The Impact of a Nurse-Led Home Visitation Program on Hypertension Self-Management among Older Community-Dwelling Koreans

Abstract

Objectives: To examine the impact of a nurse-led home visitation program for hypertension self-management among older community-dwelling Koreans. Design and Sample: As part of a larger community-based home visitation project aimed at behavioral change in this vulnerable population, a single group pre- and posttest design was used. Measures: Visiting nurses affiliated to public health center assisted vulnerable elders with hypertension self-management tailored according to their health problems through home visits for a period of 2-4 months. Results: A total of 13,452 hypertensive persons over the age of 65 completed the intervention. All outcomes were significantly improved and included hypertension knowledge, blood pressure monitoring, dietary management, medication adherence, and self-confidence in hypertension self-management (p < .001). Changes in hypertension knowledge, medication adherence, and self-confidence varied by gender with women showing greater knowledge improvement than men but less improvement in medication adherence and confidence in hypertension self-management. There was a marginal interaction effect for gender and age on dietary management (F = 3.55, p = .063), with men (>= 75 years) showing greater improvement than their female counterparts after the intervention. Conclusions: This nurse-led home visitation intervention can be helpful in self-management skill building among hypertensive Korean elders. The program may improve medication adherence and health-promoting behavioral changes.