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Hypertension: Enhancing Lifestyle Management Through Patient Education and Pender’s Health Promotion Model

Background: Uncontrolled hypertension is a significant problem in the United States with 46% of hypertensive adults not achieving adequate blood pressure control. Inadequately treated HTN results in increased risk of renal disease, cardiovascular disease, and associated mortality. Interventions aimed at improving blood pressure control have targeted providers, patients, or a combination of providers and patients. Methods: The objective of this project was to enhance lifestyle management of patients with uncontrolled hypertension as measured by patient self-report in post-discharge interviews. The intervention incorporated education for patients on lifestyle management recommendations for hypertension as well as health promotion strategies inspired by Nola Pender’s Health Promotion Model. Patients chose a goal behavior and collaborated with this DNP student to identify facilitating factors and barriers to achieve these goals utilizing a health promotion worksheet. This intervention also targeted planning strategies by providers and facilitated the development of patient-specific care plans. This DNP project was conducted on two inpatient medical/surgical units outside of Boston, MA. Results: This intervention was completed with a convenience sample of 20 patients. Outcomes, as measured by patient self-report using a Likert scale, revealed that 11 patients always completed the goal behavior (55%), 4 patients sometimes completed the goal behavior (20%) and 3 patients reported never achieving their goal behavior (15%); the outcomes of 2 patients were unknown (10%). Discussion: Although there are several limitations to be considered this intervention shows promise in enhancing lifestyle management of patients with uncontrolled hypertension.