chronic non-communicable diseases.


Assuntos
Hipertensão/psicologia , Qualidade de Vida , Idoso , China , Efeitos Psicossociais da Doença , Estudos Transversais , Exercício , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Hipertensão/economia , Masculino , Saúde Mental , Pessoa de Meia-Idade , Dor , Inquéritos e Questionários
12.
Rev Bras Enferm ; 72(3): 646-653, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269128

RESUMO

OBJECTIVE: Assess the level of health literacy of adults, with and without hypertension, treated in three basic health units (UBS) in Picos, Piauí. METHODS: Cross-sectional study conducted with 357 adults. Data were collected using a questionnaire with sociodemographic variables, and literacy was assessed by the Test of Functional Literacy in Adults. Descriptive analysis was performed followed by the association between literacy and exposure variables with Pearson's chi-squared (X2) test and Mann-Whitney U test. RESULTS: Inadequate or marginal health literacy was found in three units investigated (71.5%; 77.8% and 85.2%);. Age and the years of schooling were factors associated with inadequate literacy in adults with hypertension (p<0.0001). CONCLUSION: Inadequate literacy was found in more than 70% of the hypertensive patients investigated. This finding reinforces the need to improve the self-care skills of hypertensive patients, especially the older ones and those with few years of schooling.


Assuntos
Alfabetização em Saúde/normas , Hipertensão/psicologia , Adolescente , Adulto , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Inquéritos e Questionários
13.
Altern Ther Health Med ; 25(3): 26-31, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31160543

RESUMO

Objectives: Objective • Health-related quality of life (HRQoL) is an important tool in the assessment of treatment outcomes. Healthcare professionals use the concept of HRQoL to measure factors other than illness which affect human health and its status. Patient's everyday activities are adversely affected by hypertension (HTN) and results in decreased self-confidence. The present study was aimed to assess blood pressure and health-related quality of life (HRQoL) of hypertensive patients in Pakistan. Methods: A questionnaire-based cross-sectional study was undertaken with 384 hypertensive patients attending a tertiary care public sector hospital in Islamabad, Pakistan. The assessment of HRQoL was done by using an EuroQol EQ-5D scale. Values derived from the UK general population survey were used to score HRQoL. The blood pressure of each patient was measured by using a calibrated sphygmomanometer. Data analysis was performed by using SPSS version 21 (SPSS Inc., Chicago, IL, USA). P ≤ .05 was taken as significant. Results: Two hundred and fifteen (56%) patients were male with 3.31 ± 2.13 years of history of hypertension. The majority (n = 138, 35.9%) was categorized in the age group of 41 to 50 years with mean age of 50.21 ± 9.51. Mean (SD) systolic BP and mean (SD) diastolic BP was measured as 140.39 ± 15.485 and 88.74 ± 10.683 in mmHg respectively. Poor HRQoL was measured among the study participants (0.6456 ± 0.2317). Age, gender, education, occupation and monthly income had a significant relation with HRQoL score. Conclusion: Hypertension imposes an adverse effect on patient's HRQoL. Results from this study could be useful in clinical practice. Attention is required to highlight determinants of HRQoL and policies should be implemented for better management of HTN, particularly in early treatment phases where it is still possible to improve HRQoL.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Hipertensão/psicologia , Qualidade de Vida , Adulto , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/fisiologia , Chicago , Estudos Transversais , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Paquistão , Inquéritos e Questionários , Resultado do Tratamento
14.
JMIR Mhealth Uhealth ; 7(6): e13257, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31162124

RESUMO

BACKGROUND: Home blood pressure monitoring (HBPM) is one component of effective supported self-management, which may potentially be mediated by mobile apps. OBJECTIVE: The aim of this study was to identify the self-management features (HBPM and broader support strategies) offered by currently available apps and to determine the features associated with download frequency and user ratings. METHODS: We searched Google Play store, Apple App store, National Health Services Apps Library and myhealthapps.net (first search on February 1, 2018; updated August 18, 2018). We included high blood pressure apps available in the United Kingdom and extracted their features, number of downloads, and the average users' rating from the app stores. We mapped the features to the holistic Practical Reviews In Self-Management Support (PRISMS) taxonomy of self-management support. We employed a regression analysis to determine if any features were associated with download frequency or user rating. RESULTS: We included 151 apps. The 3 most common features were as follows: monitoring blood pressure (BP) and charting logs; lifestyle (exercise or dietary) advice; and providing information about hypertension. The other 11 components of the PRISMS taxonomy were rarely featured. There was little evidence to support associations between specific features and the download statistics and rating scores, with only 2 uncommon features achieving borderline significant associations. The presence of social support features, such as a forum, was weakly but significantly (R2=.04, P=.02) correlated with the number of downloads. Apps designed specifically for particular BP monitors/smart watches were weakly associated with a higher rating score (R2=.05, P<.001). Apps with more ratings were associated with more downloads (R2=.91, P<.001). CONCLUSIONS: The functionality of currently available apps is limited to logging BP, offering lifestyle advice, and providing information about hypertension. Future app development should consider broadening the remit to produce a system that can respond flexibly to the diversity of support that enables people to self-manage their hypertension.


Assuntos
Hipertensão/terapia , Aplicativos Móveis/normas , Autogestão/psicologia , Humanos , Hipertensão/psicologia , Aplicativos Móveis/estatística & dados numéricos , Autogestão/estatística & dados numéricos , Reino Unido
15.
Afr Health Sci ; 19(1): 1811-1820, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31149012

RESUMO

Background: Patient activation is a central concept in chronic illness care model. Activated patients have ability and willingness to manage their health. Objective: Aim of this study was to test the reliability and validity of a Patient Activation Measure. Methods: Research sample consisted of 130 patients who had diabetes, hypertension or rheumatoid arthritis. Data was collected through socio-demographic information form and a Patient Activation Measure (PAM). Reliability and validity of PAM were analyzed. Results: Internal consistency reliability coefficient of the PAM was α: .81. Correlation coefficients between item and total scale scores varied from .38 to .66. Result of explanatory factor analysis Kaiser Meyer Olkin coefficient was .75 and Barlett test was x2: 646.870; p: 0. 000. Result of confirmatory factor analysis, model fit indexes were x2/df: 1.59, RMSEA: 0.071, CFI: 0.96, NNFI: 0.95. The result of Rasch analysis, reliability coefficient varied from 0.83 to 0.87 and in validity assesment, item fit statistics for INFIT varied from 0.68 to 1.53 and for OUTFIT varied from 0.65 to 1.54. Conclusion: PAM has enough validy and reliability for use in determining activation scores and level of the patients in Turkey. It could be used in planing appropriate interventions for the activation level and help to improve self management.


Assuntos
Doença Crônica/psicologia , Participação do Paciente/psicologia , Psicometria/estatística & dados numéricos , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Adulto , Idoso , Artrite Reumatoide/psicologia , Artrite Reumatoide/terapia , Doença Crônica/terapia , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Análise Fatorial , Feminino , Humanos , Hipertensão/psicologia , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Reprodutibilidade dos Testes , Fatores Socioeconômicos , Traduções , Turquia
16.
Health Qual Life Outcomes ; 17(1): 107, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234889

RESUMO

BACKGROUND: Multimorbidity is common among the middle-aged and elderly residents. And it is associated to the reduction of health-related quality of life (HRQoL), including physical and psychological dimensions. However, there are few studies that have paid attention to the HRQoL of residents with multimorbidity in China. Therefore, this study aims to investigate the relationships between different multimorbidity patterns and HRQoL among middle-aged and elderly adults in China. METHODS: Based on a cross-sectional survey, the information regarding 18,137 adults, who were at least 45 years of age, was collected through interviews. Self-perceived HRQoL was assessed with the EQ-5D-3 L instrument, and the EQ-5D-3 L index score was calculated using the Chinese EQ-5D-3 L value set. The Tobit regression was used to explore the impacts of multimorbidity groups on HRQoL. RESULTS: Of 18,137 respondents, more than a fifth (3773,20.8%) of people had multimorbidity. Mean (SD) of EQ-5D index and VAS values were 0.95(0.14) and 76.02(13.66), respectively. Significant correlations were found between a lower HRQoL and increasing numbers of chronic conditions (P < 0.001). Most of chronic diseases co-occurred frequently, and the association between hypertension and diabetes mellitus was the strongest (adjusted OR = 3.82). The most prevalent disease is hypertension (5052,27.9%), and the most prevalent chronic diseases pair is hypertension and diabetes mellitus (841,4.6%). Among those chronic diseases with high prevalence, the effects on HRQoL ranged from chronic pain to hypertension (adjust b = - 0.036 to - 0.008). In the common multimorbidity patterns, co-occurrence of chronic pain and bone disease (adjust b = - 0.039) had the greatest impact on HRQoL. CONCLUSIONS: The HRQoL of middle-aged and elderly adults declines by multimorbidity. More attention should be paid to the HRQoL of residents with multimorbidity in China. The effect of different multimorbidity patterns on HRQoL is not simply added by two diseases, but changes by the different combination. Identifying different multimorbidity patterns of residents can provide more targeted measures to improve the HRQoL.


Assuntos
Multimorbidade , Qualidade de Vida , Adulto , Idoso , China/epidemiologia , Doença Crônica/epidemiologia , Doença Crônica/psicologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/psicologia , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários
17.
Gen Physiol Biophys ; 38(3): 265-270, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31184313

RESUMO

This study investigated the effect of lisinopril (angiotensin-converting enzyme inhibitor) on potential behavioural alterations in spontaneously hypertensive rats (SHR). Three groups of 15-17-week-old rats were investigated for 2 weeks: Wistar control group, SHR group and SHR+lisinopril group. Systolic blood pressure (SBP) was normal in Wistar rats, SHR expressed hypertension and lisinopril normalized the SBP. We observed increased time spent in and increased frequency of entries to the central area of the open field in SHR, while lisinopril induced a trend to reduce the time spent in the central area of the open field and reduced the frequency of entries there. There was a positive correlation between SBP and reduced anxiety-like behaviour in normotensive rats; no correlations in the SHR or SHR+lisinopril groups were observed. We conclude that lisinopril normalized the increase in SBP and partly reversed the alterations of anxiety-like behaviour in SHR.


Assuntos
Anti-Hipertensivos/farmacologia , Ansiedade/tratamento farmacológico , Comportamento Animal/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Hipertensão/psicologia , Lisinopril/farmacologia , Animais , Ansiedade/prevenção & controle , Pressão Sanguínea , Hipertensão/fisiopatologia , Ratos , Ratos Endogâmicos SHR , Ratos Wistar
18.
Public Health ; 173: 5-8, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31207425

RESUMO

OBJECTIVE: The objective of this study was to explore factors influencing patients with hypertension to participating in a hypertension self-management education (HSME) programme and challenges of sustaining the learnt self-care practices. STUDY DESIGN: This was a qualitative study with focus group discussions. METHODS: Focus group discussions using a semistructured moderator guide were conducted among participants who had attended the HSME programme. Data were audio recorded, transcribed verbatim and analysed using a thematic analysis approach. RESULTS: Three focus groups involving 19 participants were conducted. Four major themes emerged from the data collected. Most participants enjoyed the group-based HSME sessions because sharing experiences with those having similar health problems can reduce their sense of isolation. However, the participants highlighted the difficulty in sustaining self-care practices in the presence of friends and family influences. CONCLUSION: A number of patient-, family- and community-level motivators and barriers to patients' hypertension self-management have been identified. Efforts to tailor behavioural interventions to sustain daily self-care activities during social and cultural events are imperative.


Assuntos
Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/terapia , Motivação , Educação de Pacientes como Assunto , Autocuidado/psicologia , Autogestão/psicologia , Idoso , Feminino , Grupos Focais , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
19.
Qual Life Res ; 28(9): 2585-2595, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31049824

RESUMO

PURPOSE: To examine whether and how self-management and psychological resilience could moderate the relationships between symptoms and health-related quality of life (HRQoL) among hypertensive patients in China. METHODS: This was a cross-sectional study of 220 participants recruited from January to May, 2018. Demographic and clinical information were obtained from medical records and by patient interview. The Chinese version of 17-item Hypertension-specific Symptom Scale, 21-item Self-Management Scale, and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) as well as Short Form 12 Health Survey (SF-12) were used to collect information in this research. The moderation effects of self-management and psychological resilience were explored using the PROCESS macro for SPSS. RESULTS: Among all patients, 128 (58.2%) were female, 106 (48.2%) had a bachelor degree or higher, and 133 (60.5%) had moderate to severe Charlson Comorbidity Index. Both self-management and psychological resilience were negatively correlated to symptoms (r = - 0.259, p < 0.001; r = - 0.282, p < 0.001) but positively correlated to physical (r = 0.316, p < 0.001; r = 0.344, p < 0.001) and mental (r = 0.273, p < 0.001; r = 0.309, p < 0.001) HRQoL. After controlling for potential covariates, self-management could moderate the associations between symptoms and physical HRQoL (p = 0.041, ΔR2 = 0.010), while psychological resilience could moderate the relationships between symptoms and mental HRQoL (p = 0.02, ΔR2 = 0.010). CONCLUSIONS: For hypertension patients, HRQoL is dependent on the severity of symptoms, engagement of self-management behaviors, and psychological resilience, which should be carefully considered when to improve patients' HRQoL by health care providers.


Assuntos
Nível de Saúde , Hipertensão/psicologia , Qualidade de Vida/psicologia , Resiliência Psicológica , Autogestão/psicologia , Adulto , Grupo com Ancestrais do Continente Asiático/psicologia , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
Work ; 63(1): 49-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31127744

RESUMO

BACKGROUND: Health coaching promotes healthy lifestyles and may be particularly helpful for employees with chronic disease. OBJECTIVE: Evaluate the effects of a health coaching program that targeted health-system employees with at least one cardiovascular disease (CVD) risk factor. METHODS: Fifty-four employees volunteered for a health coaching program (6-session, 12-week program, at least one cycle). 40 (74%) completed (mean age [SD] = 53.3 [10.3] years, Female = 95%, Caucasian = 83%). A certified and integrative health coach/nutritionist provided coaching. Self-reported outcomes were collected using a pre-post design. RESULTS: Participants reported high rates of obesity (75%), hypertension (52.5%), diabetes/prediabetes (47.5%), and hyperlipidemia (40%). In addition, 20% reported chronic pain/rehabilitation needs, 17.5% seasonal depression, and 30% other significant co-morbidities. Following coaching, participants reported significant weight loss (mean [SD] 7.2 [6.6] pounds, p < 0.0001, d = 1.11), increased exercise (from 0.8 to 2.3 sessions/week, p < 0.001, d = .89), reduced perceived stress (p < 0.04, d = .42), and a trend for improved sleep (p = 0.06, d = .38). Reduced stress correlated with both increased exercise (r = -.39, p < 0.05) and decreased fatigue (r = .36, p = 0.07). CONCLUSION: Health coaching for healthcare employees with obesity and other CVD risk factors is a promising approach to losing weight, reducing stress, making healthy lifestyle changes, and improving health and well-being.


Assuntos
Doença Crônica/psicologia , Pessoal de Saúde/psicologia , Tutoria/métodos , Adulto , Idoso , Doença Crônica/epidemiologia , Feminino , Promoção da Saúde/métodos , Promoção da Saúde/estatística & dados numéricos , Humanos , Hiperlipidemias/epidemiologia , Hiperlipidemias/psicologia , Hipertensão/epidemiologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/psicologia , Projetos Piloto , Autorrelato
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