Development and validation of the Hypertension Self-care Profile: a practical tool to measure hypertension self-care.

BACKGROUND: Adequate self-care is crucial for blood pressure control. A number of hypertension (HBP) self-care instruments are available, but existing tools do not capture all the critical domains of HBP self-care and have limited evidence of reliability and validity. OBJECTIVE: The purpose of this study was to develop and validate a new tool--the HBP Self-Care Profile (HBP SCP)--in a sample of inner-city residents. METHODS: The HBP SCP encompasses comprehensive domains of HBP self-care behaviors. Guided by 2 validated theoretical approaches--Orem's self-care model and Motivational Interviewing--the HBP SCP includes 3 scales that can be used together or independently: Behavior, Motivation, and Self-efficacy. The sample included 213 English-speaking inner-city residents with HBP (mean age, 68.6 years; 76.1% women; 81.7% African American). RESULTS: Item-total correlations ranged from 0.20 to 0.63 for Behavior, 0.46 to 0.70 for Motivation, and 0.40 to 0.74 for Self-efficacy, meeting the cutoff set a priori at 0.15. Internal consistency reliability coefficients ranged from 0.83 to 0.93. Concurrent and construct validities of the HBP SCP were achieved by significant correlations between HBP SCP scales and theoretically selected instruments (P < .05 for all correlation coefficients). The HBP SCP-Behavior scale also successfully discriminated between those with or without blood pressure control (P < .05). CONCLUSIONS: The reliability and validity of the HBP SCP were supported in this sample of inner-city residents with HBP. The high reliability estimates and strong evidence of validity should allow researchers to use the HBP SCP to assess and identify gaps in HBP self-care behavior, motivation, and self-efficacy. Future research is warranted to evaluate the HBP SCP in diverse ethnic and age samples of hypertensive patient populations.

Constructing and testing a self-help intervention program for high blood pressure control in Korean American seniors--a pilot study.

Although significant progress has been made in the reduction of overall cardiovascular risk factors in the United States during the last decade, controlling high blood pressure (HBP) remains a difficult task for many individuals. In particular, socially disadvantaged groups, such as new immigrants, and ethnic minority groups, such as Korean Americans, continue to struggle with this chronic disease and suffer unnecessary complications. We conducted a quasi-experimental study to test the efficacy of a self-help intervention program for HBP control in first-generation Korean American seniors with HBP. The intervention consisted of 3 concurrently administered components: (1) structured behavioral education on HBP management, (2) home blood pressure (BP) monitoring, and (3) monthly support groups facilitated by a bilingual nurse. Of the 49 Korean American seniors (> or =60 years old) who agreed to participate, 31 received the intervention and completed the follow-up interviews at 6 months. Final analysis of BP outcomes using repeated measures and postintervention data suggested that the self-help intervention was effective in significantly improving the proportion of individuals who achieved BP control (<140/90 mm Hg) and in lowering both systolic and diastolic BP in the sample. Specifically, the BP control rate, which was 29% at baseline, increased at 6 months to 69%. Likewise, the mean systolic and diastolic BP values of 142.7 and 87.1 mm Hg at baseline decreased to 129.3 and 75.3 mm Hg, respectively, after 6 months of follow-up. This improvement of the HBP control rate in the sample highlights the clinical efficacy of the self-help intervention for this traditionally underserved immigrant group.

Cultural considerations in understanding family violence among Asian American Pacific Islander families.

There has been much research conducted in the area of family violence, however, there is a paucity of research specifically addressing family violence in Asian American and Pacific Islander (AAPI) communities. Because AAPIs are regarded as the model minority, many have the misconception that family violence does not exist in this population. This article examines Asian cultural beliefs and values to gain a better understanding of Asian attitudes towards family violence. A more in-depth exploration of the Cambodian and Vietnamese cultures regarding attitudes towards violence is included because of the higher tolerance of family violence among these 2 cultures than other Asian cultures. Public health nurses working with AAPI families can provide culturally appropriate care by taking Asian attitudes, values, and beliefs into account when developing nursing interventions with victims of abuse.