1.1 Introduction
Hypertension, commonly referred to as high blood pressure, is a significant public health concern globally. It is a major risk factor for cardiovascular diseases, which are among the leading causes of morbidity and mortality worldwide. Effective management and control of hypertension are crucial in preventing complications such as heart attacks, strokes, and kidney failure. Nurses play a pivotal role in the management of hypertensive patients, particularly in public health settings where they are often the first point of contact for patients seeking care.
According to a study by the World Health Organization (2021), consistent and accurate blood pressure monitoring, patient education, lifestyle modification counseling, and appropriate medication management are essential components of hypertension care. Nurses, being on the front lines of patient care, must be well-equipped with the knowledge and skills necessary to implement these measures effectively.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
Hypertension, often described as the "silent killer," is one of the most prevalent non-communicable diseases worldwide. The global burden of hypertension is substantial, with an estimated 1.13 billion people affected as of 2019, and it is projected to increase due to aging populations and lifestyle changes (World Health Organization, 2021). The condition is a significant risk factor for cardiovascular diseases, which account for approximately 17.9 million deaths annually, representing 31% of all global deaths (World Health Organization, 2021).
In managing hypertension, healthcare providers emphasize early detection, patient education, lifestyle modifications, and pharmacological interventions. Nurses, particularly in public health facilities, are integral to this multidisciplinary approach. They are often responsible for blood pressure monitoring, providing health education, encouraging lifestyle changes such as diet and exercise, and managing medication adherence. Despite the crucial role of nurses, studies have shown variability in their knowledge and application of hypertension management guidelines. According to research conducted by Abedini et al. (2020), there are significant gaps in nurses' understanding and execution of blood pressure control measures, which can adversely impact patient outcomes. This underscores the need for continuous education and training to ensure nurses are up-to-date with the latest guidelines and practices in hypertension management.
Public health facilities, which serve a large proportion of the population, including the underprivileged, face unique challenges. These include limited resources, high patient-to-nurse ratios, and varying levels of nurse education and training. Consequently, enhancing nurses' knowledge and skills in managing hypertension in these settings is paramount for improving patient care and health outcomes.
Early studies in the field of hypertension management primarily focused on medical interventions and patient compliance with treatment regimens. However, as the role of nursing in chronic disease management became more prominent, researchers began investigating the specific contributions of nurses to hypertension care. As interest in nursing's role in hypertension management grew, researchers conducted surveys and observational studies to assess nurses' knowledge of hypertension guidelines and their implementation in clinical practice. These studies revealed variations in nurses' understanding and application of blood pressure control measures, highlighting the need for targeted educational interventions.
One seminal study by Smith et al. (2015) examined the role of nurses in hypertension management and identified areas where nursing interventions had a significant impact on patient outcomes. This study laid the groundwork for subsequent research into nurses' knowledge and practices related to blood pressure control measures.
High blood pressure occurs when one’s blood move through the arteries at a higher speed than normal. It is also known that for now there is no cure for high blood pressure. Papadakis A, Macphere J. (2008). Over-weight here will be described or rather defined based on a calculation called “Body mass index” (BMI). According to this formular, one is regarded as over-weight if his BMI is greater than 25. Mancia G. (2007). The number of people with high blood pressure is in the increase and research has shown that this condition is heightened by overweight of the patient. That is to say, the more one increases in weight, the higher the tendency of him or her becoming hypertensive. Mori TA (2007).
The seriousness of this adult illness (high blood pressure) is not just that it can lead to more serious illness or complications, raises the risk of stroke, kidney failure, heart disease and heart attack. The matter is made worse with the existence of too much weight or fat in the body as this tends to make the condition severe. It is the duty of stakeholders in health sectors to keep the adult folk aware of the implication of over-weight by providing them with accurate, timely and up to date information regarding this health condition. It is also the duty of health personnel to warn and educate adults who are more prone to high blood pressure, about the dangers of over-weight in the management of high blood pressure. This awareness is expected to affect the feeding habit of these people, since it has been observed that poor feeding (that is, poor combination of the classes of food, not necessarily the quantity) is one of the causes of over-weight (Sacks F.M, 2008).
Therefore, in Enugu Metropolis where the research was carried out, the activities that was conducted is to know the Nurses knowledge of blood pressure control measures in hypertensive patients assessing care in a public health facility.
1.3 Statement of Problems
Investigation revealed that Nurses play a crucial role in hypertension management, as they are often the primary caregivers for patients seeking care in public health facilities. However, inadequate knowledge and inconsistent application of blood pressure control measures may negatively impact patient outcomes, leading to suboptimal blood pressure control and increased risk of cardiovascular complications (Smith et al., 2015).
Furthermore, public health facilities often face resource constraints, including limited staffing, high patient loads, and inadequate training opportunities. These challenges may further exacerbate knowledge gaps among nurses and hinder their ability to provide optimal care for hypertensive patients (World Health Organization, 2021).
Hence, it is against this backdrop that this study aims to contribute to the development of evidence-based interventions and policies that can improve hypertension management and patient outcomes in public health facilities.
1.4 Aim and Objectives of Study
The aim of the study is to assess Nurses’ knowledge of blood pressure control measures in hypertensive patients assessing care in a public health facility in Enugu Metropolis. In achieving this aim, the following specific objectives were laid out as follows:
- To identify specific areas of deficiency or gaps in nurses' knowledge and practices related to hypertension management, particularly in the context of a public health facility with limited resources and high patient volumes;
- To determine the level of knowledge among nurses regarding blood pressure control measures in hypertensive patients;
- To investigate the current practices employed by nurses in managing hypertensive patients within the public health facility;
- To explore the challenges and barriers faced by nurses in delivering optimal care to hypertensive patients; and
- To recommend possible solution that will enhance nurses' knowledge and skills in blood pressure control measures, tailored to the unique needs and challenges of the public health facility setting.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What are the current practices employed by nurses in managing hypertensive patients within the public health facility?
- What is the level of knowledge among nurses regarding blood pressure control measures in hypertensive patients?
- What are the challenges and barriers faced by nurses in delivering optimal care to hypertensive patients?
- What are specific areas of deficiency or gaps in nurses' knowledge and practices related to hypertension management, particularly in the context of a public health facility with limited resources and high patient volumes?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant difference in the level of knowledge of blood pressure control measures among nurses working in a public health facility.
- H1: There is a significant difference in the level of knowledge of blood pressure control measures among nurses working in a public health facility.
1.7 Significance of Study
Upon the completion of this research, the study will inform the development of evidence-based policies and practices targeted at improving hypertension management within public health facilities. This can lead to more effective allocation of resources and better support for nurses in delivering optimal care. Furthermore, improved knowledge and practices among nurses regarding blood pressure control measures can lead to better patient outcomes, including reduced cardiovascular complications and improved quality of life for hypertensive patients.
Ultimately, the outcome of this study adds to the body of literature on hypertension management and nursing practice, particularly in the context of public health facilities. It provides valuable data and insights that can guide future research efforts and contribute to a deeper understanding of effective strategies for hypertension care.
1.8 Scope of Study
The scope of the research is focused on the Nurses knowledge of blood pressure control measures in hypertensive patients assessing care in a public health facility in Enugu Metropolis.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.10 Definition of Terms
Nurses:
Registered nurses or licensed practical nurses working within a public health facility, responsible for providing care to hypertensive patients.
Public Health Facility:
A healthcare facility operated by a government or community organization, providing healthcare services to underserved populations, often including primary care, preventive services, and health education.
Hypertensive Patients:
Individuals diagnosed with hypertension, characterized by persistently elevated blood pressure levels.
Blood Pressure Control Measures:
Strategies and interventions aimed at managing and maintaining optimal blood pressure levels in hypertensive patients, including medication management, lifestyle modifications (e.g., diet, exercise), and patient education.
