https://orcid.org/0000-0001-9049-702X
Abstract
Introduction
Hypertension (HTN) is a silent killer, accountable for life-threatening complications. An individual’s illness perception may affect adherence to treatment which is crucial to prevent complications of HTN. The objective of this study was to identify illness perception and treatment adherence among patients with HTN in a tertiary hospital in Kathmandu, Nepal.
Methods
Descriptive correlational study was conducted in the out-patient department of Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu Nepal. Non-probability purposive sampling was used. A face-to-face interview was conducted from September to December 2018, using a structured questionnaire that included socio-demographic variables, illness perception questionnaire (revised) and Hill bone compliance to high blood pressure therapy scale. Data analysis was done by using descriptive and inferential statistics (chi-square test, Spearman rank correlation).
Results
Among 204 participants, 51% were male, 77% were literate, mean ± S.D. age was 60±12. About 72% experienced headache and 88% said that headache is related to HTN. Behavioural factors and psychological factors were regarded as the leading cause of HTN. Almost 63% participants believed HTN as highly threatening illness. Higher scores in timeline (acute/chronic), personal control, and treatment control revealed that patients believed HTN as a chronic disease with a higher rate of personal and treatment control. Regarding treatment adherence, the mean score was 16.58 (SD = 2.08), and only 14.7% had perfect adherence. Participants were more adherent to medication and appointment keeping rather than reduce salt intake. Duration of HTN diagnosis (p=0.027) and duration under HTN medication (p= 0.021) were found to be significantly associated with treatment adherence. There was a significant positive correlation between illness perception and treatment adherence (ρ = 0.282, p<0.01).
Conclusion
Illness perception and treatment adherence are correlated. Hence, it is beneficial to improve illness perception to achieve perfect treatment adherence. Reinforcement is essential to maintain adherence to both medications and behaviour therapy.
Data Sharing Statement
The datasets of this study are available from the corresponding author on reasonable request.
Ethical Considerations
The study was reviewed and approved by Institutional Review Committee (IRC), Institute of Medicine and research committee, Maharajgunj Nursing Campus, Tribhuvan University. This study complied with the Declaration of Helsinki. Before data collection, the respondents were informed about the purpose and objective of the study and written consent was obtained from each of them. The identity of the respondents was kept confidential.
Acknowledgments
The authors are thankful for the support provided by the University Grant Commission, Tribhuvan University, Institute of Medicine, Institutional Review Committee, Maharajgunj nursing campus, Dr Surya Devkota, Mrs Bimala Neupane (Manmohan Cardiothoracic Vascular and Transplant Center). We are grateful to Assistant Professor Yvonne Commodore-Menash, Mr Bibhav Adhikari, Mr Tirtha Paudel and all the participants and assistants who made this study possible.
Disclosure
Rajina Shakya reports faculty research grants from University Grant Commission, Nepal, outside the submitted work. The authors declare no other potential conflicts of interest for this work.