بررسی تأثیر آموزش مبتنی بر خودکارامدی بر کنترل فشار خون در بیماران مبتلا به پرفشاری خون

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استادیار، گروه پزشکی اجتماعی، دانشکده‌ی پزشکی دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دستیار، گروه پزشکی اجتماعی، دانشکده‌ی پزشکی دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: با توجه به شیوع بالای فشار خون و اهمیت کنترل آن توسط بیمار، پژوهش حاضر با هدف تعیین تأثیر آموزش مبتنی بر خودکارامدی بر کنترل فشار خون در بیماران مبتلا به پرفشاری خون انجام گردید.روش‌ها: در این مطالعه‌ی نیمه تجربی، 80 بیمار مبتلا به پرفشاری خون در دو گروه 40 نفره (مورد و شاهد) قرار گرفتند. آموزش استراتژی‌های خودکارامدی برای اعضای گروه مورد انجام شد و گروه شاهد مداخله‌ای دریافت نکرد. بیماران قبل و سه ماه بعد از آموزش، پرسش‌نامه‌ی خودکارامدی عمومی (General Self-Efficacy Scale یا GSES) و مقیاس استرس ادراک شده‌ (Perceived Stress Scale یا PSS) را تکمیل نمودند. فشار خون بیماران نیز قبل و سه ماه بعد از مداخله اندازه‌گیری و بین دو گروه مقایسه گردید.یافته‌ها: میانگین فشار خون سیستولیک قبل و بعد از مداخله در گروه مورد به ترتیب 9/15 ± 7/136 و 3/13 ± 3/124 میلی‌متر جیوه بود و سطح آن در گروه موردکاهش معنی‌داری پیدا کرد (001/0 = P). میانگین فشار خون سیستولیک قبل و بعد از مداخله در گروه شاهد به ترتیب 8/14 ± 0/134 و 5/9 ± 8/134 میلی‌متر جیوه به دست آمد و تفاوت معنی‌داری بین دو زمان مشاهده نشد (790/0 = P). تغییرات نمره‌ی خودکارامدی در گروه مداخله به طور معنی‌داری بیشتر بود (001/0 > P). همچنین، تغییرات نمره‌ی استرس در دو گروه اختلاف معنی‌داری را نشان داد (001/0 > P).نتیجه‌گیری: به نظر می‌رسد خودکارامدی در کنترل فشار خون بیماران مؤثر می‌باشد و پیش‌نیاز رفتار محسوب می‌شود و می‌توان از استراتژی‌های ارتقای خودکارامدی جهت کنترل فشار خون در بیماران مبتلا به پرفشاری خون بهره برد.

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of a Self-Efficacy-Based Education Program on Blood Pressure Control in Patients with Hypertension

نویسندگان [English]

  • Reza Rouzbahani 1
  • Parastoo Golshiri 1
  • Zahra Eskandari 2
1 Assistant Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Resident, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Regarding the high prevalence of hypertension and the significance of its control by patients, the present study aimed to specify the effect of a self-efficacy-based education program on blood pressure control in patients with hypertension.Methods: In a quasi-experimental clinical trial study, 80 patients with high blood pressure were divided into two equal groups of 40 patients. The self-efficacy strategies were trained in the intervention group while no intervention was offered in the control group. The patients filled out the Sherer General Self-Efficacy Scale (GSES) and the Cohen Perceived Stress Scale before and three months after the intervention. Moreover, the patients’ blood pressure was measured and compared before and three months after the intervention.Findings: In intervention group, the mean systolic blood pressure was 136.7 ± 15.9 and 124.3 ± 13.3 mmHg before and after the intervention, respectively, which significantly decreased (P = 0.001). In control group, the mean systolic blood pressure was 134.0 ± 8.18 and 134.8 ± 9.5 mmHg before and after the intervention, respectively, which showed no significant difference (P = 0.790). The changes in the self-efficacy score were significantly higher in the intervention group as compared with the control group (P < 0.001). Moreover, comparison of the stress score of two groups indicated a significant difference in this regard (P <0.001).Conclusion: Self-efficacy seems to be effective in controlling patients’ blood pressure, and be regarded as a pre-requisite for appropriate behavior. To put concisely, self-efficacy enhancement strategies can be employed to control blood pressure in patients with hypertension.

کلیدواژه‌ها [English]

  • Blood Pressure
  • Self efficacy
  • Physiological stress

مراجع

  1. Han HR, Lee H, Commodore-Mensah Y, Kim M. Development and validation of the Hypertension Self-care Profile: A practical tool to measure hypertension self-care. J Cardiovasc Nurs 2014; 29(3): E11-E20.
  2. Shima R, Farizah MH, Majid HA. A qualitative study on hypertensive care behavior in primary health care settings in Malaysia. Patient Prefer Adherence 2014; 8: 1597-609.
  3. Damirchi A, Mehrabani J. Prevalence of obesity, overweight and hypertension and related-risk factors in adults men. Olympic 2009; 17(3): 87-103. [In Persian].
  4. Bahrami Nejad N, Hanifi N, Moosavi Nasab N. Comparing the effect of two family- and individual-based interventions on blood pressure and lifestyle. J Qazvin Univ Med Sci 2008; 12(1): 62-79. [In Persian].
  5. Bandura A, Adams NE. Analysis of self-efficacy theory of behavioral change. Cognit Ther Res 1977; 1(4): 287-310.
  6. Bandura A. Self-efficacy mechanism in human agency. American Psychologist 1982; 37(2): 122-47.
  7. Warren-Findlow J, Seymour RB, Brunner Huber LR. The association between self-efficacy and hypertension self-care activities among African American adults. J Community Health 2012; 37(1): 15-24.
  8. Chehrei A. Sampling and Sample size calculation in medical research. 3rd ed. Tehran, Iran: Pezhvak Elm Arya; 1997. [In Persian].
  9. Sherer M, Maddux JE, Mercandante B, Prentice-dunn S, Jacobs B, Rogers RW. The Self-efficacy Scale: Construction and validation. Psychol Rep 1982; 51(2): 663-71.
  10. Bakhtiari Barati S. Evaluation of simple and multiple relationships between self-efficacy, self-steem, and self-discovery variables with academic performance in third year new-system high school students of Ahvaz City [MSc Thesis]. Ahvaz, Iran: Shahid Chamran University of Ahvaz; 1997. [In Persian].
  11. Vaghari E. Investigating the relationship between self-efficacy and styles of response to crisis in young couples [MSc Thesis]. Tehran, Iran: Tarbiat Moallem University; 2000. [In Persian].
  12. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24(4): 385-96.
  13. Tol A, Pourreza A, Rahimi Foroshani A, Tavassoli E. Assessing the effect of educational program based on small group on promoting knowledge and health literacy among women with type2 diabetes referring to selected hospitals affiliated to Tehran University of Medical Sciences. Razi J Med Sci 2013; 19(104): 10-9. [In Persian].
  14. Karami Moghadam P, Entesarfoomani G. The efficacy of stress management training on improving self-efficacy and adjustment of hypertension in women with high blood pressure. Proceedings of the 3rd National Conference on Psychology and Education; 2017 Feb 2-3; Shadegan, Iran. [In Persian].
  15. Kakavand A, Damercheli N. The role of mediator of perceived stress in the relationship between personality traits and hypertension among the elderly. Journal of Aging Psychology 2017; 2(4): 271-9. [In Persian].
  16. Baljani E, Rahimi J, Amanpour E, Salimi S, Parkhashjoo M. Effects of a nursing intervention on improving self-efficacy and reducing cardiovascular risk factors in patients with cardiovascular diseases. Hayat 2011; 17(1): 45-54. [In Persian].
  17. Peyman N, Ezzati Rastegar K, Taghipour A, Esmaily H. Effect of education on the weight self-efficacy lifestyle among adolescent girls with overweight and obesity. Armaghane-danesh 2012; 17(2): 117-28. [In Persian].
  18. Dehghan H, Khankeh H, Mohammadi F, Rezasoltani P. The study of the effect of educational intervention based on the self-efficacy theory on diabetes management among patients who attained in Diabetes clinic of Ale Jalil hospitals in Aq qala city. Journal of Prevention and Health 2015; 1(1): 1-10. [In Persian].
  19. Najimi A, Mostafavi F, Sharifirad G, Golshiri P. Development and study of self-efficacy scale in medication adherence among Iranian patients with hypertension. J Educ Health Promot 2017; 6: 83.
  20. Khosravizade A, Hassanzadeh A, Mostafavi F. The impact of self-efficacy education on self-care behaviours of low salt and weight setting diets in hypertensive women covered by health-care centers of Dehaghan in 2013. J Pak Med Assoc 2015; 65(5): 506-11.
  21. Mohebi S, Azadbakht L, Feizi A, Hozoori M, Sharifirad G. Effects of an educational program based on improvement of perceived self-efficacy on the control of metabolic syndrome risk factors. Razi J Med Sci 2014; 21(120): 9-18. [In Persian].
  22. Harmell AL, Mausbach BT, Roepke SK, Moore RC, von Kanel R, Patterson TL, et al. The relationship between self-efficacy and resting blood pressure in spousal Alzheimer's caregivers. Br J Health Psychol 2011; 16(Pt 2): 317-28.
  23. Kim M, Song M. Effects of self-management program applying Dongsasub training on self-efficacy, self-esteem, self-management behavior and blood pressure in older adults with hypertension. J Korean Acad Nurs 2015; 45(4): 576-86. [In Korean].
مجله دانشکده پزشکی اصفهان
دوره 37، شماره 525 - شماره پیاپی 525
خرداد و تیر 1398
صفحه 454-461

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سابقه مقاله

  • تاریخ دریافت: 08 فروردین 1398
  • تاریخ بازنگری: 12 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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