Multidimensional Determinants of Hypertension Self-Management to Inform the Development of a Person-Centered Nursing-Based Self-Care Bundle: A Cross-Sectional Study in Primary Care
Ni Putu Ayu Ratna Dewi, Nursalam, Sriyono, Ni Luh Putu Inca Buntari Agustini, Komang Ardidhana Nugraha PutraObjectives
This study aimed to identify multidimensional factors associated with hypertension self-management and examine candidate self-care support domains to inform the development of a person-centered nursing-based self-care bundle.
Methods
A cross-sectional study was conducted among 152 patients with hypertension aged 40–59 years in primary healthcare centers in Bali, Indonesia, using multistage random sampling. Data were collected using researcher-developed questionnaires informed by established instruments, theories, and previous studies, and preliminarily tested for validity and reliability, measuring patient, family, socio-cultural, healthcare service, candidate self-care support domains, and self-management ability. Partial least squares structural equation modeling was used to examine associations among constructs.
Results
Patient factors were associated with candidate self-care support domains (β=0.593, p<0.001) and self-management ability (β=0.379, p<0.001). Family, sociocultural, and healthcare-service factors were associated with candidate self-care support domains but not directly with self-management ability. Candidate self-care support domains were also associated with self-management ability (β=0.481, p<0.001).
Conclusions
The findings provide a cross-sectional needs-assessment foundation for developing a person-centered nursing-based integrated self-care bundle for hypertension self-management. Future studies should refine the bundle through expert validation and test its feasibility and effectiveness using intervention designs.