A Causal Model of Lifestyle Modification Behaviors in Thai Adults with Hypertension

Patcharawadee TONGNUANG, Piyanuch JITTANOON, Umaporn BOONYASOPUN, Karnsunaphat BALTHIP, Diane Ruth LAUVER

Abstract


Lifestyle modification behaviors are a key strategy for controlling hypertension. Understanding the causal model of lifestyle modification behaviors would shape the behaviors which are necessary for controlling blood pressure levels among Thai adults with hypertension. The purpose of this study was to examine the proposed relationships between psychosocial variables, such as desire, attitude, perceived behavioral control (PBC), intention, trying, social support, illness identity, self-efficacy, and lifestyle modification behaviors (LMB). This study was a path analytic study using a self-administered questionnaire which was responded to by 240 selected Thai adults with hypertension at the out-patient clinic in 5 hospitals throughout Thailand. A set of questionnaires was used for collecting data and the internal consistency was between 0.75 - 0.95. Data were analyzed by path analysis. The results found that PBC and social support had positive and direct influences on LMB (β = 0.31, p < 0.001; β = 0.36, p < 0.001, respectively). Desire and PBC had positive and direct influences on intention (β = 0.55, p < 0.001; β = 0.19, p < 0.01, respectively). Self-efficacy, intention, and PBC had positive and direct influences on trying (β = 0.46, p < 0.001; β = 0.19, p < 0.01; β = 0.15, p < 0.05, respectively). The revised model accounted for 47, 30, and 39 % of the variance in intention, trying, and lifestyle modification behaviors, respectively. Knowledge about the factors influencing lifestyle modification behaviors in Thai adults with HTN will assist a nurse in developing interventions/programs to promote lifestyle modification behaviors in this population.

Keywords


Hypertension, lifestyle modification behaviors, Thailand, causal model

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References


World Health Organization. A Global Brief on Hypertension: Silent Killer, Global Public Health Crisis. World Health Organization, Switzerland, 2013.

World Health Organization. Available at: http://apps.who.int/iris/bitstream/10665/170250/1/ 9789240 694439 _eng.pdf, accessed December 2016.

Thai Ministry of Public Health. Available at: https://hdcservice.moph.go.th/hdc/reports/ report.php? source=formated/format_1.php&cat_id=6a1fdf282fd28180eed7d1cfe0155e11&id=29eec762c9591d1f8092da14c7462361, accessed May 2017.

T Pangjunant and N Panthuvaj. Available at: http://www.thaincd.com/news/hot-news-view.php?id=9129, accessed August 2015.

Bureau of Non-Communicable Disease Thailand. The Annual Report 2015. The War Veterans Organization of Thailand under Royal Patronage of His Majesty the King Press, Bangkok, 2016.

A Pakdeepinit, S Kaewklin and S Khongchin. Available at: http://www.thaincd.com/document/file/ info/non-communicable-disease2559.pdf, accessed December 2016.

BD Rigsby. Hypertension improvement through healthy lifestyle modifications. J. Assoc. Black Nurs. Facul. High. Educ. 2011; 22, 41-3.

M Rocha-Goldberg, L Corsino, B Batch, CI Voils, CT Thorpe, HB Bosworth and LP Svetkey. Hypertension improvement project (HIP) Latino: Results of a pilot study of lifestyle intervention for lowering blood pressure in Latino adults. Ethn. Health 2010; 15, 269-82.

Y Ruixing, L Hui, W Jinzhen, L Weixiong, Y Dezhai, P Shangling and L Xiuyan. Association of diet and lifestyle with blood pressure in the Guangxi Hei Yi Zhuang and Han populations. Public Health Nutr. 2009; 12, 553-61.

PA James, S Oparil, BL Carter, WC Cushman, C Dennison-Himmelfarbet, J Handler, DT Lackland, ML LeFevre, TD MacKenzie, MO Ogedegbe, SCJ Smith, LP Svetkey, SJ Taler, RR Townsend, JTJ Wright, AS Narva and E Ortiz. 2014 evidence-based guideline for the management of high blood pressure in adults. J Am. Med. Assoc. 2014, 311, 507-20.

Thai Hypertension Society. Thai Guidelines on the Treatment of Hypertension Updates 2012. Huanam Printing, Bangkok, 2012.

CD Ford, MJ Kim and BL Dancy. Perceptions of hypertension and contributing personal and environmental factors among rural Southern African American women. Ethn. Dis. 2009; 19, 407-13.

LL Lee, MC Watson, CA Mulvaney, CC Tsai and SF Lo. The effect of walking intervention on blood pressure control: A systematic review. Int. J. Nurs. Stud. 2010; 47, 1545-61.

A Chanasuk. 2009, Effect of Dietary Behavioral Modification Program on Blood Pressure in Persons with Hypertension. Master’s Thesis, Pathumthani, University, Bangkok, Thailand.

S Champoo. 2008, Effectiveness of Self-management Program on Health Behavior and Blood Pressure among Hypertensive Patients. Master’s Thesis, Burapha University, Chonburi, Thailand.

CW Chiu and F Wongb. Effects of 8 weeks sustained follow-up after a nurse consultation on hypertension: A randomised trial. Int. J. Nurs. Stud. 2010; 47, 1374-82.

JL Middleton. A proposed new model of hypertensive treatment behavior in African Americans. J. Natl. Med. Assoc. 2009; 101, 12-7.

S Chen, J Tsai and K Chou. Illness representations and adherence to therapeutic regimens among patients with hypertension: A structural modeling approach. Int. J. Nurs. Stud. 2011; 48, 235-45.

M Scisney-Matlock, HB Bosworth, JN Giger, OL Strickland, RV Harrison, D Coverson, NR Shah, CR Dennison, JM Dunbar-Jacob, L Jones, G Ogedegbe, ML Batts-Turner and KA Jamerson. Strategies for implementing and sustaining therapeutic lifestyle changes as part of hypertension management in African Americans. Postgrad. Med. J. 2009; 121, 147-59.

SJ Yang, D Jung and AE Choi. Prediction model of blood pressure control in community-dwelling hypertensive adults in Korea. Nurs. Health Sci. 2010; 12, 105-12.

M Baghianimoghadam, S Aivazi, SS Mzloomy and B Baghianimoghadam. Factors in relation with self-regulation of hypertension based on the Model of Goal Directed behavior in Yazd city. J. Med. Life 2011; 4, 30-5.

SD Taylor, RP Bagozzi and CA Gaither. Decision making and effort in the self-regulation of hypertension: Testing two competing theories. Brit. J. Health Psychol. 2005; 10, 550-30.

E Pinprapapan, S Panuthai, T Vannarit and W Srisuphan. Causal model of adherence to therapeutic regimens among Thais with hypertension. Pac. Rim Int. J. Nurs. Res. Thai. 2013; 17, 268-81.

M Perugini and RP Bagozzi. The role of desires and anticipated emotions in goal-directed behaviors: Broadening and deepening the theory of planned behavior. Brit. J. Soc. Psychol. 2001; 40, 79-98.

I Ajzen. The theory of planned behavior. Organ. Behav. Hum. Decis. Process. 1991; 50, 179-211.

AD Heymann, R Gross, H Tabenkin, B Porter and A Porath. Factors associated with hypertensive patients’ compliance with recommended lifestyle behaviors. Isr. Med. Assoc. J. 2011; 13, 553-7.

P Purateeranrath. Health beliefs and social support with self-care of essential hypertension patients at Surin hospital, Surin Province. Med. J. Srisaket Surin Buriram Hospitals 2011; 26, 449-62.

S Sukprungprom. 2008, Factors Related to Health Promoting Behavior of Hypertension Patients in Amphawa District, Samut Songkhram Province. Master’s Thesis, Mahidol University, Bangkok, Thailand.

E Pinprapapan, S Panuthai, T Vannarit and W Srisuphan. Causal model of adherence to therapeutic regimens among Thais with hypertension. Pac. Rim Int. J. Nurs. Res. Thai. 2013; 17, 268-81.

BC Wingo, RA Desmond, P Brantley, L Appel, L Svetkey, VJ Stevens and JD Ard. Self-efficacy as a predictor of weight change and behavior change in the premier trial. J. Nutr. Educ. Behav. 2013; 45, 314-21.

H Leventhal, I Brissette and EA Leventhal. The Common-Sense Model of Self-Regulation of Health and Illness. In: L Cameron and H Leventhal (Eds.). The Self-Regulation of Health and Illness Behavior. Routledge, New York, 2003, p. 42-65.

S Chen, J Tsai and W Lee. The impact of illness perception on adherence to therapeutic regimens of patients with hypertension in Taiwan. J. Clin. Nurs. 2009; 18, 2234-44.

BH Munro. Statistical Methods for Health Care Research. 4th ed. Lippincott, Philadelphia, 2001.

Self-efficacy for Managing Chronic Disease 6-item Scale. Available at: http://patienteducation. stanford.edu/research/secd6.html, accessed July 2013.

S Leelacharas. 2005, Illness Representations in Thai Women Diagnosed with Hypertension and Relationships to Medication-Taking Behavior. Ph. D. Dissertation, University of Michigan, USA.

S Limcharoen. 2006, Factor Related to Adherence to Treatment among Essential Hypertensive Patients. Master’s Thesis, Burapha University, Chonburi, Thailand.

GM Maruyama. Basic Structural Equation Modeling. Sage, Thousand Oaks, California, 1998.

JB Schreiber, A Nora, FK Stage, EA Barlow and J King. Reporting structural equation modeling and confirmatory factor analysis results: A review. J. Educ. Res. 2006; 99, 323-38.

BG Tabachnick and LS Fidell. Using Multivariate Statistics. Vol. II, 5th ed. Pearson Education, Boston, Miami, 2007.

I Ajzen. Perceived behavioral control, self-efficacy, locus of control, and the Theory of Planned Behavior. ‎J. Appl. Soc. Psychol. 2002; 32, 665-83.

RM Peters and TN Templin. Theory of Planned Behavior, self-care motivation, and blood pressure self-care. Res. Theor. Nurs. Pract. 2010; 24, 172-86.

N Baiya. 2011, Patient Factors and Family Factors Influencing Health Behavior of Hypertensive Patients. Master’s Thesis, Burapha Univerity, Chonburi, Thailand.

JS House, KR Landis and D Umberson. Social relationships and health. Science 1988; 241, 540-45.

K Glanz, BK Rimer and K Viswanath. Health Behavior: Theory, Research, and Practice. 5th ed. A Wiley Brand, Jossey-Bass, California, 2015.

American Heart Association. Available at: http://www.heart.org/HEARTORG/Conditions/ HighBloodPressure/SymptomsDiagnosisMonitoringofHighBloodPressure/What-are-the-Symptoms-of-High-Blood Pressure_UCM_301871_Article.jsp#.WBonAMk-u99, accessed December 2016.

S Leelacharas and D Rujiwatthanakorn. Thai women’s perceptions of the causes of hypertension based on age and educational level. Pac. Rim Int. J. Nurs. Res. Thai. 2012; 16, 3-12.


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