Authors (including presenting author) :
Leung WS (1), Ip YM (1), Lam YS (1), Lo KM (1), Shum YY (1), Tse PL (1), LEE KY (1), Karn KY (2)
Affiliation :
(1) Community Nursing Service, United Christian Hospital, (2) Nursing Services Division, United Christian Hospital
Introduction :
Hypertension (HT) is one of the common non-communicable diseases and a major cause of premature death worldwide (World Health Organization (WHO), 2023). In Hong Kong, it is estimated that around 27% of the population aged 15 or above suffer from HT. Uncontrolled HT may cause serious complications including heart failure, coronary heart disease, stroke, and kidney failure (Food and Health Bureau, 2022). Evidence has shown that HT care programs effectively reduce uncontrolled HT and its associated complications. To address the challenge of limited manpower, a comprehensive and smart HT care program was initiated in the community. This program goes beyond traditional face-to-face home visits and educational booklets. It incorporates smart technologies to empower patients/carers in the self-management of HT for effective control.
Objectives :
(1) to enhance the knowledge of HT care
(2) to promote behavioral changes and lifestyle modification
(3) to promote Blood Pressure (BP) control
(4) to reduce Accident and Emergency Department (AED) attendance due to HT
Methodology :
The program was launched from March to June 2023. Patients are living at home and aged 65 or above with inclusion criteria of 1) diagnosed with HT, and 2) under Community Nursing Service (CNS) and follow-up in Hospital Authority (HA), and 3) with uncontrolled BP (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg) or were referred for HT care; and 4) patients or caregivers are able to read and communicate in Chinese or English; and/or 5) electronic sphygmomanometer is available at home. Participants were recruited through convenient sampling, and a 6-8 weeks empowerment program with a comprehensive care pathway and educational kit were provided. The educational kit, which comprised smart care components consisted of providing QR codes for easy access the training materials and exercise videos through their smartphones or other devices.
Result & Outcome :
Total of 20 participants were recruited into the empowerment program. 7 were living alone while 13 were living with family or a maid. Continuity of care through home visits and telephone supports were provided according to patient’s need. The program significantly reduced home visits to a total of 20, compared to the traditional program. Participants accessed the educational material and exercise visually through the QR codes. This visual learning was beneficial for their understanding and the ability to review related information at their convenience. Thus, 74% increase in the mean score of participants' HT knowledge. The BP control, body weight (BW), and body mass index (BMI) of participant were also improved with behavior change in lifestyle. Importantly, the Emergency Department admission rate was decreased from 40% to 0%.
The positive outcomes proved that this smart empowerment program is effective in enhancing the knowledge on self-management of HT and promoting the behavioral change of the participants especially in self-monitoring of BP, diet and exercise hence improving their HT control. On the way forward, more smart care delivery model such as tele-health will be considered to implement in the chronic disease care pathway.
