Effect Of The Intervention Education On Self-Efficacy And Compliance Of Hypertensive Patients In The Community

Hypertension is a well-recognized and important risk factor of the cardiometabolic syndrome, Hypertensive patients have to adhere to treatment for life.Nevertheless compliance of treatment for patients in the world were not well .Studies show that since Patients couldn't accept the suggestion of change their behavior, the longer patients have to treat,the worse patients' compliance is and the more content patients have to obeied,the much worse patients's compliance is. There are five aspects of compliance to attent :lifestyle ,responsibility, smoking and adhere medicaine .Studies indicate that the self-efficacy as the tache variable to connect knowledge to behavior was identified as the most powerful predictor that determines behavior. The perceived self-efficacy plays an important role in compliance of treatment through a series of process such as direct experiences, indirect experiences, detailed consulting and popular explanation. Self-efficacy emphasize on the importance of latent energy of self-care for patients in chronic diseases. Therefore, there are two ways in the study, one is to intervention the effect of self-efficacy, another is to intervention compliance for hypertensive patients.Objective: The purpose of this study was as follows: first, to identify level of patients's compliance and self-efficacy of patients, second, to develop the intervention stratege based on the self-efficacy of Bandura(1977). Third ,to investigate that the intervention would increase self-efficacy and compliance of self-care in patients with hypertension. It will help nurse in community to evaluate the leve of compliance and self-efficacy of patients and to provided necessary support according to the need of patients.Methods: It's a quasi-experimented study. A convenience sampling was conducted. The subjects for this study were 90 hypertensive patients in community and data collection was carried out from February 14, 2004 untill April 4, 2004.The design of this study was one group pretest and posttest designed. All the subjects were messured by questionnaire survey to evaluate the level of compliance and self-efficacy of patients before the intervention and after two months the patients received intervention. According to self-efficacy theory, we used cases education, group lectures, discussion, consulting, activities and so on for instruction and follow up for two months. Compliance scale is 0.877 in reliability and 0.76 in validity. self-efficacy scale is 0.841 in reliability and it's 0.82 in validity.The analysis of data is achieved using the software SPSS 13.0 pakage.Intervention strategy: The intervention was developed to based on performance accomplishment and vicarious experience which are induction modes of efficacy expectation. It composed of 30minutes a group education ,30minutes walk and 30minutes cases education ,discussion and encounter group activities.In the process of intervention,the goals divided into attainable goals and finished step by step and each attainable goal be evaluated each week. On the basis of knowledge and skill, patients were chosen to introduce their confidence and experiences for each person in the group.By which ,the patients will find the solution to their problems.The nurse pedagogue is only to ask questions, guide and control the direction of discussion and summarize for the patients.Result: The results are as follows: 1) There is a middle-low level (38±7.305) of patient's compliance before intervention and there is a high level (17.75±3.392) after intervention. There is a significant difference between scores before and after intervention ( t=-14.577, P=＜0.01) .2) There is a low level(55.38±10.274) of patient's self-efficacy before intervention and there is a middle level(33.06±4.697) after intervention. There is a significant difference between scores before and after intervention (t=-20.335,P＜0.01 ).Conclusions: 1) The results showed that compliance of patients before intervention was not well and self-efficacy of patients was bad . 2) The effectiveniss of the intervention was affirmative, which contributed to the improvement of compliancc and self-efficacy of patients. 3) The self-efficacy level after giving intervention was higher than one before giving the intervention .4) The compliance level after giving intervention was higher than one before giving the intervention. The results suggested that intervention on compliance and self-efficacy in the community need to be improved, which will raise the self-care ability of patients.