Guideline for implementation of Jacobson’s progressive muscle relaxation technique as non-pharmacological management of hypertension at selected hospitals in Arsi Zone, Oromia Regional State, Ethiopia

Abstract

Hypertension is a leading cause of premature cardiovascular deaths and is rising in low- and middle-income countries like Ethiopia. Relaxation-based stress management can lower blood pressure, yet Jacobson’s Progressive Muscle Relaxation remains under-researched as a non-pharmacologic therapy in Ethiopia. The study aimed to identify the prevalence, associated factors of hypertension and evaluate Jacobson’s Progressive Muscle Relaxation for lowering blood pressure in adult hypertensive patients at Arsi Zone hospitals and formulated guidelines for its use as a non-pharmacological strategy in hypertension management. A multi-phase sequential mixed-methods design was employed, integrating cross-sectional analysis, a quasi-experimental study, and guideline development among adult patients in Arsi Zone hospitals, carried out across three distinct phases. Phase I included 840 participants. Phase II involved 102 participants, with 51 in the pre-test group and 51 in the post-test group. In Phase III, guidelines were developed based on findings from earlier phases, existing literature, the researchers’ reflections, and expert input. Data were analysed using Statistical Package for the Social Sciences version 29, applying multivariable logistic regression; variables with p < 0.25 were entered into the model, and statistical significance was defined as p < 0.05. Hypertension prevalence was 28.7% (n=241). Multivariate logistic regression identified several significant risk factors. Increasing age markedly raised odds, especially 60–70 years. Lifestyle factors such as current smoking, alcoholism, high fat and salt intake, not consuming fruits or vegetables, physical inactivity, use of vehicles for transportation, working more than 8 hours daily, and sleeping less than 6 hours nightly were strongly associated with hypertension. Overweight, obesity, and abdominal obesity substantially increased risk, as did a family history of hypertension. The intervention produced large reductions in blood pressure in the experimental group, with mean systolic and diastolic decreases of 20.863 and 13.784 mmHg, respectively, both highly significant by t-test values. In conclusion, the study showed that Jacobson’s Progressive Muscle Relaxation effectively reduces blood pressure, and the prevalence of hypertension was high. Guidelines were developed to promote Jacobson’s Progressive Muscle Relaxation as a non-pharmacological therapy for hypertension management in the studied population. Guideline implementation helps prevent hypertension complications and reduces premature hypertension-related deaths.