Effects of a multicomponent proactive nursing program applying the chronic care model on blood pressure control and satisfaction with care of hypertensive older persons

Abstract

Hypertension is a common health problem in older persons and has been met with limited success in controlling blood pressure worldwide. The purposes of this research were to evaluate the effects of a multicomponent proactive nursing (MPN) program on blood pressure control and satisfaction with care of hypertensive older persons. The 3 month MPN program based on the Chronic Care Model (Wagner, 1998), was developed by literature review and implemented at two health centers in Nakhon Si Thammarat, Thailand. A hundred participants were studied with matched pairs and random assignment to the intervention or control group. The intervention consisted of education, monitoring, and skill training. Testing was conducted at baseline, 3 and 6 month on both an experimental and a control groups. Data was analyzed by repeated measures ANOVA and Chi-square. The results indicated that the participants in the experimental group had lower mean values of systolic and diastolic blood pressure at three and six months. Post-test mean values of systolic and diastolic blood pressure were significantly lower in the experimental group (p < .001). The percentage of participants maintaining blood pressure control was also significantly greater in the intervention group at 3 months (p < .001) and at 6 months (p = .005). The findings indicated that the MPN program effectively improved blood pressure control and in hypertensive older persons. Moreover, the program was effective for increasing patient satisfaction with nursing care score in the experimental group (p < .001) compared to the control group. These results suggest that implementing this program at health centers would result in better control of HTN in this high risk group.