A PROPOSITION AND FEASIBILITY OF HYPERTENSION DISEASE MANAGEMENT TRAINING PROGRAM FOR REGISTERED NURSES

Abstract

Introduction and Background: Hypertension is a serious public health threat and a highly prevalent disease referred to as the silent killer. The Lebanese Ministry of Public Health has a non-communicable disease prevention and control plan including hypertension, but the focus is more on screening and not on management of hypertension. Given those shortcomings in our system, it is extremely essential to develop a training program for nurses in primary health care centers to empower hypertensive patients to self-care for their disease.

Goals: To propose a hypertension management training program for nurses working in primary health care centers in Lebanon that includes an overview on hypertension, motivational interviewing skills and a protocol for managing hypertension. Also, to explore the feasibility and acceptability of the proposed training program in Abey Primary Health Care Centers and identify its facilitators and barriers.

Methods: A desk review was conducted on the role of nurses in managing hypertension in primary health care based on evidence from guidelines adopted in the United States, Canada, and Lebanon. Accordingly, the prototype for a hypertension disease management training program for nurses is developed. The program consists of two parts: Hypertension Disease Management Course and Patient’s Visits. The course will introduce nurses to new topics (self-care practices, motivational interviewing and goal setting sessions) and tools (The Hypertension Self-Care Activity Level Effects tool- H-SCALE tool; Hypertension Knowledge-Level Scale tool- HK-LS tool; and Assessment of Chronic Illness Care tool- ACIC tool). Whereas the second part of the program (patient’s visits) will explain in depth how and what nurses and the doctor should do during patients’ first visit and how to follow up with patients using motivational interviewing and goal setting sessions.

Program Evaluation Plan: with respect to the nurses: nurses must pass this course through participating in the sessions through games and activities, taking the Objective Structured Clinical Examination, and completing the final exam. Nurses must achieve 70 points over 100 on the total grade to complete the course and be part of this program. With respect to patients: first, a Quasi-Experiment on one group study (patients) done to assess patients’ awareness of hypertension through a Pretest and a Post-test in the first visit based on the HK-LS tool. Second, Quasi-Experiment on one group study (patients) done to assess the blood pressure and self-care practices of hypertensive patients at Abey PHCC at baseline and at 6 months of follow up through the H-SCALE tool. With respect to the program: the program is evaluated by using the ACIC tool at baseline and after 6 months of the program.