ABSTRACT
In Auchi, Nigeria, hypertension is a major public health issue. The goal of this qualitative phenomenological survey was to learn more about hypertension patients’ knowledge, perceptions, attitudes, and lifestyle habits in order to better understand their health and treatment needs. A self-structured questionnaire and a lengthy interview were used to assess a cohort of 108 hypertensive people who were chosen at random. The statistical software for social sciences (SPSS) was utilized for the analysis, and chi-square significance tests were used at the 0.05 level. Males were assessed in greater numbers than females, with 60 (55.6%) outnumbering girls, 48 (44.4%). Their age range was 35 to 80 years (mean = 59.05 9.06 years), with 56 to 60 years being the median age group (24.1 percent ). Sixty-six percent (61%) recognized hypertension was high blood pressure (BP), while 22 percent (20%) felt it meant much thinking and worrying, and 57 percent (53%) thought it was genetic. 43 percent thought it was caused by evil spirits, while 32 percent said it was caused by bad food or poisoning. A small percentage of people (18%) were aware of some risk factors. Headache, restlessness, palpitation, excessive pulsation of the superficial temporal artery, and “internal heat” were among the symptoms attributed to hypertension, but 80 (74 percent) said it was correctly diagnosed by blood pressure measurement. Despite the fact that 98 (90.7%) thought the condition indicated substantial morbidity, only 36 (33.3%) adhered to treatment and even fewer exercised lifestyle change.
CHAPTER ONE
INTRODUCTION
BACKGROUND OF THE STUDY
According to Andreoli, Carpenter, Grigs, and Loscalzo (2004), hypertension causes health problems, disability, and death in the adult population around the world. According to Ejike, Ezeanyika, and Ugwu (2010), hypertension is the third leading cause of death worldwide, accounting for one out of every eight deaths. They also predicted that approximately one billion adults worldwide had hypertension in 2010, with that figure expected to climb to 1.56 billion by 2025 if no meaningful intervention programs are implemented. According to Aram, George, Henry, Williams, Lee, and Joseph (2003), fifty million Americans, or one in every three adults, have high blood pressure. Twenty-eight (28) to thirty-one percent of individuals in the United States have hypertension (Fields, Burt, & Cutler) (2004). Primary hypertension affects 90 to 95 percent of this group (high blood pressure related to unidentified cause). Secondary hypertension affects the remaining five to ten percent of this group (high blood pressure related toidentified cause). Hypertension affects almost 130 million people in China between the ages of 35 and 74. (Camel &Delene, 2006). In Ghana, studies found that forty percent of rural inhabitants have hypertension, while eight percent to thirteen percent of urban dwellers have hypertension. It is the fastest-growing cardiovascular illness in Sub-Saharan Africa, impacting about 20 million people (Kadiri, 2005). Hypertension, often known as high blood pressure, is defined as blood pressure in the arteries that is consistently above 90 millimetres of mercury (mmHg) between heartbeats (diastolic) or 140 millimetres of mercury (mmHg) at the beats (systolic) (Aquilla, 2008). Hypertension, according to Hyman and Parlik (2003), is defined as persistently high blood pressure with a systolic pressure of more than 140 mmHg and a diastolic pressure of more than 90 mmHg. Normal blood pressure is less than 120/80 mmHg; pre-hypertension is blood pressure between 120/80 and 139/89 mmHg; and high (bad) blood pressure is 140/90 mmHg or more. Blood pressure of 120/80 mmHg is considered normal for a 30-year-old person, according to the Expert Committee on Non-Communicable Diseases (1993), whereas blood pressure over 130/80 mmHg is deemed high. Secondary hypertension, which accounts for 5% to 10% of all hypertension cases, has a known cause. According to Chris (2009), an irregularity in the arteries delivering blood to the kidneys is the most common cause of secondary hypertension. Other causes include sleep apnea, stress, adrenal gland diseases and tumors, lifestyle, spinal cord injury, hormone abnormalities (oral contraceptive estrogen replacement), thyroid disease, pregnancy toxemia, renal problems such as vascular lesion of renal arteries, diabetic neuropathy, pains, anxiety, and hypoglycemia, as well as anxiety and hypoglycemia. Adults are predisposed to hypertension due to a number of causes. The risk factors for hypertension include genetic factors that can be passed down from parents, aging, which occurs when the body loses its elasticity, obesity, which is defined as an increase in weight of more than 10% above normal body weight due to generalized fat deposition in the body, excessive salt intake, which raises blood pressure, stress, which produces chemical substances that cause generalized vasoconstriction, and oral constriction. Hypertension, which has been identified as the greatest risk factor for cardiovascular morbidity and mortality, remains a serious global public health concern (Kearney, Whelton, Reynolds, Muntner, Whelton& He, 2004). It causes artery hardening, which puts people at risk for heart disease, peripheral vascular disease, stroke, heart failure, and kidney failure. Hypertension is the most common noncommunicable disease in the world, and it affects people of all ethnicities to varying degrees. According to Castelli (2004), its incidence is rising in emerging countries where the adoption of a Western lifestyle and the stress of urbanization, both of which are projected to increase morbidity linked with an unhealthy lifestyle, are not declining.
Thatch and Schultz (2004) identified occipital headache, dizziness, restlessness, failing vision, shortness of breath, and a rapid accelerated heartbeat as signs and symptoms of hypertension. In order to prevent hypertension, adults should be aware of risk factors. When these indications appear, they will be able to recognize them and avoid or manage hypertension.
Facts, information, understanding, awareness, insight, wisdom, reasons, comprehension, meaning, concept, and experience are all terms that are related to knowledge (Albelum, 1987). It is a collection of organized information that people share. Knowledge, according to Nnachi (2007), is the ability to grasp or comprehend phenomena, as well as the collection of positive information through the exercise of some capability that humans presumably share. Health knowledge might be defined as putting into practice an individual’s ability to mobilize resources intellectually, physically, and emotionally. According to Hamburg and Russell (2000), health awareness and comprehension of relevant aspects have a positive impact on overall well-being quality. They went on to argue that exposure to adequate health information has a favorable impact on a person’s health attitude and practice, and that knowledge is, thus, the key to optimum well-being. According to Umaru (2003), knowledge is gained through learning in the cognitive, emotional, and psychomotor domains. Knowledge is defined in this study as all understanding and familiarity gained through learning and experience that enables adults to recognize risk factors as such. Lothar, Gottfried, and Heide (2011) define risk factors as individual traits that influence a person’s odds of developing a specific disease or group of diseases in the future. A risk factor, according to Lucas and Gilles (2003), is anything that has been identified as increasing a person’s chances of contracting an illness or developing a condition. Those who have behaviors or qualities that raise the chance of having hypertension will be regarded at risk of acquiring hypertension. In this study, risk factors relate to the qualities, situations, or activities that enhance the likelihood of hypertension occurring, such as excessive salt intake and smoking. When risk factors are linked to hypertension, they are referred to as hypertension risk factors.
There are two sorts of hypertension risk factors: those that can be changed and those that cannot. Obesity, excessive salt intake, smoking, environmental stress, oral contraceptives, sedentary lifestyle, high plasma lipids, and uncontrolled aldosterone secretion are all risk factors that can be altered. Genetic predisposition, age, and gender are risk factors that cannot be changed. Adults should have a good understanding of the risk factors in order to avoid hypertension.
Preventive measures are interventions aimed at preventing the onset of a certain disease and lowering its incidence and prevalence in the general population. Preventive measures, according to Starfield, Hyde, and Gervas (2007), are “any measures that limit the advancement of a disease at any stage of its course.” Preventive measures are defined in this study as all activities whose primary goal is to improve, restore, and preserve health, as well as actions aimed at preventing hypertension in adults. Primary and secondary preventive measures are the two categories of preventative measures. Primary prevention is an intervention that prevents a disease from occurring or acts made prior to the commencement of a disease that eliminates the likelihood of a disease occurring. It denotes intervention during a disease’s or health problem’s pre-pathogenesis stage. It can be achieved through measures aimed at improving adults’ overall health and well-being, as well as their quality of life (health promotion), or through particular protective measures (specific protection). Actions that slow the progression of a disease are referred to as secondary prevention.
The specific intervention in secondary prevention, according to Salama (2011), is early diagnosis of hypertension, which entails a screening test. It aims to halt the illness process and restore health by identifying and treating undiagnosed disease before irreversible pathological changes occur, particularly in adults.
Adulthood is the phase of a man’s life that lasts the longest. An adult, according to Hornby (2001), is a person who has reached full size or strength, is cognitively and emotionally mature, and is legally old enough to vote or marry. An adult, according to Ebiringa and Nwagbo (1997), is someone who has achieved the age of maturity, who covers his nakedness, lives alone, can answer a community summons, and is taxable. They went on to say that an adult is someone who has gained a sense of perspective, is more balanced in their thinking, and is accountable for his own and others’ actions. Samuel (2006) defined adulthood as the time when a person has completed all of the teenage developmental tasks, has reached a recognized age bracket, and is free of parental or social constraints. Samuel (2006) divided adults into three stages: young adulthood (ages 21 to 40), middle adulthood (ages 41 to 65), and older adulthood (ages 65 and up) (65 years and above). Young adulthood, which spans the ages of 21 to 40, is when most people reach their peak physical fitness. It’s a crucial transitional period. Adults in this age range are energetic and full of life. Middle age is defined as the period between the ages of 41 and 65, which is characterized by a nice plateau (Ejifugha, 2003). Adults in this group are at a crossroads in their physical and mental development. Adults in this category have a tendency to overeat and may not exercise on a regular basis. Many people are overweight, if not obese. Adults in this category smoke, drink, and take drugs as a result of psychological stress. The term “older adult” refers to people who are 65 years or older. Aging factors gradually influence the individual, perhaps leading to cardiovascular disorders such as hypertension. A person who has attained the age of adulthood is referred to as an adult in this study.
Many factors can influence one’s understanding of hypertension. Studies on hypertension knowledge have looked at age, race, education level, parity, gender, income, location, occupation, and marital status, according to the literature (Hamdan, Saeed, Kutbi, Choudhry&Nooh, 2010). The current study, on the other hand, is focused on demographic parameters such as age, gender, location, and educational attainment.
Adults’ ability to gain enough knowledge of hypertension has been found as a key factor that can hinder their ability to learn about it. Growth, development, maturity, and mortality are all determined by age. Maturity comes with age, and with maturity comes the ability to rationalize, concretize, accept or reject a notion, information, habit, attitude, or practice (Ejifugha, 2003). It is said that the more years one adds to one’s life, the longer one will live.
After menopause, however, the incidence of hypertension attributable to arteriosclerosis in women rapidly increases, surpassing that of men in old age. Men have a substantially higher chance of acquiring hypertension than women of the same age from puberty to 54 years. After 54 years, the situation has flipped.
Due to the absence of a feminine stronger hormone that protects against hypertension, women are now reported to have a higher incidence of hypertension.
Adults’ ability to seek proper knowledge of hypertension may be limited by their location, which is an environmental element. According to Hamdan, Saeed, Kutbi, Choudhry, and Nooh (2010), hypertension is linked to age, gender, and geographic region.
Similarly, Lech and Piotr (2009) found that rural adults were diagnosed with hypertension more frequently than urban adults. Adults living in cities have more possibilities and access to hypertension seminars, health discussions, workshops, and medical checkups (accessibility to health information). Unfortunately, persons living in rural areas may not have the same chances because such programs may not exist. In most cases, these programs are only available to a tiny, privileged group of people who live in well-developed cities, at the expense of the vast majority of people who live in rural areas and suffer from diseases and ignorance.
According to studies, education levels are linked to knowledge, which could include hypertension risk factors and preventive strategies. Adults who were more knowledgeable selected positive lives, while illiterate adults embraced unhealthy lifestyles, according to Hamdan, Saeed, Kutbi, Choudhry, and Nooh (2010). The more one’s educational attainment, the greater one’s acquisition of knowledge, attitude, and behavior, whereas the lower one’s educational attainment, the lesser one’s rise in knowledge of hypertension risk factors and prevention strategies. Similarly, Myo, Thaworn, Janthila, Nongluk, Suchart, Wilawan, Phatchanan, Puangpet, Nara, and Apiradee (2012) found that persons who had completed primary school were more likely to be aware of hypertension than those who had not. The study looked at age, gender, geography, and educational level as variables.
STATEMENT OF PROBLEM
Hypertension has been linked to a slew of negative outcomes, and having a good understanding of the risk factors can aid in hypertension prevention. As a result, persons in the Owerri Senatorial Zone must understand hypertension in order to reduce the prevalence of hypertension disease, enhance health, and achieve optimal well-being. Adults in the neighborhood, on the other hand, are likely to have insufficient knowledge of hypertension. There does not appear to be any evidence that people are aware of hypertension. As a result, this research into hypertension knowledge is required.
Unfortunately, most adults engage in unhealthy lifestyles such as excessive alcohol consumption, sedentary lifestyle, excessive sodium intake, tobacco and cigarette smoking, and obesity because they are unaware of the risk factors and preventive measures for hypertension. Hypertension is one of the disorders that affects a large number of the adult population and is responsible for one out of every eight fatalities worldwide, making it the world’s third biggest cause of mortality. According to Ejike, Ezeanyika, and Ugwu (2010), around one billion adults had hypertension in 2010, with the number anticipated to climb to 1.56 billion by 2025. Furthermore, hypertension is Nigeria’s most frequent non-communicable disease, with over 4.3 million people diagnosed as hypertensive. Many people in Nigeria die as a result of hypertension. This is an unacceptable state, given that hypertension may be prevented and managed to decrease its impact on people’s health and life in Nigeria.
OBJECTIVES OF THE STUDY
The overall goal of this study is to determine patient knowledge and perceptions about hypertension and its treatment. The following are the precise goals:
1. To assess hypertension patients’ knowledge, perceptions, attitudes, and lifestyle practices in Auchi.
2. Describe the impediments to optimal hypertension control.
3. Determine the level of hypertensive patients’ knowledge and perceptions about hypertension and its care.
RESEARCH QUESTIONS
1. What do hypertension patients in Auchi know,
2. What are the impediments to optimal hypertension management?
3. What is the level of hypertensive patients’ knowledge and perception of hypertension and its management?
SIGNIFICANCE OF THE STUDY
Health educators, medical and paramedical officers, public health officers, counsellors, media educators, researchers, curriculum planners, government, and adults will all benefit from the findings of this study in many ways. The research could aid in the development of a positive attitude about hypertension. The ministry of health could benefit from the study by identifying a knowledge gap in the population and emphasizing initiatives to teach adults how to avoid risk factors. Other researchers may find it valuable to do this study in locations where illness prevention and health promotion are needed in the case of hypertension.
SCOPE OF THE STUDY
The research included all of Auchi’s local government areas in Edo State. Adults aged fifty and up who lived in both urban and rural settings were included in the study. The goal of the study was to determine how well patients understood and perceived hypertension and its treatment. The idea of hypertension, indications and symptoms, risk factors, and hypertension prevention techniques were all covered. The effects of demographic factors such as age, gender, location, and educational level on knowledge
LIMITATION OF THE STUDY
During the course of this research effort, the researcher was confronted with a variety of obstacles. They include time limits, money constraints, and some respondents’ unwillingness to cooperate. Because some of the respondents did not return their questionnaires, this research endeavor had drawbacks. Only responses from respondents who completed and submitted their questionnaires accurately were used by the researcher.
DEFINITION OF TERMS
Hypertension is a condition characterized by unusually high blood pressure and a high level of psychological stress.
Hypertension is treated with a combination of lifestyle changes and antihypertensive medicines. The goal of hypertension treatment is to lower blood pressure to between 140/90 and 160/100 mmHg.
Facts, information, and skills gained via experience or study; theoretical or practical comprehension of a subject.
Perception is the organization, identification, and interpretation of sensory data in order to represent and understand the presented data or environment.
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