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Levels and Predictors of Self-Care Among Patients with Hypertension in Pakistan

Authors Ajani K, Gowani A, Gul R, Petrucka P

Received 16 December 2020

Accepted for publication 19 February 2021

Published 25 March 2021 Volume 2021:14 Pages 1023—1032


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Khairulnissa Ajani,1 Ambreen Gowani,1 Raisa Gul,1,2 Pammla Petrucka3

1School of Nursing, Aga Khan University, Karachi, Pakistan; 2School of Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan; 3College of Nursing, University of Saskatchewan, Saskatoon, Canada

Correspondence: Khairulnissa Ajani
Aga Khan University School of Nursing, P.O. Box 3500, Stadium Road, Karachi, Pakistan
Email [email protected]

Background: Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan.
Methods: This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban cosmopolitan setting within Karachi Pakistan. Four hundred and two patients were screened using the H-SCALE questionnaire, while socio-demographic predictors of self-care and level of knowledge of hypertension were identified using a study-specific checklist. Self-care was assessed against six clinical domains including medication adherence, diet, weight management, physical activity, and abstinence from alcohol.
Results: Participants were recruited from the two largest tertiary care hospitals in Karachi. Good knowledge about hypertension, including its causes, management, and complications was reported by 4.47% of the participants. Highest levels of self-care adherence were found for abstinence from alcohol (100%), smoking cessation (83.33%), and medication compliance (71.89%), whereas lowest levels were found for diet (27.11%), and physical activity (24.88%). In terms of predictors for self-care, age, male gender, and self-checking of blood pressure at home, followed by the level of education were the most common predictors for each self-care behavior in the given population.
Conclusion: Overall knowledge of self-care for hypertension is sub-optimal among hypertensive patients in Pakistan which is reflected in their behaviors. There is a need to introduce healthcare educational programs in Pakistan which can improve self-care behaviors of hypertensive individuals and potentially reduce the prevalence of associated cardiovascular diseases and its complications.

Keywords: hypertension, self-care management, cross-sectional study, Pakistan

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