Development of a self-care management programme for adult patients diagnosed with hypertension in Khomas Region, Namibia

Abstract

Hypertension (HPT) remains a major community health challenge in Namibia, where the adoption of sustainable, patient-centred measures is required to improve the disease management. The study was carried out to develop a self-care management programme for empowering adult patients diagnosed with HPT to control the disease while at home in the Khomas region of Namibia. A convergent parallel mixed-methods research design was employed to explore the knowledge, attitudes, practices, experiences and perceptions of adult patients and primary health care (PHC) nurses about HPT self-care management. Quantitative and qualitative data were collected simultaneously, analysed separately, and later combined at the interpretative stage. Quantitative data were obtained through a descriptive cross-sectional study while qualitative component adopted an exploratory descriptive design. Data collection was done through self-administered questionnaires involving 328 adult patients and 112 PHC) nurses, and in-depth individual interviews with 16 nurses and 12 adult patients. The descriptive and inferential statistical methods were used to analyse quantitative data via the SPSS software, and the thematic analysis was utilised to analyse qualitative data. Quantitative findings revealed that patients had partial knowledge on management of HPT and overall expressed positive attitudes towards self-care management and had supportive nursing practices. Patients had significant gaps in their lifestyle change, dietary consciousness, and regular behavioural follow-up. PHC nurses were perceived as facilitators of the follow-ups, exercise, and weight monitoring, with minimal involvement in dietary education and monitoring medication side effects. Based on the integrated findings, a patient-centred HPT self-care management programme was developed. The programme focused on nurse-based education, lifestyle change, psychosocial interventions and community engagement to enhance patient empowerment and better blood pressure (BP) management. Recommendations were made for the key stakeholders, which are the Ministry of Health and Social Services (MoHSS), PHC providers, non-governmental organisations (NGOs), and community-based organisations aiming at enhancing health promotion and training self-care through multisectoral measures. The results obtained from this study add to the body of knowledge concerning the dangers of potential complications arising out of HPT and their impact on stroke prevention, early diagnosis of nephrological disorders and avoiding disabilities. For future studies, should undertake longitudinal studies that focus on evaluating the cardiovascular and renal health of patients who have undergone a self-care management programme devised by this study. Practical importance of the results is determined by success of developing and expanding the programme into PHC facilities.