The Effect Of Nursing Intervention On With Self-Efficacy Of Hospitalized Patients Essential Hypertension

Objectives: The purposes of this study were to (1) evaluate the reliability and validityof the Hypertension Self-efficacy Scale (HSES) developed by self.(2) screen thehospitalized patients with hypertension to investigate the self-efficacy inself-management. (3) identify the main factors that affect the self-efficacy. (4) evaluatethe effect of nursing intervention to justify the most effect nursing intervention and theobjects.Methods: This study was designed as a similar experience. It comprised three stages.The first stage was preparation period, which included: (1) selecting standards of theincluding and excluding. (2) developing the Hypertension Self-efficacy Scale andtesting its reliability and validity. (3) training investigator. The second stage was practiceperiod. It included (1) evaluating and analyzing the basic self-efficacy. 163 hospitalizedhypertension patients suited for the screen standard with convenience sampling at twotriary- hospitals in Guangzhou were studied. The marks of their self-efficacy levels werecollected and the data were analyzed by a descriptive statistic and one-way ANOVA, using the SPSS 10.0 program. (2) According to the results, the factors of affecting thepatients who acquired less than two scores in self-efficacy were investigated. (3) The nursing intervention was carried out by the means of question-aim and courseseducation according to the basic self-efficacy. The third stage was evaluation. Theself-efficacy levels were evaluated again six months after intervention. Data wereanalyzed by paired t test and one-way ANOVA, using the SPSS 10.0 program.Results: (1) The Cronbach's alpha reliability coefficients of the HypertensionSelf-efficacy Scale was 0.80. The test-retest Pearson's correlation coefficient was 0.81, The factor analysis suggested that total variable of four factors cumulative is 67.524%.The factor loan of each item ranges from 0.641 to 0.871. (2) The self-efficacy levels ofthe patients were not high. There were no statistically significant differences inself-efficacy level between different gender and among different ages (p=0.162 and p=0.124). There were statistically significant differences among different culturallevel(p=0.014), occupation(p=0.006), the duration with hypertension(p=0.001), address(p=0.000) and medical costs (p=0.007). There were more than half of the 163patients who acquired less than two scores in six items. These six items were insistingon exercise, reasonable diets, controlling quantity of diets, controlling emotion, measuring blood pressure and regular consultant visit respectively. The retired patientsacquired the highest score and the peasants acquired the lowest among differentoccupations. The self-efficacy level of the patients who had hypertension for longerwere higher. The levels of citizen and those who were at public expense were higherthan those of peasants and those who paid by themselves. (3) The main factors ofaffecting the self-efficacy levels mainly were "didn't know what foods should be eatenand how to arrange" "didn't know how to measure blood pressure" and suffered from"no disease ". (4) There were statistically significant differences in self-efficacy levels between before and after intervention among all participants (p=0.00). Each one gets agoal to equally raise 0.30-1.33 cents, the everybody always divides to equally raise5.50-12.09 cents, There were statistically significant differences among differenteducation backgrounds, medical costs (p=0.031 and p=0.014), and differentoccupations (p=0.008), duration of having hypertension (p=0.006) and address(p=0.007)Conclusion: (1) The study indicates that the Hypertension Self-efficacy Scale is suitedto investigate the self-efficacy of the patients with hypertension (2) The self-efficacylevels of all participants were not high especially in insisting on exercise, reasonablediets, controlling quantity of diets, controlling emotion, measuring blood pressure, andregular subsequent visit. (3) In the process of nursing intervention, patients should beguided to identify what food could be eaten and arrange them and should be guided tomeasure the blood pressure. (4) It suggests that the self-efficacy of hypertension patientscould be promoted by nursing intervention, especially the middle-aged patients whocome from village and town or have low cultural degree or short duration shouldbe paid attention.