Search results

This study aims to examine the effects of a self-management program (SMP) on self-care behavior, blood pressure and quality of life among older adults with uncontrolled hypertension.

A quasi-experimental design with repeated measures was conducted in two primary care units in Krabi, Thailand. One hundred and fifty-six older adults with uncontrolled hypertension were selected based on the inclusion criteria and divided into experimental and control groups with 78 participants in each. The experimental group received the SMP, including the intervention related to the self-management process (from the 1st to 4th weeks) and a follow-up phase (from the 5th to 16th weeks). The control group received standard care. The outcomes were measured over time, including self-care behavior (baseline, 4th and 16th weeks), blood pressure (baseline, 4th, 8th, 12th and 16th weeks) and quality of life (baseline and 16th week).

The generalized estimating equations showed that the SMP, compared with the control group, statistically significantly improved self-care behavior (p < 0.001), decreased blood pressure (p < 0.001) and improved quality of life (p < 0.001) at the 16th week.

The SMP improved the self-care behavior, decreased blood pressure and improved the quality of life among older adults with uncontrolled hypertension. Registered nurses could administer this program for long-term benefits and help reduce the burden on primary care services.

This study aims to explore the perceptions of quality of life among older Thai adults with hypertension.

A descriptive qualitative design was used. Semistructured interviews were conducted with 40 older adults. Thematic analysis was used to analyze the data.

The analyses were divided into six major themes: happiness in life; health and functionality; activity in social relationships; religion anchor; autonomy to manage their own life; and security in finances and environment.

The findings can guide health care professionals and policymakers when planning and implementing interventions and policies for improving the quality of life of older adults, particularly that of rural older adults with low incomes.

The findings showed minor differences between urban and rural older adults in financial security, where the rural participants expressed greater financial insecurity than the urban counterparts. However, no other major differences emerged.

Hypertension is a key determinant for the development and progression of chronic kidney disease (CKD). The purpose of this study is to assess the rate of uncontrolled blood pressure (BP) and identify its associated factors in patients with predialysis CKD in Bali, Indonesia.

A cross-sectional study was conducted among 165 patients who attended the nephrology clinic in a central public hospital in Bali. Data were obtained by measuring BP at threshold 130/80 mmHg, as well as collected through standardized questionnaires. Univariate analysis was done using Chi-square test, and multivariate analyses were carried out using multiple logistic regression.

A total of 165 patients (111 males and 54 females) with predialysis CKD participated in this study. About 64% of the participants had uncontrolled BP. In multiple logistic regression, all selected variables significantly explained 63.2% of the variance in uncontrolled BP. However, low physical activity (odds ratio [OR] = 24.287, 95% confidence interval [CI]: 3.114–189.445), unhealthy dietary pattern (OR = 10.153, 95% CI: 2.770–37.210), as well as perceived moderate stress (OR = 4.365, 95% CI: 1.024-18.609) and high stress (OR = 10.978, 95% CI: 2.602–46.312) were significantly associated with uncontrolled BP.

The study findings provide evidence for health care providers to improve BP control among patients with predialysis CKD.

Controlling BP among patients with predialysis CKD was poor. Lifestyle modification and stress management are keys to improving BP control.

Hypertension is a common disease among elderly. Adherence to antihypertensive medication is a key predictor of optimal blood pressure control that prevents the risk of cardiovascular disease and potentially death. The purpose of this paper is to assess adherence to antihypertension and identify associated factors among the elderly in a rural area, Buengkan province, Thailand.

A health facilities based cross-sectional study was conducted in Buengkan district. A simple random sampling method was used to select 408 participants. A structured questionnaire adapted from the World Health Organization STEPwise approach was used to collect data. The medication adherence level was identified by pill count with percentage ⩾70 defined as good adherence. Descriptive and summary statistics were used. Bivariate analysis was done using Pearson’s χ² test, and multivariable analyses were also carried out.

A total of 408 (143 males and 265 females) elderly hypertension patients with uncontrolled blood pressure participated in this study. Most of the participants were found to have lower adherence to medication treatment (86.8 percent), whereas the remaining ones (13.2 percent) were found to have good adherence. The multivariable logistic regression analysis showed that having a daughter as a care taker (adjust odd ratio=7.99, 95% confidence interval: 1.23–51.778) was significantly associated with high medical adherence.

Hypertension medication adherence among elderly patients with uncontrolled blood pressure was poor. Having a care taker, especially a daughter, is a key to improve adherence. Effective strategy to improve adherence should focus on and involve family participation into the program.

This study examined the risk factors associated with hypertension in Bhutan.

The cross-sectional data of 30,889 adults from the National Health Survey of Bhutan was used in this study. Multivariable regression accounting for the complex survey design was performed to identify the risk factors. The backward elimination approach was applied in the multivariable analysis.

The prevalence of hypertension was 17%. Increasing age, being female, being previously married, higher wealth status, past alcohol use, having diabetes, loneliness, health service use and low vegetable intake was associated with increased hypertension risk, whereas, higher education level, being employed and residing in the eastern region was associated with reduced risk. Age, gender, education, wealth status, diabetes status, loneliness and health service use were common factors in all the regions. Marital status and vegetable intake were associated with hypertension in the western and central regions, and alcohol use in the eastern and central regions.

Affecting around one-sixth of the population, hypertension is a significant public health problem in Bhutan. Interventions to improve health education and access, motivate healthy lifestyles, and reduce harmful alcohol use, and strategies to create health-promoting social and built environments are needed to curb the hypertension epidemic and its consequences.

This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.

Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.

Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.

This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

Hypertension is the most common chronic disease throughout the world. Self-care is the key criteria in determining the final course of the disease. However, the majority of elderly people do not observe self-care behaviors. The purpose of this paper is to analyze the experiences of elderly people with hypertension in order to understand the barriers of their self-care behaviors.

This is a qualitative study with a conventional content analysis approach conducted in Tehran, Iran in 2017. Data collection was done among 23 participants – 14 elderly people; 6 cardiologists, geriatric physicians and nurses working in the cardiovascular ward; and 3 caregivers – who were selected by purposeful sampling. Using semi-structured, face-to-face interviews, data collection was continued until data saturation.

Three main categories, including attitude limitations, inefficient supportive network and desperation, all showed barriers to self-care by the experiences of elderly people with hypertension.

Lack of knowledge of the disease and its treatment process is one of the main barriers to self-care in elderly people with hypertension. Deficient supportive resources along with economic and family problems exacerbate the failure to do self-care behaviors.

This study was designed to assess the risk factors associated with hypertension (HTN) and diabetes among artisans in Ogun State, Nigeria. Evidences suggest increasing prevalence, incidences and morbidity of diabetes and HTN in Nigeria. However, the purpose of this study is to plan and prioritize effective intervention programs, there is need to provide data on the prevalence and risk factors for HTN and diabetes among local groups.

In total 300 apparently healthy artisans who have never been diagnosed of diabetes or HTN were randomly selected from five communities. A structured questionnaire was used in obtaining information on the personal characteristics of the respondents. An adapted dietary habit and lifestyle questionnaire were used to assess the dietary habits and lifestyle of the respondents. The WHO global activity questionnaire was adapted and used to gather information on the physical activity level of the respondents. Random blood glucose, blood pressure and anthropometric measurements were assessed using standard instruments. Chi-square (χ²), correlations and multinomial logistic regression analysis were performed to identify significant determinants of diabetes and HTN.

Mean age was 34.8 ± 9.9 and prevalence of diabetes and pre-diabetes were 1 and 4.7 per cent, respectively, while HTN and pre-HTN were 48.0 and 30.3 per cent, respectively. About half (55.7 per cent) of the respondents skip at least a meal daily and 31 per cent snack daily. Most (61.4 per cent) consume alcohol and 65.7 per cent engage in high physical activity. Abdominal obesity was significantly higher among women (p = 0.004). Using the chi-square analysis, age, abdominal obesity and educational status were factors found to be significantly associated with diabetes (p = 0.002; p = 0.007; p = 0.004) while age, gender, abdominal obesity and alcohol consumption had significant association with HTN. Although not statistically significant, respondents were 0.8, 1.0 and 1.1 times more likely to be diabetic with increasing body mass index, waist circumference (WC) and age (odd ratio (OR) = 0.78; confidence intervals (CI): 0.51-1.18; OR = 1.04; CI: 0.89-1.21; OR = 1.06; CI: 0.96-1.18, respectively). Abdominal obesity was significantly associated with HTN (OR = 1.08; CI: 1.03-1.13; p = 0.001). Also, older respondents were 1.1 times more likely of becoming hypertensive (OR = 1.07; CI: 1.02-1.11; p = 0.003). Increased risk of diabetes and HTN was found among respondents with increasing age and WC.

This study was cross-sectional in design; it cannot be used to establish a cause-effect relationship between diabetes, HTN and the observed variables (anthropometric characteristics, dietary habits and lifestyle risk factors). Because of the few numbers (1 per cent) of respondents identified to be diabetic several important risk factors could not be included in the model.

An understanding of the risk factors associated with diabetes and HTN among sub-groups in the population will help to plan effective interventions targeted at specific groups.

The findings of this study show the associated risk factors for diabetes and HTN among artisans in Ogun State.

The dementias are important disorders of ageing which result in cognitive and functional decline, behaviour change, increasing dependency and premature death. Alzheimer's disease and other dementias are at least as prevalent in older people with learning disabilities as in the general population. In addition, people with Down's syndrome have high rates of early onset Alzheimer's disease. Assessment of dementia in people with learning disabilities is confounded by pre‐existing cognitive and functional impairments and high rates of comorbid disorders. This paper discusses assessment of dementia in people with learning disabilities from a clinical perspective, with reference to the current evidence base.

Obesity is a chronic disease and it is very important to determine the underlying factors at the early stage. Disturbance in eating behaviors may predict the obesity risk.

In the present study, it was aimed to investigate eating behavior of Turkish adults by using The Three-Factor Eating Questionnaire-R18 (TFEQ-R18) and to analyze the association between anthropometric measurements and socio-demographic factors.

Individuals composed of 698 males, aged 28.6 ± 10.3 years and 1,736 females, aged 25.1 ± 7.8 years. Demographic characteristics participants were obtained via a questionnaire. TFEQ-R18for assessing eating behavior was used. Results claim that the usage of TFEQ-R18 was appropriate for non-obese individuals (Cronbach’s α value 0.83 for underweight group (n = 180, 7.4%), 0.76 for normal group (n = 1604, 65.9%), 0.69 for overweight group (n = 492, 20.2%), 0.69 obese group (n = 158, 6.5%). Gender seems to effect emotional eating scores (p = 0.026) and employment status seem to affect all TFEQ-R18 sub-group dimensions (cognitive eating scores, p = 0.022, uncontrolled eating scores, p < 0.001, emotional eating scores, p < 0.001). Divorced individuals tend to have higher cognitive restraint scores (16.2 ± 3.7). Although, single people have higher emotional eating scores (7.5 ± 2.6) (p = 0.006). There is a positive correlation among waist–height ratio, waist and neck circumference and cognitive restraint and uncontrolled eating scores (p < 0.001). However, body weight and height correlate negatively with cognitive restraint scores (p < 0.001).

According to the authors’ knowledge, this study gives brief results for the usage of TFEQ-R18 and the ability to predict eating behaviors in the general population.