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The Effectiveness of Intervention in the Nursing Centre Model to Improve Self-Management of Hypertensive Patients in Indonesia

Authors:

Neti Juniarti ,

Department of Nursing, Faculty Of Nursing Universitas Padjadjaran, Jatinangor, Jawa Barat, ID
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Sitti Johri Nasela,

Poltekkes Kemenkes Maluku, Ambon, Maluku, ID
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Ahmad Yamin

Department of Nursing, Faculty Of Nursing Universitas Padjadjaran, Jatinangor, Jawa Barat, ID
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Abstract

Introduction: A way of re-orienting the model of care is needed to provide efficient and effective healthcare services using the primary and community care services. Strategies for coordinating services focus on ways of reducing the fragmentation of care delivery through improving continuity of care and relationships with people. The Nursing Centre (NC) was initiated as a continuity of care model to improve self-management of hypertensive patients. The aim of this study was to analyse the effectiveness of intervention in the NC to improve self-management of hypertensive patients in Indonesia.

Methods: This research used a pre and post-test with control group design. The treatment provided was a package of intervention within one of the nursing centre in Bandung, Indonesia. The sample was 35 people in the intervention group and 33 people in the control group. Data collection was conducted from May to June 2018 using Hypertension Self-Management Behaviour Questionnaire (HSMBQ). Treatment group was given intervention in the NC in accordance with self-management of hypertension protocol. Intervention in the first week was conducted in the NC, followed by home visits once a week for three weeks. The data were analysed using RASCH model, paired t test, and independent t test. 

Results: The RASCH model analysis showed the mean “logit” of pre-test in treatment group increased from -0.46 (SD=0.45) to +2.56 (SD=1.04) after receiving intervention in nursing centre model. Mean person measure (logit) of control group increased from -0.41 (SD=0.36) in the pre-test to -0.30 (0.38) in the post-test. The mean of self-management scores for intervention and control group were 62.71 (SD=19.831) and 61.27 (SD=16.457) respectively, which both included as a low level of self-management. The mean score of hypertension self-management after treatment in the intervention group was 131.26 (SD=12.106) which is in a very good level, while the mean of post-test score of self-management in the control group was 65.42 (SD=14.078). There was a significant difference of hypertension self-management among patients who received intervention within the nursing centre compared to those who in the control group (p=0.000).

Discussion: the increased of hypertension self-management behaviour in the intervention group occurred because the NC was designed according to framework of 4Cs (completeness, collaboration, coordination, and continuity). We argue that this 4 Cs intervention led by nurses in the NC is more effective to improve hypertension self-management rather than in a regular treatment. In this way, patients and their families would become active participants in their own care planning and implementation.  

Conclusion: The intervention in the NC is effective to improve self-management of hypertensive patients in Indonesia

Lesson Learned: Completeness, collaboration, coordination, and continuity of care are important to improve self-management of patients with hypertension as the most common chronic disease in the world.

Limitations: This study was conducted in one area in Indonesia so even though the results could not be generalised, the findings are likely to be applicable within similar settings.

Suggestions for Future Research: Research is needed to examine the effectiveness of the intervention in the NC for other chronic disease self-management.

How to Cite: Juniarti N, Johri Nasela S, Yamin A. The Effectiveness of Intervention in the Nursing Centre Model to Improve Self-Management of Hypertensive Patients in Indonesia. International Journal of Integrated Care. 2021;20(S1):20. DOI: http://doi.org/10.5334/ijic.s4020
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Published on 26 Feb 2021.

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