Thực trạng công tác chăm sóc sức khỏe sinh sản của nữ công nhân tổng công ty may hưng yên năm 2015

LIST OF ABBREVIATIONS ACE: Angiotensin-converting enzyme ARBs: Angiotensin II receptorblockers A- Score: Attitude score BP: Blood pressure CVD: Cardiovascular DBP: Diastolic Blood Pressu

MINISTRY OF EDUCATION AND TRAININGMINISTRY OF HEALTH

HANOI MEDICAL UNIVERSITY

………***………

NGUYỄN VĂN TOÀN

A SURVEY ON KNOWLEDGE, ATTIUDESAND PRACTICEREGARDING TO HYPERTENTIONAMONG ELDERLY PEOPLE IN SELECTED TWO COMMUNESIN BAC GIANG CITY IN

2014

BACHELOR OF SCIENCE NURSING ADVANCED PROGRAM IN NURSING

2010 – 2014

HANOI – 2015 MINISTRY OF EDUCATION AND TRAININGMINISTRY OF HEALTH

HANOI MEDICAL UNIVERSITY

………***………

NGUYỄN VĂN TOÀN

A SURVEY ON KNOWLEDGE, ATTIUDES AND PRACTICE REGARDING TO HYPERTENTION AMONG ELDERLY PEOPLE IN SELECTED TWO COMMUNES IN BAC GIANG CITY IN 2014

BACHELOR OF SCIENCE NURSING ADVANCED PROGRAM IN NURSING

2010 – 2014

SUPERISOR: MR BÙI VŨ BÌNH Master of science in nursing

HANOI– 2015

ACKNOWLEDGEMENTS

This study depended on the contribution of many individuals I am deeply appreciative of those who offered advice and help The following individuals deserve special mention

First of all, I grateful acknowledge the Presidential Board and the Undergraduate Training and Management Department of Hanoi Medical University for giving me the opportunity to complete this thesis

I would like to express my sincere gratitude to the full support, unfailing patience, invaluable advice and detailed guidance of Mr Bui Vu Binh, Lecturer of the Nursing and Midwifery Department, Hanoi Medical University, whose comments gave me a clear insight into this study It was my privilege to have him as my supervisor

I would like to acknowledge participants from two ward Dinh Ke and Hoang Van Thu for their cooperation, willingness and enthusiasm in answering the interview that help me to do this thesis better

Last but not least, from the bottom of my heart, I would like to thank

my dear family and friends who always stand by my side, support and encourage me to complete this thesis

Hanoi, June 15th, 2015

Nguyen Van Toan

DECLARATION

I declare that this thesis represents my own work, except where due acknowledgement is made, and that is has not been previously included in a thesis, dissertation or report submitted to the university or any other institution for a degree, diploma or other qualifications

Signed Nguyen Van Toan

TABLE OF CONTENTS

ACKNOWLEDGEMENTS i

DECLARATION ii

TABLE OF CONTENTS iii

LIST OF TABLES vi

LIST OF FIGURES vi

LIST OF ABBREVIATIONS vii

INTRODUCTION 1

CHAPTER 1 - LITERATURE REVIEW 3

1.1 Overview of hypertension 3

1.1.1 Hypertension definition 3

1.1.2 Causes of hypertension 4

1.1.3 Risk Factors 4

1.1.4 Complications 4

1.1.5 Management: 5

1.2 Epidemiology 6

1.2.1 Global burden 6

1.2.2 The prevalence of Hypertension in Vietnam 7

1.2.3 Hypertension and elderly people with hypertension 7

1.3 Knowledge, attitude and practice 9

1.3.1 Knowledge, attitude and practice definitions 9

1.3.2 Knowledge, attitude and practice regarding to Hypertension 10

1.4 Factors influence to healthy blood pressure practice 13

1.4.1 Educational level 13

1.4.2 Economical status 13

1.4.3 Information approach and health care worker-patient relationship 13

1.4.4 Other factors 14

1.5 Framework 16

CHAPTER 2 - SUBJECTS AND METHOD 17

2.1 Study design 17

2.2 Sampling and Setting 17

2.2.1 Setting 17

2.2.2 Sampling 17

2.2.3 Sample size 18

2.3 Research instruments 18

2.4 Research Indicators and Variables 18

2.5 Bias and controllingbias 19

2.5.1 Acquired bias 19

2.5.2 Controlling bias 19

2.6 Research progress 20

2.6.1 The process of making research 20

2.6.2 Data collection 20

2.6.3 Data analysis 20

2.7 Ethical considerations 21

CHAPTER 3 - RESULTS 22

3.1 General characteristics of the participants 22

3.2 Knowledge, attitude and practice related to hypertension care 24

3.2.1 Knowledge of participants on hypertension 24

3.2.2 Attitudes towards Hypertension 26

3.2.3 Self-care on Hypertension 27

3.3 Factors associated with hypertension 29

3.3.1 Participants characteristic and hypertension status 29

3.3.2 Correlations among Age, Knowledge score, Attitudes score, and Practice score 31

3.3.3 Knowledge, attitude, practice with having hypertension 32

CHAPTER 4 - DISCUSSION 34

4.1 General characteristics of the participants 34

4.2 Knowledge, attitude, practice of elderly regardingto hypertension 35

4.2.1 Knowledge 35

4.2.2 Attitude 37

4.2.3 Practice 37

CONCLUSIONS 41

RECOMMENDATIONS 42

LIST OF TABLES

Table 3.1: Demographic characteristics of the participants 22

Table 3.2: Hypertension and source of knowledge 23

Table 3.3: Knowledge on Hypertension 24

Table 3.4: Attitudes towardsHypertension 26

Table 3.5: Self-care on Hypertension 27

Table 3.6: The relation between gender and hypertension 29

Table 3.7: The relation between age and hypertension 29

Table 3.8: The relation between demographic and knowledge 30

Table 3.9: The relation between demographic and attitudes 30

Table 3.10: Correlations between age, knowledge score, attitudes score, and practice score 31

Table 3.11: Knowledge, attitude, practice with hypertension 32

LIST OF FIGURES

LIST OF ABBREVIATIONS

ACE: Angiotensin-converting enzyme

ARBs: Angiotensin II receptorblockers

A- Score: Attitude score

BP: Blood pressure

CVD: Cardiovascular

DBP: Diastolic Blood Pressure

HBP: High Blood Pressure

HTN: Hypertension

KAP: Knowledge Attitude Practice

K- score: Knowledge score

P-score: practice score

SBP: Systolic Blood Pressure

WHO: World Health Organization

INTRODUCTION

Hypertension is an important public health challenge, which affects approximately one billion people worldwide [1] According to the World Health Organization (WHO), hypertension is the leading risk factor for mortality (12.7% of deaths attributable) [2] Each year at least 7.1 million people die as a consequence of hypertension [3].The overall average prevalence of hypertension in the world was estimated as 35% (37% in men and 31% in women)[4]

Hypertension has become a significant problem in many developing countries In Vietnam the rate of hypertension has increased significantly in recent years According to Son Pham (2011), 25.1% of Vietnamese people (28.3% men vs 23.1% women) over age 25 have high blood pressure The rate

of hypertension increased with age in both sexes and particularly higher in the age group over 65[5] Especially hypertension has serious complications which are usually found when peoplecheckat the health facilities

Hypertension is one of the diseases which is more common in old age and may affect the quality of life in elderly people According to the studies in the University of York, hypertension is a risk factor for stroke and ischemic heart disease in elderly people[6]

With a big concernment about knowledge, attitudes and practices regarding hypertension among elderly people, the researcher conducted this study in Bac Giang Bac Giang is a midland province, 90% of the population live in rural areas, 10% of poverty People have less access to health services than other areas

The researcher selected study in Bac Giang city Bac Giang city has 148.172 people, including the elderly accounted for 19.148 persons (12.9%) and 46.5%

of people living in urban areas, 53.5% of people living in rural areas.The researcher conducted this study on 200 participants in some communes of Bac Giang city in a period from September to November, 2014

The research did this study with two main objectives:

1 Describe the knowledge, attitude and practices of elderly people regarding

to hypertension

2 Explorefactors that affect knowledge, attitude and practices of elderly people regarding to hypertension

CHAPTER 1 - LITERATURE REVIEW

1.1 Overview of hypertension

1.1.1 Hypertension definition

According to the World Health Organization-International Society of Hypertension (WHO/ISH) Guidelines for the Management of Hypertension [7], hypertension is defined as a systolic blood pressure (SBP) of 140 mmHg or greater and/or a diastolic blood pressure (DBP) of 90 mmHg or greater in subjects who are not taking antihypertensive medication.For subjects with diabetes mellitus, end organ damage or metabolic syndrome, blood pressure levels of130/80 mmHg or greater are defined as hypertension[8, 9]

A classification of blood pressure levels in adults over the age of 18

is provided in Table 1

Table 1.Definition and classification of blood pressure (diastolic blood pressure) levels (According to Vietnam Ministry of Health’s Guidelines for Prevention and Management of Hypertension)[8]

Category SBP

(mmHg)

DBP (mmHg)

Hypertension stage 1 (mild) 140-159 and/ or 90-99

Hypertension stage 2 (moderate) 160-179 and/ or 100-109 Hypertension stage3 (severe) ≥ 180 and/ or ≥ 110

Key: SBP= Systolic blood pressure DBP= Diastolic blood pressure

1.1.2 Causes of hypertension

Primary (essential) hypertension:

For most adults, there's no identifiable cause of high blood pressure This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years

1.1.3 Risk Factors

According to Mayo clinic high blood pressure has many risk factors,

including: age, race, family history, being overweight or obese, not being

physically active, using tobacco, too much salt (sodium) in diet, too little potassium in diet, drinking too much alcohol, stress, certain chronic conditions [11, 12] Many modifiable factors contribute to the high prevalence rates of hypertension They include eating food containing too much salt and fat, inadequate intake of fruits and vegetables, overweight and obesity, harmful use

of alcohol, physical inactivity, psychological stress, socioeconomic determinants, and inadequate access to health care Worldwide, detection, treatment and control of hypertension are inadequate, owing to weaknesses in health systems, particularly at the primary care level[13]

1.1.4 Complications

According to Mayo clinic the excessive pressure on your artery walls caused

by high blood pressure can damage your blood vessels, as well as organs in

your body The higher your blood pressure and the longer it goes uncontrolled, the greater the damage Uncontrolled high blood pressure can lead to: heart attack or stroke, aneurysm, heart failure, thickened, narrowed or torn blood vessels in the eyes, metabolic syndrome, and trouble with memory or understanding [14]

1.1.5 Management:

If left uncontrolled, hypertension causes stroke, myocardial infarction, cardiac failure, dementia, renal failure and blindness There is strong scientific evidence of the health benefits of lowering blood pressure through population-wide and individual (behavioral and pharmacological) interventions[13]

According to the British Guidelines for HTN 2004, all people with high blood pressure, borderline or high normal blood pressure should be advised in lifestyle modifications People should maintain normal body weight, reduce salt intake, limit alcohol consumption, and engage in regular aerobic physical exercise (brisk walking rather than weightlifting) for ≥ 30minutes per day, ideally on most of days of the week but at least on three days of the week Moreover, people should consume at least five portions/day of fresh fruit and vegetables; and reduce the intake of total and saturated fat

Most people with high blood pressure will require at least two blood pressure lowering drugs to achieve the recommended goals[15].Aburto et al found that higher potassium intake was associated with a 24% lower risk of stroke (moderate quality evidence) The results suggest that increased potassium intake is potentially beneficial to most people without impaired renal handling of potassium for the prevention and control of elevated blood pressure and stroke[16]

1.2 Epidemiology

1.2.1 Global burden

The overall average prevalence of hypertension in the world was estimated

as 35% (37% in men and 31% in women)[4] The estimated total number of adults with hypertension in 2000 was 972 million; 333 million in economically developed countries and 639 million in economically developing countries The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1.56 billion[17].

According to the Global Status Report on noncommunicable diseases 2014, the leading causes of NCD deaths in 2012 were: cardiovascular diseases, cancers, respiratory diseases, including asthma and chronic obstructive pulmonary disease and diabetes[13] Globally cardiovascular disease accounts for approximately 17 million deaths a year, nearly one third of the total Of these, complications of hypertension account for 9.4 million worldwide every year Hypertension is responsible for at least 45% of deaths due to heart disease and 51% of death due to stroke as a measure of WHO in 2013[18]

Nearly 80% of deaths due to cardiovascular disease occur in low-and middle income countries[18] They are the countries that can least afford the social and economic consequences of ill health Current age standardized mortality rates

of low-income countries are higher than those of developed countries

The economic aspects of hypertension are critical to modem medicine The medical, economic, and human costs of untreated and inadequately controlled hypertension are enormous Hypertension is distributed unequally and with iniquity in different countries and regions of the world Treatment of hypertension requires an investment over many years to prolong disease-free quality years of life The high prevalence and high cost of the disease impacts

on the microeconomics and macroeconomics of countries and regions The

criteria used for inclusion in clinical guidelines for hypertension impact on the cost and cost/utility of diagnosis or treatment

1.2.2 The prevalence of Hypertension in Vietnam

Pham Thai Son in a national survey in Vietnam in 2013 found that the prevalence of hypertension was high (overall 25.1%, 28.3% in men and 23.1%

in women) The proportions of hypertensive aware, treated and controlled were unacceptably low (48.4%, 29.6% and 10.7% respectively)

According to Do Thi Phuong (2013), the overall prevalence of hypertension among total 18,000 participants was 21% and 42% of the people had prehypertension, only 37% had normal blood pressure[19]

The increasing prevalence of hypertension is attributed to population growth, ageing and behavioral risk factors, such as unhealthy diet, harmful use

of alcohol, lack of physical activity, excess weight and expose to persistent

stress

1.2.3 Hypertension and elderly people with hypertension

Hypertension is the most important risk factor of cardiovascular and kidney diseases; and a leading risk factor for mortality[20] Hypertension has become

a significant problem in many developing countries In 2008, nearly a billion adults aged 25 years and older had hypertension, and three quarters of the number were living in developing countries[21] However, despite such high prevalence awareness and blood pressure control are fairly poor in developing countries as a result of inadequate access to information, healthcare facilities, inappropriate dietary habits, poverty and high cost of medications[22]

In Vietnam, hypertension has become an important public health problem The rate of hypertension has increased significantly in recent years According

to Son Pham (2011), 25.1% of Vietnamese people (28.3% men vs 23.1% women) over age 25 have high blood pressure The rate of hypertension

increased with age[5] The level of awareness and efforts to control of hypertension remains relatively low[5, 23] A recent national survey found that among hypertensive people only a half (48.4%) were aware of their high blood pressure and only a third (29.6%) were undertaking treatment.In addition, only a third of the patients undertaking treatment had their blood pressure controlled[5]

Hypertension is one of the major health problems among elderly people has been investigated by many Vietnam authors Vietnam Institute

of Health Strategy and Policy presented a hypertension percentage of 28,4% among elderly people of aged 60 years or above in 2006[24].Hypertension is one of the diseases which is more common in old age and may affect the quality of life in elderly people According to the studies in the University of York, hypertension is a risk factor for stroke and ischemic heart disease in elderly people[6] Data collected over a 30-year period have demonstrated the increasing prevalence of hypertension with age The risk of coronary artery disease, stroke, congestive heart disease, chronic kidney insufficiency and dementia is also increased in this subgroup of hypertensive[25] Cardiovascular disease (CVD) was the leading cause of death in adults One major reason for this trendies the patterns of BP changes and increasing hypertension prevalence with age approximately 1 billion people worldwide)[20] Hypertension prevalence is less in women than in men until 45 years of age,similar in both sexes from 45 to 64 and much higher in womenthan men over 65 years of age[26] The severity of hypertension related

to the age of the woman After 60 years the majority of women have high blood pressure or treatment of blood pressure control Further blood pressure control is often difficult in elderly women[27]

There are many risk factors that can lead to high blood pressure in the elderly, such as diabetes, tobacco addiction, alcoholism, obesity or metabolic disorders ofblood fat, atherosclerosis circuit In addition, hypertension can be caused byheredity, sedentary habits are vegetarians or have an adverse effect

on the psychological(stress)

Symptoms of hypertension were very poor, even several elderly people with hypertension but do not know because there is not anything unusual manifestations

1.3 Knowledge, attitude and practice

1.3.1 Knowledge, attitude and practice definitions

Knowledge definition: Knowledge is a set of understandings, knowledge and of “science.” It is also one’s capacity for imagining, one’s way of perceiving Knowledge of a health behavior considered to be beneficial, however, does not automatically mean that this behavior will be followed The degree of knowledge assessed by the survey helps to locate areas where information and education efforts remain to be exerted

For example: Hypertension is an acute disease? Yes/ No/ don’t know

Attitude definition: Attitude is a way of being, a position These are leanings or

“tendencies to…” This is an intermediate variable between the situation and the response to this situation It helps explain that among the possible practices for a subject submitted to a stimulus, that subject adopts one practice and not another Attitudes are not directly observable as are practices, thus it is a good idea to assess them It is interesting to note that numerous studies have often shown a low and sometimes no connection between attitude and practices For example:Smoking and drinking alcohol have little effect on blood pressure Agree/ Uncertain/ Disagree

Practice definition: Practices or behaviors are the observable actions of an individual in response to a stimulus This is something that deals with the concrete, with actions For practices related to health, one collects information

on consumption of tobacco or alcohol, the practice of screening, vaccination practices, sporting activities, sexuality etc

For example: Do you smoke? Yes/ No[28]

1.3.2 Knowledge, attitude and practice regarding to Hypertension

The main reasons for this inadequate control of blood pressure include demographic characteristics, health beliefs and the presence of other chronic diseases Other reasons include lack of hypertension awareness and lack of knowledge about high blood pressure While it is difficult or impossible to change demographic and personal characteristics, cultural norms and socioeconomic status, increasing knowledge through educational interventions

on treatment can positively.Because hypertension is emerging as a major public health problem in many developing countries, KAP data on hypertension as crucial steps in the design of sound prevention and control programs It is particularly important to maximize the efficiency of such programs in these countries to minimize delay in achieving effective hypertension control[29].In a descriptive survey by Oliviera et al (2005) [30] to understand the current status of hypertension knowledge, awareness, and attitudes in a group of hypertensive patients, results showed that patients are knowledgeable about hypertension in general, but are less knowledgeable about specific factors related to their condition According to a cross-sectional study assessed knowledge, attitude and practice of exercise for blood pressure control among 20 years and older Nigerian patients with hypertension in 2013; more than half of the respondents, (60.0%) demonstrated poor exercise practice A majority, 67.3% had poor knowledge of exercise for hypertension

control while a quarter, 26.0% had positive attitude towards exercise There were significant associations between knowledge of exercise and level of education, attitude and practice of exercise,respectively Significant association was found between knowledge and each of socio-economic status and attitude Practice of exercise for blood pressure control was low among Nigerian patients with hypertension which was significantly influenced by poor knowledge of and negative attitude towards exercise practice for blood pressure control[31]

Also conducted in Nigerian in 2010, the study of Godfrey indicated that 61% respondents knew HTN to be high blood pressure, 20% thought it meant excessive thinking and worrying while 53% claimed it was hereditary 40% participants felt it was caused by malevolent spirits, 30% believed it was caused by bad food or poisoning A few (18%) knew some risk factors Symptoms attributed to HTN were headache, restlessness, palpitation, excessive pulsation of the superficial temporal artery and “internal heat”, but 74% attested to its correct diagnosis by BP measurement Although 90.7% felt the disease indicated serious morbidity, only 33.3% were adherent with treatment and fewer practiced life-style modification 30% knew at least one antihypertensive drug they use Psychosocial factors like depression and anxiety, fear of addiction and intolerable drug adverse effects impacted negatively on patients’ attitude to treatment[32]

In Vietnam, Pham Thai Son in 2012 found that the proportions of hypertensive aware, treated and controlled were unacceptably low (48.4%, 29.6% and 10.7% respectively) Most Vietnamese adults (82.4%) had good knowledge about high blood pressure People received their information on hypertension from mass media (newspapers, radio, and especially television) Most people would choose a commune health station (75%) if seeking health

care for hypertension The programmer on hypertension control was able to run independently at the commune health station Severity of hypertension and effectiveness of treatment were the main factors influencing people’s adherence to the programmer The hypertension control programmer successfully reduced blood pressure (systolic blood pressure: -2.2 mmHg in men and -7.8 mmHg in women; diastolic blood pressure: -4.3 mmHg in men and -6.8 mmHg in women), the estimated CVD 10- year risk (-2.5% in women), and increased the proportions of treatment (22% in men and 13.6% in women) and control (11% in men and 17.3% in women) among hypertensive people[33]

Assessment for KAP score often based on questionnaires available has been verified in previous studies or based on questionnaires developed based on the old question Depending on the different questions the author will have different score For example, according to research by the author Olusegun Adesola Busari el al have the following scoring method: “Patients’ knowledge, attitudes and practices on HTN were assessed using a standardized and structured questionnaire which was developed and pre-tested for the study.It had both closed and open-ended questions.Consent was obtained after the purpose of the study was adequately explained to therespondents The questionnaire covered sociodemographic, occupational and educational variables, information on knowledge of HT and its treatment, attitude toward Closed ended questions often included three or more answering options in addition to the option “I do not know”, which was a possible option for many questions Answering option, “No” was always preceding option,

“Yes” Responses to the questions on knowledge were scored The total score obtainable was 12 and any score less than 7 was described as poor knowledge”[29]

1.4 Factors influence to healthy blood pressure practice

There are a lot of factors affecting K-A-P regarding hypertension among elderly people In this chapter, the researcher specifically concerns about the Demographic factors

1.4.2 Economical status

Lower socio-economical status can lead to poorer knowledge, negative attitudes and ineffective practice regarding HTN A cross-sectional survey in Nigerian found a significant association between each of socio-economic status and knowledge (χ2=19.192; p=0.001)[36] Similarly, Tran Thien Thuan found that low income was a reason for negative attitudes and wrong practice amongst HTN adult patient[34]

1.4.3 Information approach and health care worker-patient relationship

According to a survey of under-graduated students in Hue, most people found information about HTN from their relatives and friends (80.7%), whilst that from television was 67.7% However, there were 48.5% found information

through health propagandas and health care workers and only 6.2% through local radiocast

In another study of Mumtaz, 10% patients reported that a physician or other health care provider was a source of information about HTN; 6% found information from television, newspapers, magazines and radio[35]

Health care providers and health propaganda play a very important role in enhancing the HTN knowledge of people, especially in rural and remote areas Besides methods of approaching information, the relationship between health care providers, especially doctor and patient also affect to their KAP Tran Thien Thuan has reported that one of the reasons why people had ineffective practice regarding HTN was the difficulty of and irregular health examination in local health care units Mumtaz also indicated that the better doctor-patient relationship having, the more effective in providing good control

of blood pressure provide Greeff in 2006 emphasized that building a trusting relationship between the health care worker and the patients is one of the most important aspects when motivation patient[37]

1.4.4 Other factors

In researcher’s opinion, the age of patients can have an impact on the ability

of knowledge absorption, attitudes and effective practice regarding HTN When people get older, they may become more conservative Furthermore, many first-stage symptoms and complication of HTN can be skipped because

of the confusion between them and the normal degeneration of age

Last but not least, there is a close relationship between the three factors: knowledge, attitudes and practice regarding HTN The cross-sectional study in Nigerian indicated a significant relationship between knowledge and attitude (χ2=25.634; p=0.001); practice of exercise for blood pressure control was significantly influenced by poor knowledge of and attitude towards exercise

practice for BP control[36] Tran Thien Thuan’s study had similarly findings when poor and wrong knowledge was a reason of negative attitude and wrong practice among patients

CHAPTER 2 - SUBJECTS AND METHOD

2.1 Study design

In the limited scope of knowledge, skills and other necessary conditions, the author chose the cross-sectional The researcheronly assessed knowledge, attitudes and practices of elderly people with high blood pressure, no intervention

2.2 Sampling and Setting

2.2.1 Setting

The study was conducted in the two selected communes in the Bac Giang city, Vietnam in a period of one months from October to November, 2014

2.2.2 Sampling

Sampling method: Convenient sampling

Subject should be defined:

- Elderly people age 60 years

Inclusion criteria:

- Those people with permanent residence in the Bac Giang city, 60 years of ageand above

- Consent to participate and be able to complete the Questionnaire interview

- accept participate in the study

2.4 Research Indicators and Variables

No Indicators, Variables Tools for

collecting

Collecting method

2.5 Bias and controllingbias

From screening data: carefully read and clean before screening

2.6 Research progress

2.6.1 The process of making research

Developing the research proposal and questionnaire

Approved by The Review Board

Correcting the questionnaire, performing Pilot study and contact with Departments

The process took place from October to November

2.6.3 Data analysis

The statistical analysis was performed by the Statistical Package for Social Sciences (SPSS) version 21 Chi square tests were used to test the relationship between variables in the cross-tables T-test were used to test the difference

between qualitative variables with quantitative variables Pearson correlation were used to test correlation

They also got information about that all data collected was kept confidentially which means safety for all people included in the survey Unauthorized persons will not be able to access the information Data was not presented by each individual and therefore anonymity was guaranteed

All mentioned information was also given as written information in the invitation letter to the participants before interviewing

CHAPTER 3 - RESULTS

3.1 General characteristics of the participants

Table 3.1: Demographic characteristics of the participants

109 people (57.1%)

Table 3.2: Hypertension and source of knowledge

n

Percent (%)

3 Source of information related to HTN

- Books, mass media, internet

- Health care workers

Comments:

Among 191 subjects participated in the study, there were 75 people (39.3%) were diagnosed hypertension, 116 (60.7 %) were not diagnosed All HBP patients used HBP medication People mainly approach to hypertension information through health care workers (83people, 43.5%); following by books, internet, mass media (72 people, 37.7%) and other HBP patients (26 people, 13.6%)

3.2 Knowledge, attitude and practice related to hypertension care 3.2.1 Knowledge of participants on hypertension

Table 3.3: Knowledge on Hypertension

Count Percent Basic Knowledge

1 Correct HBP index as suggested by VNHA

2 Optimal systolic pressure (<120mmHg) 57 29.8

3 Optimal diastolic pressure (<90mmHg) 116 60.7

4 Distance between systolic and diastolic 43 22.5

Complication of Hypertension

6 Hypertension can lead to myocardial infraction 166 86.9

7 Hypertension can lead to cerebral accident 175 91.6

8 Hypertension can lead to obesity 43 22.5

Other factors related to Hypertension

10 Exerciseregularly may lower the risk of HTN 180 94.2

12 People with high blood pressure should not use

13 HTN patients should eat a lot of vegetables and

14 Can reduce blood pressure without medication 96 50.3

16 High blood pressure is easy to discovered disease 22 11.5

17 Hypertensive patients should not eat salt and fat 151 79.1

18 Almost people with hypertension need more 1

medicine to control their BP 28 14.7

Levels of understanding on HBP

- Good (15-19 scores)

- Fairy good (10-14 scores)

- Poor (9 scores or lower)

12

151

28

6.3 79.1 14.7 Total knowledge score of HBP (range: 0-19)