Nursing Management in Patients With Hypertension

According to the World Health Organisation, 60% of all deaths in the world result from chronic illnesses, and 80% of these deaths occur in low and middle income countries (WHO 2008a).One of the most common chronic illnesses is hypertension, and it affects almost 20% of the adult population. The fact that chronic diseases have become widespread nowadays reveals the importance of chronic disease control and community-based disease management programs (Cranston 2006). Chronic disease management includes the treatment of the disease and preparing and strengthening the patients to help patients to gain self-management skills. With an effective disease management; symptoms, recourses to emergency units and hospitalisation can be reduced, physiological and psychological effects of the disease can be limited, dependence can be prevented, and life quality can be enhanced (Haskett 2006). Among the models of chronic disease management, the most well-known, the most frequently used and the most effective one is "Chronic Care Model"(CCM) (Piat et al. 2007). Since social and economic burden has gradually increased in chronic care management, "CCM" was presented as a guide with the aim of enhancing the quality of the care and reducing the care costs (Geyman 2007). The main point of the model identified by Wagner et al. is the "existence of a fruitful interaction between the health care team and the patient" (Rothman & Wagner 2003, Solberg et al. 2005). According to the model, the "patient" motivated by a relation of knowledge, skill and trust and the "health care team" having the necessary expertise, knowledge and sources can take effective decisions for a high quality care and conduct an effective chronic disease care management by using the available sources (ICN 2010, Wagner 2001). This research was conducted to evaluate the effects of the use of the CCM in patients with hypertension on life quality and clinic results and to conduct a study concerning the use of this model in the chronic diseases in Turkey.

METHODS Research Design:The research was conducted in the nephrology polyclinic of a university hospital for six months with a controlled semi-experimental design in matched groups.

Population and sample:Population of the research consisted of all patients who applied to and followed in the nephrology polyclinic. In the selection of the sample, patient files were listed by using the polyclinic records. Out of this list,2 groups were created as intervention and control group matched in consideration of socio-economic variables such as age, sex and educational background. According to the power-analysis method, 15 intervention and 15 control group patients constituted the sample of the research. The power of the study was determined as 90% in p=0,05 reliability coefficient .

Data collection tools:In collecting the data, researcher used the socio-demographic features form prepared in consideration of the literature and expert views and the following forms for follow-up.

Attitude and habits scale concerning hypertension Information about hypertension WHOQOL-BREF(Tr) life quality assessment scale Chronic Disease Care Assessment Scale (PACIC) Hospital Anxiety and Depression Scale Integration of CCM into the study I. Organization of Health Care