Impact of a protocol of care on physical, psychological responses and compliances to therapeutic regimen among hypertensive patients in hemodialysis unit

Abstract EN

Aim : this study was carried out to evaluate the impact of a protocol of care on physical, psychological responses and compliances to therapeutic regimen among hypertensive patients in hemodialysis unit.

Patients and Methods : this study was conducted in hemodialysis Unit at Shiben El -Kom Teaching Hospital.

A convenient sample comprised of thirty adult patients male and female these were randomly assigned into pre / posttest.

Protocol of care was developed based on reviewing the relevant literature.

Two tools were used for data collection.

1.

A Structured interview sheet.

2.

Psychological responses measured by Stress Measurement Scale.

Results : the results revealed that, half (50 %) of the sample had hypertension from 2-5 years.

The most sources of stress as reported by patients were from disease 86.7 %, income 76.7 %, noisy 76.7 %, transportation 40 %, and family member 40 % respectively.

There was significant difference between patients' knowledge before intervention and after intervention follow up one and two as regard to nature of the disease, medication, diet, rest and sleep, and importance of exercises.

Regarding blood pressure before intervention it was found that a highest percent 53.3 % of the sample had moderate hypertension while after intervention follow up one and two a high percent 43 %, 40 % of the sample had mild hypertension respectively.

Statistically significant difference were found before intervention and after intervention follow up one and two in relation to, sodium, potassium and stress measurement respectively.

In coping strategies among studied sample, the most frequently used coping method as reported by hemodialysis patients before intervention were change place 70 %, followed by setting alone 30 %, use recreation 26.7 %, lessening to radio and seeing T.V 20 % and reading Koran (16.7 %).

While after intervention follow up one and two, the most frequently used coping method were change place 86.7 %, 93.3 % followed by listing to radio and seeing T.V 70 %, 76.7 %, use progressive relaxation technique 46.7%, 50%, use breathing exercises 50 %, 43.3 %, use distraction technique 40 %, 40 %, use physical exercises 30 %, 33.3%, use recreation 23.3 %, 26.7 %, reading Koran 16.7 %, 16.7 % and setting alone 6.7 %, 3.3 % respectively.

There were significant differences between before and after intervention in relation to patients' compliance to medication, rest and sleep, diet, exercises, and follow up.

Conclusion : enrichment of patients with knowledge and compliances to therapeutic regimen, Lifestyle change including diet, exercise, and stress management in addition to practicing coping method as use progressive relaxation technique, breathing exercises, distraction technique, physical exercises and recreation may contribute significantly to lowering of blood pressure.