Self-care Management Practices, Lifestyle Modifications, and Associated Factors among Patients with Hypertension Attending Medical Clinics at National Hospital, Galle

Abstract

Background: Hypertension is a major global health concern, particularly in low and middle- income countries. Effective self-care management, including lifestyle modifications and medication adherence, plays a crucial role in controlling hypertension. Research on hypertension self-care practices in Sri Lanka is limited, highlighting the need for evidence-based strategies to improve patient outcomes. Objectives: To assess self-care management practices, lifestyle modifications, and associated factors among hypertensive patients attending medical clinics at National Hospital, Galle Methods: A descriptive cross-sectional study was conducted among 403 hypertensive patients selected through simple random sampling. Patients aged 18 to 90 years who had been on hypertension treatment for more than six months were included, while those with vision or hearing impairments were excluded from the study. Data were collected using a translated, pre-tested Sinhala version of the Hypertension Self-Care Activity Level Effects (H-SCALE) scale and a self- administered questionnaire assessing socio-demographic and clinical factors. Data were analysed using descriptive statistics, the Chi-square test, one-way ANOVA, and student t-tests in SPSS version 26.0. Results: The mean±SD age of participants was 52.1±17.1 years, and 51.9% were males. Uncontrolled hypertension was observed in 75.2% of patients. Non-adherence rates were high across key self-care domains: 86.4% for medication adherence, 45.7% for physical activity, 98.1% for a low-salt diet, and 91.3% for weight management. Age (p=0.048) and gender (p=0.005) were significantly associated with self-care practices, with younger patients and males showing better adherence. Level of education, monthly income, duration since diagnosis of hypertension, and presence of other comorbidities such as diabetes mellitus were not significantly associated with the self-care management practices of patients with hypertension. Conclusions: Poor adherence to hypertension management practices was prevalent, contributing to high rates of uncontrolled hypertension, especially among older adults. Targeted educational interventions and self-care enhancement strategies are essential to improve hypertension control and patient outcomes.