The aims of this study are to provide a theoretical framework for improving the self-care of adults with severe hypertension and to examine the practical suitability of a middle-range theory of self-care for chronic illness by validating the structural model.

Data were collected at a university hospital in D metropolitan city from July 1 to August 14, 2015. A total of 224 Korean adult patients with severe hypertension were recruited. Data were analyzed using SPSS 22.0 and AMOS 22.0.

The results show that the fit index of the hypothetical model meets the recommended level; 7 out of 8 hypothetical model paths were statistically significant. Motivation, self-efficacy, support from others, and accessibility to care showed statistical significance and explained 67.3% of the self-care process. The self-care process explained 45.3%, 63.6%, and 26.5% of quality of life, health, and illness stability, respectively.

This model can be used as a theoretical framework for improving self-care among adult Korean patients with severe hypertension. Moreover, the practical suitability and validity of the middle-range theory of self-care for chronic illness is secured.

This study was aimed to evaluate the effect of an internet community on knowledge, self-efficacy, and self-care behavior in workers with hypertension.

The research design used was a nonequivalent control group pre-test and post-test design. Sixty hypertensive workers participated in this study(Exp.=29, Cont.=31). The data was collected from the 3rd of November 2003 to the 27th of February 2004 using an interview with questionnaires. Information related to hypertension was provided on the internet community weekly and an e-mail newsletter was sent in order to increase participation in the internet community. We used a tool developed by Park Young-Im(1994) that measured knowledge related to hypertension and self-efficacy. A tool developed by Jung Mi-Young(2001) was used for self-care behavior. The collected data was analyzed with an chi2-test and t-test using the SPSS WIN 10.0 program.

The internet community helped workers with hypertension to increase their knowledge related to hypertension, as well as increasing their self-efficacy and self-care behavior.

An internet community could be applied as hypertensive nursing intervention.

This study was done to identify and test a model of the psychosocial variables that influence adherence to therapeutic regimens in patients with hypertension.

A convenience sample of 219 patients with hypertension who were enrolled in an outpatient clinic of a cardiovascular center in Korea participated in the study. They completed self-administered questionnaires anonymously. The questionnaire was based on the Social Action Theory model and a literature review. The explanatory model was constructed and tested using structural equation modeling in order to examine the effects within the model.

The results of this study showed that perceived self-efficacy was the strongest factor influencing patient adherence in this sample. Adherence to therapeutic regimens in patients with hypertension was influenced by self-efficacy, patient-provider relationship, social support, and depression.

Adherence to therapeutic regimens in patients with hypertension was most strongly influenced by self-efficacy. These findings suggest that nursing interventions to promote patient adherence should focus on the promotion of self-efficacy including improvement in patient-provider relationship and social support, and reduction in depression.

This study was to evaluate the effects of foot reflexology on blood pressure, serum lipids level and life satisfaction in essential hypertension patients.

The research design used was a nonequivalent control group pretest-posttest design. Foot Reflexology was used as the experimental treatment from June 23rd, 2003 until August 31st, 2003. Thirty-four subjects were assigned to an experimental group(18) and control group(16). Foot Reflexology was administered twice a week for 6 weeks and self foot Reflexology was administered twice a week for 4 weeks on the experimental group.

There was a significant decrease in systolic blood pressure but no significant decrease indiastolic pressure in the experimental group compared to the control group. The total cholesterol level in the experimental group compared to the control group was not significantly decreased after foot reflexology. However, the triglyceride level in theexperimental group compared to the control group was significantly decreased after foot reflexology. On the other hand, high density lipoprotein and low density lipoprotein levels in the experimental group compared to the control group was not significantly decreased after foot reflexology. Life satisfaction in the experimental group compared to the control group was significantly improved after foot reflexology.

The results proved that foot reflexology was an effective nursing intervention to decrease systolic pressure, and triglyceride but not for the blood cholesterol and to improve life satisfaction. Therefore, blood cholesterol should be further evaluated in a larger group of subjects and for a longer period. Further research is regarded as necessary to evaluate and to compareeffects of self-foot reflexology and foot reflexology.

This study was designed to determine the effects of health coaching and mediating variables on quantitative aspect of health in low-income hypertensive people.

The experimental group for the current study consisted of 21 clients who received health coaching services, and the control group consisted of 22 clients who received home-visiting nursing services. Two groups received health coaching or home-visiting nursing services once a week for 8 weeks. The evaluation variables were self-efficacy, nutrition management, health behaviors, self-rated health, and quality of life.

The results revealed that the level of nutrition management was significantly higher in the experimental group than the control group (F=10.33, p=.005).

These results confirm that health coaching is a useful strategy that encourages clients to continuously maintain their own health behaviors. Thus, the findings of the current study provide useful data for establishing measures for the health management of those afflicted with chronic disease, such as hypertension. Furthermore, health coaching may be developed into useful intervention strategies for dealing with chronic diseases and improving home-visiting nursing.

The purpose of this study was to develop a self-management program applying Dongsasub training based on self-efficacy theory, and to verify the program effectiveness on self-esteem as well as self-efficacy, self-management behaviors, and blood pressure.

The study design was a non-equivalent, pre-post controlled quasi-experiment study. Thirty-eight patients aged 65 and older from a senior welfare center in Seoul participated in this study (20 patients in the experimental group and 18 patients in the control group). The self-management program applying Dongsasub training consisted of eight sessions. After development was complete the program was used with the experimental group. Outcome variables included self-efficacy, self-esteem, self-management behaviors measured by questionnaires, and blood pressure measured by electronic manometer.

Self-efficacy (t=2.42, p =.021), self-esteem (t=2.57, p =.014) and self-management behaviors (t=2.21, p =.034) were significantly higher and systolic blood pressure (t=-2.14, p =.040) was significantly lower in the experimental group compared to the control group. However, diastolic blood pressure (t=-.85, p =.400) was not significantly different between the two groups.

The results indicate that the self-management program applying Dongsasub training can be used as a nursing intervention in community settings for improving self-management behaviors for older adults with hypertension.

The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension.

The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program.

There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure.

The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.

Cost-benefit analysis is one of the most commonly used economic evaluation methods, which helps to inform the economic value of a program to decision makers. However, the selection of a correct benefit estimation method remains critical for accurate cost-benefit analysis. This paper compared benefit estimations among three different benefit estimation models.

Data from community-based chronic hypertension management programs in a city in South Korea were used. Three different benefit estimation methods were compared. The first was a standard deterministic estimation model; second, a repeated-measures deterministic estimation model; and third, a transitional probability estimation model.

The estimated net benefit of the three different methods were $1,273.01, $-3,749.42, and $-5,122.55 respectively.

The transitional probability estimation model showed the most correct and realistic benefit estimation, as it traced possible paths of changing status between time points and it accounted for both positive and negative benefits.

The aim of this study was to assess the suitability and readability of printed educational materials for patients with hypertension in Korea.

A total of 33 written educational materials related to hypertension were collected from public health centers, hospitals, and internet web site. Among them, we analyzed 19 materials which fit the inclusion criteria: leaflets (n=9), booklets (n=3), and guide book (n=7). Two trained nurses evaluate the materials using suitability assessment tool (SAM; Doak, Doak, & Root, 1996a) and graded lexical items for teaching Korean (Kim, 2003).

Overall, 14 (73.7%) of 19 materials scored adequate, and 5 (26.3%) scored inadequate. On the average, the education materials contained 36.1% to 50.5% of 1st grade reading level words and 12.9% to 21.6% of 4th grade level and over.

The reading level of the materials was higher than a 6th grade reading level. It is proposed that the written educational materials should be developed by health professionals according to suitability and quality by taking the target group's literacy capacity into consideration.

In this study cardiovascular health status and health behavior of Korean women based on their household income were explored.

For this cross-sectional study, 91 women residing in the community were recruited to complete survey questionnaires and biophysical tests including blood pressure (BP), body mass index (BMI), body fat rate, waist circumference (WC), and blood chemistry tests.

Compared to non-low income women (NLIW), low income women (LIW) were more likely to be older, less educated, and jobless, and further more LIW were postmenopause and reported having been diagnosed with hypertension or hypercholesterolemia. Significant differences were found in systolic BP, triglyceride level, BMI, body fat rate, and WC between the groups. Two fifths of the LIW had indications for metabolic syndrome. Their 10-yr risk estimate of myocardioal infarction or coronary death demonstrated a higher probability than that of NLIW. Although these significant differences were due to age gap between the groups, advanced age is known to be one of the key characteristics of LIW as well as a non-modifiable risk factor.

Effective community programs for vulnerable women at risk of cardiovascular disease should be based on strategies targeting unhealthy behaviors and modifiable risk factors.

To investigate the effectiveness of aromatherapy on blood pressure, heart rate variability, aortic pulse wave velocity and the aortic augmentation index of essential hypertensive patients.

Using a coin toss, 22 participants were assigned to the experimental group and 20 to the control. The experimental group was given a blend of oils of lemon (Citrus limonum), lavender (Lavandula angustifolia), and ylang ylang (Cananga odorata) which were prepared in the ratio of 2:2:1, respectively. The control group was given an artificial lemon fragrance of Limonene (35 cc) and Citral (15 cc) mixture. The experiment, inhalation, was conducted for 3 weeks (2 min per inhalation, 2 times per day) to both groups.

There was a noticeable difference in systolic blood pressure between the groups (p=.001), however the difference in diastolic blood pressure between the two groups was not significant. There was a notable difference in sympathetic nerve system activity of heart rate variability (p=.047). However, the differences in aortic pulse wave velocity or the aortic augmentation index were not significant.

Aromatherapy is effective in lowering systolic blood pressure and sympathetic nerve system activity.

This study was done to examine the effects of moxibustion on physiological indices, such as 24-hr blood pressure, pulse pressure, and pulse rate, and autonomic nervous symptoms among adults with prehypertension.

Participants were adults whose systolic and diastolic blood pressures were in the prehypertension stage and were not under treatment for the condition. Both experimental and control group consisted of 13 participants who were taking classes on acupuncture and moxibustion at a private institute. The experimental group received moxibustion once a day for 15 min, at least 5 days a week for 8 weeks. The results were analyzed using χ²-test, t-test, Fisher's exact test, Wilcoxon rank sum test and repeated measures ANOVA with the SAS program. Bonferroni correction method was adopted for multiple comparisons.

No significant change was observed in the 24-hr systolic and diastolic blood pressure between the two groups. Differences in the 24-hr pulse pressure and pulse rate were also not significant. However, significant decreases in headache, symptoms of flushing and fatigue were observed in the experimental group.

The results suggest that moxibustion contributes to alleviating symptoms such as headache, flushing and fatigue associated with the autonomic nervous system among adults with prehypertension.

This study was performed to identify effects of pneumoperitoneum on hemodynamic changes of hypertensive patients undergoing laparoscopic colectomy under general anesthesia.

Data collection was done from January 2 to June 10, 2008. Seventy-six patients, including 38 hypertensive patients, who had taken antihypertensive drugs more than 1 month and 38 normotensive patients undergoing laparoscopic colectomy were enrolled in this study. The hemodynamic parameters were heart rate (HR), mean arterial pressure (MAP) and cardiac output (CO) which were measured 7 times from before induction of anesthesia to 5 min after deflation of the pneumoperitoneum. Collected data were analyzed using Repeated Measures ANOVA and Bonferroni comparison method.

HR in the hypertensive group was significantly decreased at deflation of the pneumoperitoneum and 5 min after deflation of the pneumoperitoneum (p=.012). MAP in the hypertensive group was not different from the normotensive group (p=.756). CO in hypertensive group was significantly lower than normotensive group (p<.001) from immediately after pneumoperitoneum to 5 min after deflation of the pneumoperitoneum.

The results indicate that pneumoperitoneum during laparoscopic surgery does not lead to clinically negative hemodynamic changes in heart rate, mean arterial pressure or cardiac output of hypertensive patients, who have taken antihypertensive drugs for more than 1 month.

The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community.

The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence.

Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months.

The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.

This study aimed to compare self-care behaviors and depressive symptoms between the young old (65-74 yr) and the old-old (75-84 yr) in low-income women with hypertension.

This study used a descriptive research design. The subjects of this study were 136 elderly women over 65 yr living in D city. Data was collected from September to December 2007 through personal interviews using a questionnaire. The collected data was analyzed using the SPSS WIN 12.0 Program.

Self-care behaviors, functional status, and number of medications showed a significant difference between young elderly and middle elderly. There was a negative correlation between self-care behaviors and depressive symptoms. 52.2% of variance in self-care behaviors of young elderly and 76.8% of variance in self-care behaviors of middle elderly were explained by depressive symptoms, number of medications, and functional status.

It is necessary to manage depressive symptoms to improve the self-care behaviors of low-income elderly with hypertension. Depressive symptoms need to be considered in planning hypertension programs for low-income elderly women.

The purpose of this study was to identify the effects of aromatherapy on blood pressure and stress responses of clients with essential hypertension.

There were fifty-two subjects divided into an essential oil group, placebo group, and control group by random assignment. The application of aromatherapy was the inhalation method of blending oils with lavender, ylangylang, and bergamot once daily for 4 weeks. To evaluate the effects of aromatherapy, blood pressure and pulse were measured two times a week and serum cortisol levels, catecholamine levels, subjective stress, and state anxiety were measured before and after treatment in the three groups. Data was analyzed by repeated measures of ANOVA, one-way ANOVA, and χ²-test using the SPSS 10.0 program.

The blood pressure, pulse, subjective stress, state anxiety, and serum cortisol levels among the three groups were significantly statistically different. The differences of catecholamine among the three groups were not significant statistically.

The results suggest that the inhalation method using essential oils can be considered an effective nursing intervention that reduces psychological stress responses and serum cortisol levels, as well as the blood pressure of clients with essential hypertension.

This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities.

The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do.

Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased.

A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.