• Journal of agricultural medicine and community health
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• v.18 no.1
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• pp.43-54
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• 1993

In order to find the factors associated with the death of hypertensives, 12 year follow-up study for 267 hypertensives whose average blood pressure were 140/90 mmHg or above during their first health screening in 1979-1980 at YongJin Township, Wanju Country, North Cholla Province by the Community Health Team of Chonju Presbyterian Medical Center. The study results are as follows : 1. Initial general characteristics of hypertensives were studied. The age distribution of studied hypertensives showed 27.3% in 40-49 years, 25.8% in 50-59 years, 29.6% in 60-69 years and 17.2% In 70 + years old group. Marital status showed that 82.8% of hypertensives had their wife or husband. 74. 5% were employed on agriculture. 56.5% of hypertensives were illiterate. 2. Among the hypertensives, 91.6% of male and 22.8% of female reported that they were smokers. 82.6% of hypertensives had body mass index lower than 25 Kg/$m^2$. 46.8% of average systolic blood pressure were 160mmHg or above and 54.3% of average diastolic blood pressure were 95mmHg or above. 3. Twenty percent of hypertensives reported that they were treating hypertension at the beginning of follow up, while 68.5% reported that they were not treated. 28.1% reported that they were treating hypertension within 6 months before last follow-up. but 69.3% reported that they were not treated for hypertension within Ii months before last follow up. So 50.6% were classified as never treated group and 41.2% as treated group. 4. Average blood pressure for initial 3 years were calculated. The change of average systolic blood pressure was observed as $161.3{\pm}19.4mmHg$ at the first year, $145.6{\pm}28.0mmHg$ at the second year and $141.4{\pm}37.2mmHg$ at the third year. Average diastolic blood pressure were changed from $96.2{\pm}14.4mmHg$ at the first year to $90.6{\pm}18.6mmHg$ at the second year and $86.4{\pm}22.9mmHg$ at the third year. 5. By the follow-up of hypertensives, 54 hypertensives (46.2%) among 117 male hypertensives and 50 hypertensives (33.3%) among 150 female hypertensives died for 12 years. 42.6% of male death and 52.0% of female death were caused by cerebrovascular diseases. 6. Through univariate statistical test about the association between general characteristics or cardiovascular risk factors of hypertensives and mortality for 12 years, age variable among male and among female age, marital status, occupation. educational level. systolic blood pressure and treatment status were shown as significant variable to influence upon the mortality. 7. By multiple logistic regression analysis, among male age and systolic blood pressure were selected as significant variable to be associated with the total mortality for 12 years. Among female age, systolic blood pressure and treatment status were selected as statistically significant variable to be associated with the total mortality for 12 years.

• Research in Community and Public Health Nursing
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• v.12 no.1
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• pp.202-213
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• 2001

This study was conducted to identify the changes of the relationship among general characteristics, self-efficacy. and self-care of the hypertensives in rural area. For this purpose, self-regulation program was carried at two Community Health Practitioner Post located in the suburbs of Daejeon City from September to November. 1999. Data were analyzed with non-parametric statistics, t-test, pearson correlation. The results were as follows; 1. The level of self-care was significantly different according to sex, status of smoking, and the level of self-efficacy of non-smoker was significantly higher than smoker. 2. After self-regulation program, there were significant positive relationship among self-efficacy, self-care, internal locus control, and negative relationship between perceived barrier and self-care. From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area, and this program can be recommended for the management of hypertensives.

• Research in Community and Public Health Nursing
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• v.8 no.1
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• pp.45-60
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• 1997

Essential hypertension is a typical chronic disease requiring adequate and continuous management. Many studies supported that self-care was the essential factor to promote the wellbeing of hypertensives and self-efficacy increased healthy, behavior. The comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care performance for hypertensives in company. And this self-regulation program was recommended to apply for hypertensives in rural area. The purpose of this study is to identify the general characteristics affecting self-care and interrelationship among the factors including self-care, self-efficacy, HLOC, perceived benefits, barriers and family support. 40 subjects were interviewed from Dec. 1996 to Jan. 1997 and the data was analyzed by the SPSS PC+ program with t-test and multiple correlation to determine the variables affecting the self-care behavior. The results were as follows: 1) Level of self-care was significant difference according to sex(t= -2.27, p=.0l9). religion (t=1.57, p=.055) and smoking habit (t=4.42, P=.000). Perceived self-efficacy was more significantly high among the non-smoking group (t=3.25, P=.000) and female group (t=-2.534, p=.0l3). 2) There were significant positive correlation among the variables: self-care and self-efficacy (r=.5460, p=.000), external-LOC and self-care(r=.2548, p=.056), external-LOC and self-efficacy(r =. 2901, p=.035), self-efficacy and perceived benefits (r=3307, p=.019). And there were significant negative correlation between self-care and barriers (r=-.5438, p=. 000), self-efficacy and barriers (r= - .4153, p=.004). From the above results, it can be concluded that the self-care is more required in male hypertensives and self-efficacy is one of the important factors to increase healthy behavior in cluding self-care. Thus self-regulation program can be recommended in the management of the hypertensives in community settings.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1303-1317
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• 2000

This study was conducted to identify a effect of the comprehensive self-regulation program for hypertensives as a nursing intervention on self-care performance and the physiologic parameters in rural areas. For this purpose, a nonequivalent control group and a pre and post-test quasi- experimental design was used. Fifty-four were evaluated subjects from two Community Health Practitioner Posts in the suburbs of Taejon City. The subjects of the control and experimental groups were matched for age and sex. The self-regulation program developed by author given to the experimental group. The program consisted of group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring, recording of self-care activities, and encouraging and reinforcing self-efficacy. The whole program was carried out from September to November of 1999. The data were analyzed by repeated measure ANCOVA, t-test, and ANCOVA. The results were as follows ; There was significant improvement in the scores on knowledge (F=.68, P=.004), perceived self-efficacy (F=26.39, P=.000), self-care performance (F=26.11, P=.000) of the experimental group compared with those of the control group. There was no significant change on the score of locus of control, perceived benefits and perceived barrier, blood cholesterol level, body weight between two groups (P>.05). From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area.

• Journal of Preventive Medicine and Public Health
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• v.33 no.2
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• pp.215-225
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• 2000

Objective : The purpose of this study was to examine the therapeutic compliance and its related factors in the rural hypertensives. Method : A questionnaire survey and blood pressure measurement were performed to 3,876 residents of a rural area, and 660 hypertensives were selected as subjects of study. The study employed a hypothetical model which was composed of constructs from the health belief model and KAP model. The analysis techniques employed included contingency table analysis and structural equation modeling. Result : The proportion of those who were compliant to the treatment of hypertension was 44.2% of subjects. As the result of structural equation modeling, when patients had more favorable attitude toward treatment, higher perceived benefit, or lower perceived barriers to treatment, the therapeutic compliance was significantly higher(T>2.0). When patients had more knowledge about hypertension, or higher perceived severity of hypertension, the attitude toward the treatment of hypertension was more favorable significantly(T>2.0). And when patients had the support for treatment from family or neighbor, the attitude toward treatment was more favorable(T>2.0). When patients had experience of health education, they had more knowledge, higher perceived susceptibility of complication, perceived severity for hypertension, and perceived benefit of treatment, compare to patients without health education(T>2.0). Conclusion : In consideration of above findings, in order to improve the therapeutic compliance in the rural hypertensives, it would be necessary to change attitude, perception, knowledge about hypertension and its treatment, by various methods such as effective health education and programs for maintaining the supportive environment for hypertension treatment.

• Journal of Preventive Medicine and Public Health
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• v.33 no.1
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• pp.56-68
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• 2000

Objectives : To describe health behaviors related to hypertension in rural population of Korea and focused to identify inappropriate awareness, treatment, and control of hypertension. Methods : We surveyed 5,517 adults (2,288 males, 3,229 females) older than 30 years in 58 rural areas, purposely sampled nationwide from December 1996 to February 1997. Blood Pressure was checked twice af the time of the first visit. For those who showed high blood pressure using the JNC-6 criteria at their initial visit, we followed up their blood pressure one week later. Also information on the health behavior related to hypertension was collected through the person-to-person interview using structured questionnaire at the first visit. Results : For the past one year, females had more experiences of checking their blood pressure than males (77.3% versus 69.5%, p=0.001). Through the results of consecutively checked blood pressure, only 51.7% of the hypertensives were aware of their condition. Of the hypertensives who aware of their condition, 44.4% did not receive any medication and/or recommendation. And 50.4% of the hypertensives who had anti-hypertensive medication were classified as still having hypertensive blood pressure by 160/95 mmHg criteria. Of the medicated, 54.8% were found to take medication regularly for the past six months. Among the medicated, only 11.4% knew the name of anti-hypertensive drug they had. Conclusions : 'Rule of halves', which works in the situation of no special efforts for hypertension control, was identified. This study showed that much efforts to control hypertension would be required in the rural population of Korea.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.133-146
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• 2001

The purpose of this study was to investigate the treatment status and its related factors of the newly detected rural hypertensives through community health promotion program. A questionnaire survey and blood pressure measurement were performed to 6,977 residents of a rural area, and 282 hypertensives detected by blood pressure measurement were selected as subjects of the study. The study employed the health belief model as a hypothetical model. The major results of this study were as follows: The proportion of person experienced treatment among hypertensives was 12.0%. Treatment experience rate was significantly related with age and educational level(p<0.01). That is, if they were older, lower educational level, the treatment experience rate was higher. The major reasons of no treatment were 'they had not hypertensive symptoms ' (45.6%), 'their blood pressure was not high so much that they received treatment ' (43.2%). The chief facilities for treatment were public health institutions(57.9%) such as health center and health subcenter, and hospital/ clinics(29.8%). The treatment experience rate was higher when they had higher perceived severity for hypertension, lower perceived barrier to treatment, although statistically not significant. Treatment experience rate was significantly related with cues to action and health education experience(p<0.05). That is, if they had hypertension related symptoms such as headache previously, patients suffered from hypertension complication and health education experience for hypertension, the treatment experience rate was higher. In multiple logistic regression analysis for treatment experience, having a cerebrovascular patient in their acquaintance and the experience of health education for hypertension were significant variables. On consideration of above findings, it would to be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.93-106
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• 2003

Objectives: This study was conducted to investigate the treatment status and its related factors of the rural hypertensives. Methods: A questionnaire survey was performed to 618 rural hypertensives during September, 2002. Results: The proportion of those who were compliant to the antihypertensive medication was 68.9%. The compliance rate to the antihypertensive medication was significantly related with sex and economic status(p<0.05). That is, if they were female, higher economic level, the regular antihypertensive medication rate was higher. The regular antihypertensive medication rate was higher when they had higher knowledge for hypertension, higher severity for hypertension of him or her(p<0.01). And the compliance rate to the antihypertensive medication was significantly related with hypertensives' own explanatory model for hypertension(p<0.01). The rate of drug use except antihypertensives was 12.5%. The rate of drug use except antihypertensives was higher when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rate of medical equipment use was 18.9%. The utilization rate of medical equipment such as jade mat, germanium material was significantly related with age, experience of side effects of antihypertensive drug, medication status for antihypertensive drug(p<0.05). The rate of folk therapy use was 16.2%. The rate of folk therapy use was higher when they had no family, when they had knowledge about hypertension on the average, when they had hypertension over 10 years(p<0.05), and when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rates of drug use except antihypertensives, medical equipment use, and folk therapy were significantly related with hypertensives' own explanatory model for hypertension(p<0.05). Conclusions: On consideration of above findings, it would be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.155-164
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• 2002

Hypertension is the most frequent disease of chronic circulatory diseases and major intermediate cause or risk of the cerebrovascular disease which is a leading cause of death in Korea. Therefore, management of hypertension is an important issue in Korean healthcare. Especially, therapeutic compliance of hypertensives is very important because the hypertensive patients should receive anti-hypertensive treatment as long as the condition exists. However, many patients drop out of treatment, which is a major problem that needs to be solved through a hypertension control program. This study was carried out to provide basic data and counter measule for the hypertension control program in the community which aimed to keep the patients receiving treatment continuously. In order to investigate compliance of hypertensive patients during three months follow-up and the rate of control of hypertension, the data were collected during February, 2001, by reviewing medical records of 295 hypertensive patients who had been registered to Gunnam-myeon health subcenter before November, 2000. The author also study the dropout reasons by interviewing 58 patients among 68 dropout patients. The results were as follows: 1. Among the 295 subjects, 108(36.6%) were male and 187(63.4%) were female. Statistically, female hypertensives had a higher mean age than male(64.6 vs 66.3, p<0.05). 2. The 54.9% of the patients took anti-hypertensive medicine continuously for the past three months. And 19.3% had drug intermittently, and 25.8% dropped out of treatment. 3. Among several variables, such as sex, age, health insurance, the time taken from a patient's village to the health subcenter, only the last one was found to be significantly related to therapeutic compliance in the contingency table analysis. 4. The dropout reasons by multiple response were as follows, 'no symptom or no problem' (23.9%), 'change to other hospitals'(19.4%), 'geographical barrier'(17.9%), 'change to a neighborhood drugstore' (14.9%), 'immobility'(7.5%), 'economic barrier'(6.0%), 'unsatisfactory services of the health subcenter'(4.4%). 5. The mean blood pressure of 295 subjects was $144.9{\pm}12.9/86.88{\pm}8.6mmHg$. 6. The 32.5% of the subjects were controlled below 140/90mmHg. Conclusions: In order to improve the low rates of treatment and control of hypertension in rural hypertensives, a more active and systematic hypertension control program, including out-reaching follow-up management, is required in rural area. Especially, for health education of hypertensive patients, emphasis should placed on correcting wrong attitude toward hypertension.

• Journal of Society of Preventive Korean Medicine
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• v.5 no.2
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• pp.29-39
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• 2001

Purpose: This study was conducted to investigate and compare the growth, blood pressure, and s-cholesterol of urban and rural students in Korea. Methods: April 1999, We examined the students' health of a boys high school and a girls high school in a urban area - Jeonju, Korea.(boys were 317, girls were 343). And we also examined the students' health of a high school in a rural area - Gimje, Korea.(boys were 33, girls wee 36). Height, body-weight, Body Mass Index(BMI)I, blood pressure, and s-cholesterole were checked and compared between two groups. Results and Conclusion: The mean of height in urban students was $165.25{\pm}7.79cm$, and that in rural students was $163.77{\pm}8.72cm$. There was no significant difference stastically between two groups. The mean of body-weight in urban students $(57.78{\pm}10.51kg)$ was significantly higher than that in rural students $(54.71{\pm}10.11kg)$)(p<0.05). The mean of body mass index(BMI) in urban students $(21.12{\pm}3.27kg/m2)$ was significantly higher than that in rural students $(20.30{\pm}2.69kg/m2)$(p<0.05). Obese students $(BMI{\geq}27)$ were 31(4.70%) in urban students, 3(4.35%) in rural students. The mean of systolic blood pressure in rural students $(114.99{\pm}9.50mmHg)$ was significantly higher than that in urban students $(111.89{\pm}12.42mmHg)$(p<0.05) The mean of diastolic blood pressure in rural students$(75.72{\pm}9.90mmHg)$ was very significantly higher than that of urban students $(68.45{\pm}9.40mmHg)$(p<0.001). Hypertensives (${\geq}138/86mmHg\;in\;boys,\;{\geq}130/83mmHg$ in girls) were 28(4.24%) in urban students, 13(18.84%) in rural students. The mean of s-cholesterol in urban students was $174.95{\pm}32.28mg/dL$, and that in rural students was $176.81{\pm}33.18mg/dL$. There was no significant difference stastically between two groups. Hypercholesterolemias (${\geq}198mg/dL$ in boys, ${\geq}212mg/dL$ in girls) were 130(19.70%) in urban students, 14(20.89%) in rural students. These results suggest that there are differences in body weight, BMI, and diastolic blood pressure between urban and rural students and that it is necessary to consider these differences in health examination.