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Effect of Hypertension Self-Care Education on Self-Care Practices among Adults with Hypertension in Nigeria

Abstract

Hypertension is a major public health concern and an important risk factor for cardiovascular disease, stroke, kidney disease, and other serious health complications. Effective self-care practices are essential for maintaining blood pressure control and reducing the risk of hypertension-related complications. However, some adults living with hypertension may experience inadequate knowledge of self-care, poor medication adherence, unhealthy dietary practices, insufficient physical activity, inconsistent blood pressure monitoring, harmful alcohol or tobacco use, and irregular attendance at healthcare appointments. Hypertension self-care education provides an opportunity to improve patients' knowledge, confidence, and practical skills regarding appropriate lifestyle modification, medication use, blood pressure monitoring, and healthcare utilization. Against this background, this study investigates the effect of hypertension self-care education on self-care practices among adults with hypertension in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Self-Efficacy Theory. The Health Belief Model explains how adults' perceptions of their susceptibility to hypertension complications, perceived severity, perceived benefits of appropriate self-care, perceived barriers, and cues to action may influence their health behaviours. Social Cognitive Theory emphasizes observational learning, behavioural reinforcement, social support, and environmental influences in the adoption and maintenance of appropriate hypertension self-care practices. Self-Efficacy Theory emphasizes individuals' confidence in their ability to perform recommended self-care behaviours consistently despite barriers and competing demands. Collectively, these theoretical perspectives provide a suitable framework for explaining how hypertension self-care education may influence self-care practices among adults with hypertension in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adults aged 18 years and above diagnosed with hypertension and receiving care in selected hospitals and primary healthcare facilities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, healthcare facilities, hypertension clinics, and eligible adults with hypertension. Hypertension self-care education will be assessed using indicators such as exposure to structured self-care education, frequency of educational sessions, information on medication adherence, blood pressure monitoring, dietary modification, salt reduction, physical activity, weight management, stress management, avoidance of tobacco and harmful alcohol use, recognition of warning signs, and attendance at follow-up appointments. Self-care practices will be assessed using indicators such as adherence to prescribed antihypertensive medication, regular blood pressure monitoring, reduced salt intake, healthy dietary practices, regular physical activity, appropriate weight-management practices, stress-management practices, avoidance of tobacco and harmful alcohol use, and regular attendance at scheduled healthcare appointments. Where appropriate, validated hypertension self-care assessment instruments may be used to provide standardized measures of self-care practices. Data will be collected using structured questionnaires, validated self-care practice instruments, patient education records, medication or clinic records where available, and blood pressure monitoring records. Descriptive statistics will be used to summarize participants' characteristics, exposure to self-care education, and self-care practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of hypertension self-care education on self-care practices. Where a quasi-experimental design is adopted, self-care practice scores before and after the educational intervention may be compared to determine changes associated with the programme. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that hypertension self-care education has a significant positive effect on self-care practices among adults with hypertension in Nigeria. Adults who receive structured and practical self-care education are expected to demonstrate improved medication adherence, more consistent blood pressure monitoring, healthier dietary practices, increased physical activity, better stress-management practices, and improved attendance at scheduled healthcare appointments compared with adults with limited exposure to self-care education. Practical demonstrations, individualized counselling, written educational materials, and repeated follow-up education may improve patients' understanding and confidence in managing hypertension. Education may also improve recognition of hypertension-related warning signs and encourage timely healthcare-seeking when complications occur. However, financial constraints, medication costs, limited access to healthcare services, side effects of medication, cultural dietary practices, low health literacy, forgetfulness, inadequate family support, and other socioeconomic challenges may affect adherence to recommended self-care practices. The study therefore expects accessible, practical, culturally appropriate, and regularly reinforced hypertension self-care education to contribute significantly to improved self-care practices among adults with hypertension in Nigeria. The study is expected to contribute to the literature on hypertension self-care education, self-care practices, hypertension management, medication adherence, blood pressure control, lifestyle modification, chronic disease management, patient education, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, hypertension clinics, physicians, nurses, pharmacists, community health workers, public health educators, development partners, and policymakers regarding strategies for improving hypertension management. The study will also provide evidence-based recommendations for integrating structured self-care education into routine hypertension care, strengthening patient counselling and follow-up, improving access to blood pressure monitoring, supporting medication adherence, promoting healthy dietary and physical activity practices, and strengthening community-based hypertension management programmes across Nigeria.

Keywords: Hypertension self-care education, self-care practices, hypertension, medication adherence, blood pressure monitoring, lifestyle modification, chronic disease management, patient education, adults, Nigeria, public health.