Combination of self-management theory with PRECEDE-PROCEED model to promote life quality in patients with hypertension

Purpose Hypertension is a multifactorial medical condition that might cause functional changes in target organs such as heart, brain, kidneys, and blood vessels. Methods This study was an experimental study in which 137 hypertensive patients were selected to evaluate three intervention theory-based models; PRECEDE-PROCEED (P&P) model, self-management model, and a combination of these two models (composite model). Three distinct health centers in Karaj city were selected to randomly implement one of the models. Patients were chosen as follows: for the PRECEDE-PROCEED model, 45 patients from center one, for the self-management model, 45 patients from center two, and for the composite model 47 patients from center three, Repeated measurements ANOVA was used to interpret the results. Results The results showed that the mean score of quality of life in all domains including physical, psychological, social, and environmental component, as well as the total score of quality of life, improved significantly under all models. The self-management and P&P models had a similar performance, but the composite model achieved significantly higher improvement compared to other models at all time points.Moreover, the results showed significant changes from baseline to month 1 in all components; but with respect to month 1 of the intervention, at month 3 a decline in the components was observed under all models. Conclusion The results of this study showed that the designing and implementation of training programs based on the composite model achieved higher improvements in the quality of life of hypertension patients. Reduction in the quality of life scores after 1 month of intervention may indicate a short-term effect, but it should be noted that at month 3 the scores were still markedly high with respect to the baseline.