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Background: The prevalence of persons with hypertension remains high, especially in Southeast Asia, such as in Indonesia. Therefore, an effort to control blood pressure is needed. This study aimed to examine the effect of a self-management program on blood pressure among persons with hypertension in Indonesia. Materials and Methods: A quasi-experimental study with pre-test post-test with control group design was used. Seventy-seven participants were selected using convenience sampling in Belitung, Indonesia. A digital sphygmomanometer was used to measure blood pressure. Paired t-test and independent t-test were used for data analysis. Knowledge of hypertension, diet, exercise, and medication records were measured via validated questionnaires and observation sheets. Results: There was a significant effect of the eight-week self-management program on systolic blood pressure (t30 = 6.45, p = 0.01) and diastolic blood pressure (t30 = 2.53, p = 0.02). A significant difference in blood pressure was also identified between the experiment and control group, particularly in systolic blood pressure (t59 = --2.89, p = 0.05) with a large effect size (0.71). Conclusions: Brisk walking with a duration of at least 30 minutes per day, dietary modification program specifically focusing on weight loss and anti-hypertensive food, monitoring program, and health education for eight weeks, are considered effective to control blood pressure among patients with hypertension, and these interventions should be a part of nursing interventions and sustainable health development programs in the community. [ABSTRACT FROM AUTHOR]

Background: The Government of Indonesia has provided a Chronic Disease Management Program, better known as PROLANIS, to reduce the incidence of hypertension; however, the prevalence of hypertension remains high in the community, especially in Belitung, Indonesia, which warrants further investigation. One of the strategies to decrease the number of hypertensions is by addressing barriers and challenges in hypertension management according to patients' points of view, which has become a lack of focus in previous studies. Purpose: This study aimed to explore the barriers and challenges of patients in managing hypertension in Belitung, Indonesia. Methods: This research employed a qualitative descriptive study design with 20 hypertensive patients who had access to the PROLANIS program in public health centers. Focus group discussions were conducted for data collection. The content analysis was used for data analysis. Results: Six themes were developed from the data, including (1) Dietary habits: the role of salt, (2) Nonadherence to medication due to the use of traditional medicine, (3) Shopping habit on nonprescription medication, (4) Confusion of antihypertensive drugs, (5) Barriers to physical exercise, and (6) Health monitoring and education. Conclusion: This study serves as an input for nurses and healthcare providers to improve the PROLANIS program, especially in hypertension management, as well as to develop new nursing interventions according to the barriers and challenges. [ABSTRACT FROM AUTHOR]

Aim To describe strategies that can enhance the recruitment of rural-dwelling older people into clinical trials. Background Recruitment to studies can be time-consuming and challenging. Moreover, there are challenges associated with recruiting older people, particularly those living in rural areas. Nevertheless, an adequate sample size is crucial to the validity of randomised controlled trials (RCTs). Data sources The authors draw on the literature and their personal experiences, to present a range of flexible and inclusive strategies that have been successfully used to recruit older people into clinical trials. Review methods This paper describes attempts to improve recruitment of rural-dwelling, older Thai people to a clinical trial. Discussion To attract potential participants, researchers should consider minimising the burden of their March 5 2015. study and maximising its benefits or convenience for participants. Three factors that may influence participation rates are: personal factors of participants, researchers' personal attributes, and protocol factors. In addition, three important strategies contribute to improving recruitment: understanding the culture of the research setting, identifying the 'gatekeepers' in the setting and building trust with stakeholders. Conclusion Even though the study covered did not recruit a large number of participants, these understandings were crucial and enabled recruitment of a sufficient number of participants in a reasonable timeframe. Implications for practice/research These strategies may be of use in rural settings and with different communities including urban communities. [ABSTRACT FROM AUTHOR]

Aims and objectives To review community programmes promoting self-care or self-management for older people with chronic disease in Thailand. Background Identifying successful elements of culturally appropriate and effective community-based interventions to promote self-care with chronic illness is increasingly important. Design Integrative review. Data sources CINAHL, Medline, Health Source Nursing Academic databases. Methods Integrative review of peer-reviewed articles written between 1946-2012. Articles were included if they described self-care, self-management, chronic disease and community care interventions targeting older people in Thailand. Results Of the 58 articles retrieved, only 13 articles met the eligibility criteria. Elements of effective interventions included: (1) providing culturally sensitive information, (2) including approaches of shared decision-making and mutual goal setting and (3) flexibility within the intervention to adapt to participant needs. Conclusions Shared decision-making and mutual goal setting between interventionists and patients improved health behaviours and outcomes. Moreover, the flexibility to adopt the intervention to local characteristics demonstrated positive results. Relevance to clinical practice Promoting effective self-care and self-management behaviours is critical to improving outcomes for chronic conditions. The tailoring and targeting of interventions appropriate to individuals and communities are likely to be most effective in leveraging behaviour change. This review has identified that mutual goal setting improved health behaviours. The flexibility to adopt self-care interventions to community-based settings showed improved patient outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study sought to assess the effect of a community‐based intervention influencing adherence status at baseline, 1, 3 and 6 months, and to evaluate the impact that a community‐based intervention and socio‐economic factors have on adherence. Background: Although high‐quality treatment and modern hypertension clinical practice guidelines have been developed worldwide, the outcomes of patients with hypertension in Thailand are not optimal. Implementing a person‐centred and integrated health services model to improve hypertension management, such as a community‐based intervention, is challenging for healthcare providers in Thailand. Design: An observational study of a community‐based intervention. Methods: The study comprised residents in 17 villages in one province of Thailand. A sample of 156 participants was allocated into the intervention and the control groups. Inclusion criteria were people aged 60 years or older diagnosed with hypertension. Exclusion criteria included the latest record of extreme hypertension and having a documented history of cognitive impairment. The intervention group received the 4‐week community‐based intervention programme. Multiple linear regression was applied to predict the adherence status at each phase. Multiple logistic regression was then implemented to predict influencing factors between the groups. Results: Patients who received the intervention had significantly lower adherence scores (reflecting a higher level of adherence) at 3 and 6 months after intervention by 1.66 and 1.45 times, respectively, when adjusting for other variables. After 6 months, the intervention was associated with a significant improvement in adherence when adjusting for other variables. Conclusion: This study provides evidence to support the use of community‐based interventions as an effective adjunct to hospital‐based care of hypertension patients in Thailand. Implications for practice: Understanding factors between health outcomes and social determinants of health is crucial for informing the development of culturally appropriate interventions. [ABSTRACT FROM AUTHOR]