TABLE OF CONTENTS PAGE
Title Page i
Certification ii
Approval Page iii
Dedication iv
Acknowledgement v
Table of Contents vi
List of Tables ix
List of Figures x
Abstract xi
CHAPTER ONE: INTRODUCTION
Background to the Study 1
Statement of the Problem 3
Purpose of the Study 4
Objectives of the Study 4
Research Questions 5
Hypotheses
Significance of the Study 5
Scope of the Study 6
Operational Definition of Terms 6
CHAPTER TWO: REVIEW OF RELATED LITERATURE
Conceptual Review 7
Pathophysiology 7
Diagnosis 9
Prevention 12
Management of Hypertension 12
Exploring Alternative Ideas: Shifting Focus to Elements with Greatest
Impact on Public Health 18
PAGE
National Institute of Health Guide to Lowering Blood Pressure with 29
Dietary Approaches to Stop Hypertension DASH (2014).
The DASH Eating Plan 30
DASH Tips for Gradual Change 31
Lifestyle – in Summary 32
Dieting as a Solution to Overweight and Hypertension 34
Dietary Compliance
Dietary Self-Efficacy: Determinant of Compliance Behaviours and
Biochemical Outcomes in Haemodialysis Patients 39
Spike in Blood and Hypertensive Crisis 40
PAGE
Theoretical Review 41
Empirical Review 43
Summary of Literature Review 52
CHAPTER THREE: RESEARCH METHOD
Research Design 53
Area of Study 53
Population of Study 53
CHAPTER FOUR: PRESENTATION OF RESULTS 57
Research Question One: What are the eating practices adopted by hypertensive
patients attending UNTH Clinic? ` 58
Research Question Two: What is extent of Compliance with dietary 59
modification among hypertensive patients attending UNTH Clinic?
Research Question Three: What is the extent of compliance with physical
exercises activities among hypertensive patients in UNTH? 60
Research Question Four: What is the relationship between demographic
factors and 62
compliance to modification to dietary practices and physical
exercise activities among hypertensive patients in UNTH?
Summary of Findings 63
Testing of Hypotheses
PAGE
CHAPTER FIVE: DISCUSSION
Discussion of Major Findings 64
Conclusion 66
Implication to Nursing 67
Limitations of Study 67
Suggestion for Further Studies 67
Summary 67
Recommendations 68
Appendix I: Questionnaire
Appendix II: Informed Consent Form
Appendix III: Letter of Introduction
Appendix IV: Ethical Approval
Appendix V: Calculation of Sample Size
LIST OF TABLES PAGE
Table 1: Demographic characteristics of respondents 57
Table 2: Distribution of respondents’ dietary practices 58
Table 3: Distribution of respondents who complied to dietary modification 59
Table 4: Distribution of respondents based on their compliance with
specific dietary modification 59
Table 5: Distribution of respondents who engaged in physical exercises 60
Table 6: Distribution of respondents based on their compliance with specific
physical exercise 60
Table 7: Distribution of respondents based on their compliance with specific
areas of physical exercise 61
Table 8: Relationship between demographic factors and compliance with
Lifestyle modifications among the study participants 62
LIST OF FIGURES PAGE
Fig. 1: Classification of Blood Pressure for Adult (JNC7) 10
Fig. 2. The Health Belief Model (HBM) 43
ABSTRACT
The management of hypertension is tripartite in nature: medication, physical exercise and dietary modification. While medication is curative, physical exercise and dietary modification are both preventive and curative. Dietary and lifestyle changes can improve blood pressure control and decrease the risk of health complications, although treatment with medication is still often necessary in people for whom lifestyle changes are not enough. Physical exercise regimes which are shown to reduce blood pressure include isometric resistance exercises, aerobic exercise, resistance exercise etc. However, substantial literature and research have shown that hypertensive patients rarely comply with these lifestyle changes with the resultant effect that even the medication does not seem to have effect in the long run. Hence the purpose of the study is to assess compliance with dietary modification and physical exercise among hypertensive patients attending Medical Out-Patient Clinic in UNTH. The objectives were to: identify dietary practices adopted by hypertensive patients in the study area; determine the extent of compliance with dietary modification among hypertensive patients that attend UNTH Medical Outpatient Clinic; determine the extent of compliance with physical exercises among hypertensive patients in UNTH, and establish the relationship between demographic factors and compliance to modifications in dietary practices and physical exercise activities. A cross-sectional descriptive survey research design was employed and a sample of 240
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