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 Table of Contents  
Year : 2015  |  Volume : 1  |  Issue : 3  |  Page : 90-93

The investigation of nutritional status in hypertensive elderly patients according to the behavioural intention model in health care centers of chaharmahal and bakhtiary province

1 Department of Health, Behbahan Faculty of Medical Sciences, Behbahan, Iran
2 MSc Nursing, Shahrekord University of Medical Sciences, Shahrekord, Iran
3 Department of Public Health, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
4 Department of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Date of Web Publication21-Sep-2016

Correspondence Address:
Fatemeh Amini
Shahrekord University of Medical Sciences, Shahrekord
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2468-6565.190977

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Background: Nowadays, the population of old people is growing worldwide and the diseases and complications related to it, especially hypertension may lead to many disabilities and impose high costs on the society. This study is conducted to assess the nutritional knowledge, attitude and performance of hypertensive elderly patients by means of behavioural intention model.
Methods: In this descriptive-analytical study in 2012, 100 elderly persons, referred to Farsan health center were selected randomly. The data collection was performed by a questionnaire consisted of four sections: Knowledge, attitude, performance and demographic data.
Result: 79 people (79%) of the participants were female and 21 (21%) were male. 93% of them were unemployed and 78% were married. 60% of the participants had not a family history of hypertension and 93% had never been trained about hypertension. 62% of the studied elderly patients had hypertension for about 5 years. Although the mean score of knowledge and performance was low, the mean score of attitude (belief subscales of the model) was high. The mean scores in men and women were compared and no statistically significant difference was observed (P > 0.05).
Conclusion: According to the results of this study, i recommended to plan and implement proper educational programs to promote hypertensive elderly patients' knowledge, attitude and performance. By this way, we may reduce the complications of this disease.

Keywords: Elderly, hypertension, nutrition

How to cite this article:
Alidosti M, Amini F, Tavassoli E, Heydarabadi AB. The investigation of nutritional status in hypertensive elderly patients according to the behavioural intention model in health care centers of chaharmahal and bakhtiary province. J Hum Health 2015;1:90-3

How to cite this URL:
Alidosti M, Amini F, Tavassoli E, Heydarabadi AB. The investigation of nutritional status in hypertensive elderly patients according to the behavioural intention model in health care centers of chaharmahal and bakhtiary province. J Hum Health [serial online] 2015 [cited 2019 Jul 23];1:90-3. Available from: http://www.jhhjournal.org/text.asp?2015/1/3/90/190977

  Introduction Top

Longevity and increase in the mean age of people is one of the main issues in the health of society.[1] Only by having a healthy life and special cares we can make elderly a desirable and pleasant period. The health of old people is one of the public health issues in many countries and it needs correct and accurate policies and plans.[2],[3] By investigating the status of diseases in elderly people, we find out that lifestyle modification may play an important role in disease prevention. For example, a study showed by Knoops et al. study showed that lifestyle modification in elderly people leads to 50% decrease in mortality of and getting chronic diseases.[4]

A study showed by Samadi et al. study on assessment of the need for training lifestyle to old people showed that unfortunately their healthy lifestyle knowledge, attitude and performance was relatively low.[5]

Hypertension is one of the prevalent diseases of elderly which is related to the lifestyle and nutrition. These two elements are the underlying factor for many diseases and complications such as vascular disorders, heart failure, renal dysfunction and stroke. Therefore, it is necessary to control blood pressure to prevent its consequences.[6],[7] The increase in the population of elderly people and also increase in the number of those living with hypertension indicates the necessity of more investigations and interventions of families and the whole society to control it.[8],[9]

Theories and models may be used to assess habits and lifestyle. Theories and models present a systematic view of events or successes and are a systematic process to analyse successes and defeats. One of these models is behavioural intention theory. According to this model, the most important determinant of one's behaviour is behavioural intention which considers one's probable judgment about the type of behaviour. A person's intention to do behaviour is a combination of attitude toward that behaviour and subjective norms. Attitude toward a behaviour includes one's beliefs and the results of behaviour and subjective norms evaluation which include normal beliefs that are formed in a person or family and attitude for obedience.[8],[10]

Behavioural intention model may be very important in the assessment of people's viewpoint about health behaviours. According to the studies, one of the best models to study attitudes and behaviours is behavioural intention, model.[11] Since during our literature review we could not find any comprehensive study on hypertension related nutritional behaviours, this study was conducted to determine nutritional behaviours, based on behavioural intention model in hypertensive elderly patients in Farsan city.

  Methods Top

In this descriptive-analytic study conducted in 2011, the study population was hypertensive elderly patients. One of the cities of Chaharmahal and Bakhtiary province (Farsan) was chosen randomly. In this city, 2 health care centres were chosen randomly and using sample size formula, 100 people were selected to participate in this study by simple random sampling model. The inclusion criteria were the age of 60 years and above and having a profile in the health care centre as a hypertensive patient. The exclusion criteria were relocation from the area under that health care centre and refusing to fill all parts of the questionnaire. To participate in this study, consent was also needed and participants were assured about the confidentiality of their information.

The data collection tool was a researcher made questionnaire based on the behavioural intention model. By reading scientific books and articles, this questionnaire was designed in a way that meets the research aims. To test the validity of the questionnaire, it was assessed and reviewed by 6 specialist doctors and health education professors. To test its reliability also, the questionnaire was filled by 15 people from the same society who did not participate in the research. By internal consistency method and Cronbach's alpha test, the reliability of questions was calculated to be 0.76.

The questionnaire included demographic information (sex, job, education level, marital status, duration of having hypertension, hypertension history in family and history of hypertension related trainings), 16 questions about knowledge, 5 questions about subjective norms, 8 questions about belief norms, 7 questions about attitude toward behaviour consequences, 8 questions about viewpoint about behaviour and 9 questions about performance. In knowledge questions, every correct answer was scored 1 and wrong answers, as well as 'I don't know' were scored zero. For questions of behavioural intention model which were in the 5 choice Likert scale (from completely agree to completely disagree) the scoring was from 0 to 4 and for performance questions which were in form of 4 choice self-reporting (no, sometimes, usually, always) scoring was from 0 to 3. Finally, scores of all sections (knowledge, aspects of the model and performance) were changed to percentage, and therefore, the lowest score was 0 and the highest was 100. The collected data was analysed by SPSS 15 software (SPSS Inc., Chicago, IL, USA). To determine the association between sex and education level, training courses, the source of information and behavioural intention, Fisher's exact test and to determine the association between sex and history of hypertension in family and the duration of having hypertension, Chi-square test and in order to compare the mean score of knowledge, subscales of behavioural intention model and performance in men and women, independent t-test were used.

  Result Top

79 people (79%) out of 100 participants of this study were women and 29 people (29%) were men. 93% of them were unemployed and 78% were married. 62% of the participants had hypertension for <5 years. 40% said that they have had the history of hypertension in their family. Most of the participants (93%) had never been trained about hypertension. The source of information about hypertension for many of them (48%) was doctors. Most of the participants (66%) were illiterate. Many of the participants were seriously intended to follow nutritional behaviours for hypertension control. [Table 1] summarizes the frequency of studied variables and their association with participants' gender. According to the results, the duration of having hypertension in women was significantly higher than men [Table 1]. Although the mean score of knowledge and performance was low, the mean score of attitude (belief subscales of the model) was high and there was no statistically significant difference between the mean scores in men and women (P > 0.05) [Table 2].
Table 1: The frequency of studied variables and their association with gender

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Table 2: Comparison of the mean score of knowledge, behavioural intention model subscales and performance of women and men

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  Discussion Top

According to the findings, most of the participants were illiterate and since the study population was elderly patients, it was not unexpected. Being illiterate affects people's information and training such that most of the participants of this study had never been trained. However people's literacy and abilities should not affect the educational programs. Many of the participants have had hypertension for <5 years and it has been shown in studies that systolic blood pressure has an increasing trend with the increase in age, in all ages, but diastolic blood pressure increases until the 50s and then during the age of 50–60 it will remain steady and after 60, reduces. Increased systolic blood pressure is the most prevalent form of hypertension in people beyond 50 years old and even the mild forms of that leads to a substantial increase in cardiovascular incidences.[12] Therefore, from the early stages, this disease should be considered seriously to prevent its complications.

Results also showed that majority of participated elderly patients had a definite intention to follow hypertension related nutritional behaviours and the mean score of attitude and their beliefs was high, but the mean score of knowledge and performance was lower than average. According to the results, it seems that due to have a little knowledge, the performance is affected and these patients do not have a desirable performance. In addition, since most of the participants had never been trained about hypertension, lack training and information was obvious. Therefore, conducting training programs about nutritional behaviours for elderly people is necessary and it is possible to plan some training programs by using experts of educational models and the health education group in health care centres to promote health in the society and reduce the related costs. It has been shown that nursing interventions based on patient's participation in treatment and learning has a positive effect.[13] Results of a study conducted by Savadkooh et al. also showed that after training, the self-efficacy of elderly people about following hypertension related behaviours was increased and it is an evidence of the positive effect of training in promotion of old people's health and preventing diseases to get chronic.[14] Training the lifestyle modification and paying attention to the quality of life may remarkably increase old people's efficacy and independence and helps them to control the complications related to getting old and having various treatments.[15] It seems that implementation of training programs leads to the promotion of self-efficacy and performance of hypertensive elderly and may be a good way to convict patients to make some behavioural changes and adhere to diet, treatment and physical activity and therefore, control their hypertension. The results of Baroogh's study showed that lifestyle (smoking, exercise, physical activity and obesity) has a significant association with hypertension and this result shows the necessity of doing interventions to change old people's lifestyle.[16] One of the benefits of changing lifestyle in patients is reducing adverse effects of drug therapy.[17]

  Conclusion Top

According to the results of this study, we should promote old people's knowledge about hypertension and improve their performance to prevent its related complications.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Fakhrzadeh H, Sharifi F. Cardiovascular diseases in the elderly. J Gorgan Univ Med Sci 2012;14:1-9.  Back to cited text no. 1
Khoshbin S, Ghousi A, Frahani A, Motalagh ME. Guideline of promote healthy lifestyles in the elderly, nutrition and physical activity. 1st ed. Tehran: Office of Elderly Health, Office of Family Health and Population; 2007.  Back to cited text no. 2
Najimi A, Goudarzi AM. Healthy lifestyle of the elderly: A crosssectional study. Health Syst Res 2012;8:581-7.  Back to cited text no. 3
Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: The HALE project. JAMA 2004;292:1433-9.  Back to cited text no. 4
Samadi S, Bayat A, Taheri M, Joneid BS, Roozbahani N. Attitude and practice of eldery towards lifestyle during aging. J Qazvin Univ Med Sci 2007;11:83-4.  Back to cited text no. 5
Langan RC, Bordelon PC, Ghetu MV. Eye on the elderly. Hypertension care: Striking the proper balance. J Fam Pract 2009;58:460-8.  Back to cited text no. 6
Alehagen U, Ericsson A, Dahlström U. Are there any significant differences between females and males in the management of heart failure? Gender aspects of an elderly population with symptoms associated with heart failure. J Card Fail 2009;15:501-7.  Back to cited text no. 7
Rezaie ZF, Aslankhani MA, Farsi A, Abdoli B, Sani HZ. A Comparison of three functional tests of balance in identifying fallers from non-fallers in elderly people. Knowl Health 2010;4:22-7.  Back to cited text no. 8
Baroogh N, Teimouri F, Saffari M, Hosseini Sadeh S, Mehran A. Hypertension and lifestyle in 24-65 year old people in Qazvin Kosar region in 2007. Pejouhandeh 2010;15:193-8.  Back to cited text no. 9
Ajzen I. Constructing a TPB Questionnaire: Conceptual and Methodological Considerations; 2006. Available from: http://www.uni-bielefeld.de/ikg/zick/ajzen%20construction%20a%20tpb%20questionnaire.pdf. [Last revised on 2016 Dec 09].  Back to cited text no. 10
Thormaehlen KA. Public health round-up. Bull World Health Organ 2012;90:248-9.  Back to cited text no. 11
Fakhrzadeh H, Sharifi F. Cardiovascular diseases in the elderly. J Gorgan Univ Med Sci 2012;14:1-9.  Back to cited text no. 12
Sol BG, van der Graaf Y, van der Bijl JJ, Goessens NB, Visseren FL. Self-efficacy in patients with clinical manifestations of vascular diseases. Patient Educ Couns 2006;61:443-8.  Back to cited text no. 13
Savadkooh K, Zakerimoghadam M, Gheyasvandian SH, Kazemnejad A. The effect of self-management program on self-efficacy in hypertensive patients. J Mazand Univ Med Sci 2012;22:19-28.  Back to cited text no. 14
Van Malderen L, Mets T, Gorus E. Interventions to enhance the quality of life of older people in residential long-term care: A systematic review. Ageing Res Rev 2013;12:141-50.  Back to cited text no. 15
Fakhrzadeh H, Sharifi F. Cardiovascular diseases in the elderly. J Gorgan Univ Med Sci 2012;14:1-9.  Back to cited text no. 16
Glanz K, Rimer B, Lewis FM. Health Behaviour and Health Education Theory, Research and Practice. 4th ed. San Francisco: Jossey-Bass Press; 2008.  Back to cited text no. 17


  [Table 1], [Table 2]


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