An application of the theory of planned behavior to self-care in patients with hypertension
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RESEARCH ARTICLE
Open Access
An application of the theory of planned behavior to self-care in patients with hypertension Gholamreza Pourmand1, Leila Doshmangir2,3,4, Ayat Ahmadi5* , Mohammad Noori1, Atiyeh Rezaeifar6, Rahil Mashhadi1, Rezvan Aziminia1, Amirhossein Pourmand1 and Vladimir S. Gordeev7,8
Abstract Background: Self-care behaviors and positive changes in lifestyle are essential for successful hypertension control. We used a behavioral model based on the theory of planned behavior to assess which factors influence self-care behaviors for controlling hypertension. Methods: In this cross-sectional study, five hundred patients with at leastaone-year history of diagnosed hypertension participated in this study. The data collection tool was designed based on the theory of planned behavior. Structural equation modeling was used to estimate the main parameters. Results: For self-care behaviors, ninety-six (19.2%) and forty-five (9.1%) participants had good knowledge and acceptable behavior(≥8 out of 10 points). Having perceived behavioral control regarding quitting smoking and alcohol intake was associated with the patient’s intention and behavior [b:1.283 ± .095 and b:1.59 ± .014 (p < .001)]. Having perceived behavioral control over the other self-care behaviors had a positive effect on the intention in female patients [b: .885 ± .442 (p = .045)]. Subjective norms had a positive effect on behavioral intention in younger patients [b:4.52 ± 2.24 (P = .04)]. Conclusions: Group-specific behavioral barriers are important when improving self-care behaviors in patients with hypertension. Perceived control over self-care behaviors is more important in vulnerable patients, such as the elderly and women. Keywords: Theory of planned behavior, Self-care, Hypertension, Lifestyle
Background Hypertension is one of the most important preventable contributors to morbidity and mortality [1–3]. Following the 2013 World Health Organization (WHO) report, cardiovascular diseases (CVDs) cause approximately 17 million deaths yearly globally, and hypertension is responsible for at least 55% of these deaths [1]. It is estimated that there would be more than 500 million * Correspondence: [email protected] 5 Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran Full list of author information is available at the end of the article
(about 60%) hypertensive patients around the world by the year 2025. Hypertension is considered to be a major modifiable risk factor for CVDs, resulting in more deaths than any other risk factor in the Asian regions [4]. The incidence of hypertension is associated with salt intake, stress level, and obesity [5, 6], and it is higher in lowand middle-income countries where patients have less awareness regarding the importance of hypertension control [6, 7]. According to the recent reports, about one-quarter of Iranian adults have hypertension (systolic blood pressure ≥ 140 or diastolic blood pressure ≥ 90), of which 56.6% are men, and 43.4% are women [1, 8].
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