ABSTRACT
A brief small group structured approach to improving compliance behavior and blood pressure control is described. The group intervention is based on the results of a diagnostic baseline survey of ambulatory hypertensive patients receiving care in an inner-city hospital. It was tailored to meet the expressed needs of that population group. Three main steps characterize the intervention: examining health behaviors and compliance issues with the patients using rehearsal of specific coping skills in problem solving activity; using Locus of Control concepts to facilitate process; and encouraging the patient to practice and apply the coping skills in stressful situations. Major themes within the group sessions and general outcomes are examined.
Subject(s)
Hypertension/therapy , Patient Compliance , Patient Education as Topic/methods , Blood Pressure , Female , Humans , Hypertension/diagnosis , MaleABSTRACT
The shift in patterns of disease toward chronic illness necessitates greater patient participation in its management and their own rehabilitation, and they require greater social support over longer periods. Patient activation, or the enhancement of patient and support group involvement in personal health care through teaching management techniques and problem-solving skills, has emerged in healthy education in response to this need. This paper will examine combined educational and behavioral approaches to increasing social support and patient activation in hypertension management. Activation in this study involves increased feelings of personal control over the contingencies surrounding the management of medical regimens. Both family support intervention and small group sessions oriented to changing compliance behavior by changing expectancy frames were offered to a randomized sample of 200 inner city, black, hypertensive patients who were part of a larger study. Patients were examined within a pretest-posttest randomized factorial design on measures of locus of control, belief in seriousness, efficacy of treatment, medication compliance, and blood pressure control. This combined approach showed small differences on the attitude and behavioral measures but displayed a significant effect on the program outcome variable blood pressure control (62% in control among intervention groups versus 46% in nonintervention groups).
Subject(s)
Behavior , Health Education , Hypertension/therapy , Patient Compliance , Black or African American , Attitude to Health , Female , Humans , Male , Middle Aged , White PeopleABSTRACT
This paper addresses the development and effect of health education interventions on compliance behavior and blood pressure control of hypertensive patients. The focus is on two main tactics: 1) the use of a baseline questionnaire to determine the patients' needs in the area of medical regimen management and the translation of that information into education intervention; 2) the development of a group method as a form of internality training providing a needs assessment and simultaneously responding to the assessment. The results supported the study's hypotheses with respect to blood pressure control. Both the theoretical and practical aspects of internality training as a needs assessment process and a skill training process are discussed.
