Essay Example on Using Documented Evidence to Manage Hypertension: Improving Quality of Life

Introduction

Documented evidence in nursing is usually utilized to better the delivery of care. In most cases, nursing articles document evidence from real-life situations such as clinical trials, and this is what makes them even more effective in nursing practices. Hypertension is one of the major health problems that are responsible for the majority of premature deaths across the world, and it is documented research that is used to treat and manage the condition to enable the patient to have a quality life (Bromfield and Muntner, 2013). This paper is a research critique that examines two quantitative articles, and it will give the background of the two articles, how they answer the PICOT question, their method of study, and results before comparing the outcomes.

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Research Topics:

I. Determinants of Patient’s Adherence to Hypertension Medications: Application of Health Belief Model among Rural Patients

II. Non-Adherence Related Factors to Antihypertensive Medications Among Hypertensive Patients on Follow-up

Background of Study

Heydari et al. (2014) conducted a study titled “Determinants of Patient’s Adherence to Hypertension Medications: Application of Health Belief Model among Rural Patients.” The researchers acknowledge that hypertension is a great health challenge in both developing and developed nations. The prevalence of high blood pressure in Middle Eastern countries, as stated in the research, ranges between 10% and 17%. The researchers also acknowledge that although there is much progress in antihypertensive medications and other interventions such as physical exercises, there are many cases where patients opt not to heed to these measures. Compliance, according to the researchers, is mostly influenced by the patient’s beliefs as well as their health conditions. The authors were concerned that even if evidence exists showing that some hypertensive patients have negative attitudes towards their disease, there is little documentation on the cause of poor compliance. The researchers, therefore, conducted this study to investigate these factors that influence compliance with the target that with these factors, it would be possible for healthcare practitioners to increase compliance and therefore improve care outcomes in hypertensive patients. The research question in this study can be tailored as; what are the factors that influence adherence to hypertensive medication based on the health belief model?

Berisa and Dedefo (2018) conducted quantitative research investigating non-adherence related factors to antihypertensive medications among hypertensive patients on follow up. According to the researchers, hypertension is a great global health burden considering that it is one of the most significant risk factors for cardiovascular disease. Premature deaths that are related to high blood pressure stand at more than seven million every year, making it a great threat to health. The researchers were concerned that although there are several medical interventions such as taking medications, changing diet, and exercising, some patients fail to follow these health interventions. The researchers conducted this study to examine adherence to medications and factors that are associated with non-adherence. The aim is that by identifying the factors related to non-adherence, healthcare professionals can work on these factors to improve non-adherence. The research question here may be tailored as; what are the factors that are associated with non-adherence to hypertension medications?

How do these two articles support the nurse practice issue you chose?

The nursing practice I chose was hypertension, specifically the management and treatment of this disease. The PICOT question identified earlier is; what is the effectiveness of physical exercises in hypertensive patients compared to those that do not engage in these exercises? These two quantitative examine the concept of adherence to medical intervention among hypertensive patients. The collective objective of the two studies is that the results would be used to improve the rate of adherence to medication among hypertensive patients. It is an objective that aligns with the PICOT question, where the aim is to improve the health outcomes among patients with high blood pressure. The point of focus is to improve how patients adhere to medical interventions, and these include physical exercises. The focus groups in the two articles are patients with hypertension, and this is the main issue of address in the PICOT question.

Method of study

The study by Heydari et al. was a cross-sectional study. It was conducted among 671 patients who were undergoing local care in Ardabil city, Iran. The selection of the participants followed a 2-stage random sampling, first to select health centers and second to select patients from the selected centers. Although the participants were selected randomly, their participation was voluntary. Data was collected using interviews over two months. Data that was collected through interviews were then analyzed with the use of SPSS version 18.0 for Windows. Frequencies, proportions, means, and Chi-square tests were calculated.

The study by Berisa and Dedefo was a descriptive cross-sectional study design. It was a study that was conducted at Nedjo General Hospital (NGH), Ethiopia. The criteria of selection were that the patients had attended a chronic care department for hypertension for at least one year, were not critically ill, and were able to communicate. Participation was voluntary, and a total of 172 patients agreed to participate in this study. Data was collected through questionnaires and later analyzed using Statistical Package for the Social Sciences (SPSS) version 20.

The methodology for the two articles was similar. These studies were a cross-sectional study, and this has its own merits and demerits. It is an advantageous method because one can analyze many outcomes and findings to create in-depth research (Sedgwick, 2014). However, a cross-sectional study cannot be used by the researcher to analyze a behavior over some time (Sedgwick, 2014).

Results of Study

Heydari et al. found that adherence was higher among patients of age groups 30-39 years and patients above 60 years. Male respondents had lower adherence at 22.5% than their female counterparts at 24.5%. It was also found that married respondents exhibited a higher adherence compared to the unmarried participants at 24.7% and 21.1%, respectively. The researchers also found that respondents had poor adherence to lifestyle factors. Also, those that only used one type of medication had a higher adherence compared to their counterparts who were taking more than one medication. In the other study, Berisa and Dedefo found that most of the participants were non-adherent. These were 68.6% of the participants compared to only 31.4% who were adherent. The major reasons for not adhering were cited as forgetfulness, followed by the inability to buy medicine at 47.1% and 16.9%, respectively.

Outcomes Comparison

The anticipated outcome for the PICOT question is that, in the end, the effectiveness of physical exercises in treating and managing hypertensive patients. Therefore, physical exercises can be recommended to bring positive health outcomes in patients with hypertension. The outcomes of the two articles shed light on the issue of non-adherence and factors that make patients not adhere to medical interventions. Improving adherence would mean that patients follow all health recommendations, and this would serve to improve the health outcomes of hypertensive patients.

Conclusion

Hypertension is one of the major health problems that are responsible for the majority of premature deaths across the world. The two articles examine the concept of adherence to medical intervention among hypertensive patients. The collective objective of the two studies is that the results would be used to improve the rate of adherence to medication among hypertensive patients. Results show that factors, including forgetfulness and financial constraints, are to blame for non-adherence. Therefore, tackling these factors would replicate to improved adherence and subsequent improvement of healthcare outcomes among patients with high blood pressure.

References

Berisa, H., and Dedefo, M., 2018. Non-Adherence Related Factors to Antihypertensive Medications Among Hypertensive Patients on Follow-up at Nedjo General Hospital in West Ethiopia. The Open Public Health Journal, 11(1), pp.62-71. doi: 10.2174/1874944501811010062

Bromfield, S., and Muntner, P., 2013. High Blood Pressure: The Leading Global Burden of Disease Risk Factor and the Need for Worldwide Prevention Programs. Current Hypertension Reports, 15(3), pp.134-136. doi: 10.1007/s11906-013-0340-9.

Heydari, H., Kamran, A., Ahari, S., Biria, M., and Malepour, A., 2014. Determinants of patient′s adherence to hypertension medications: Application of health belief model among rural patients. Annals of Medical and Health Sciences Research, 4(6), p.922. doi: 10.4103/2141-9248.144914

Sedgwick, P., 2014. Cross-sectional studies: advantages and disadvantages. BMJ, 348(mar26 2), pp.g2276. doi: https://doi.org/10.1136/bmj.g2276