Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Hypertension is on the increase among patients as found on the Routine Monthly Report (RMR) at Kayamandi Clinic. The staggering figures showed that the number of patients with hypertension between January 2009 until December 2009 was 5 754. It was further identified on the Routine Monthly Report (RMR) statistics that, more and more young adults between 18 and 40 years who are visiting the clinic for other health problems are diagnosed with hypertension and its complications. The incident rate of these young adults ranges between 151 and 340 per month. It is very alarming that some of them who are diagnosed with hypertension never return for further follow-up visits and are at risk of debilitating complications which are preventable in later life. The objectives of this study were to determine the knowledge young adult patients have of: • hypertension • the management of hypertension • the complications of hypertension. The study adopted a descriptive, exploratory design with a quantitative approach. The research question determines the research design or approach. In this case a broad overview is necessary of the knowledge young adults at Kayamandi Clinic have on the topic of hypertension. This then serves as a platform for further in-depth studies on this phenomenon. A yes/no scale was used to collect data. The questionnaire was designed in such a way that the participants could understand all the questions. The layout of the questionnaire was easy and the questions were straightforward. The questionnaires were written in English, Xhosa and Afrikaans. After the translation of the questionnaires, a second person scrutinized it for the correctness of the Xhosa translation. An interpreter assisted with the questionnaire in the Xhosa speaking community at the time of data collection, where a language barrier was anticipated. The Cronbach’s alpha test was used to test the reliability of the questionnaire. Informed consent was obtained from each participant. Permission was obtained from the University of Stellenbosch via the Health Research Ethical Committee ((HREC). Permission was also obtained from the Director: Department of Health, Western Cape Province and the authorities of the Cape Wine lands district. A statistician from the University of Stellenbosch was consulted regarding the data analysis and the interpretation of the data. Data was articulated in the form of frequency tables and histograms. The Spearman test was used to determine the correlation between variables. 10% of the participants used in the pilot study were from Cloetesville Clinic and 21% of the participants used for the main study were from Kayamandi Clinic, that is n=210 participants. The results of the study showed that for the n=172 participants that partook in the study, there was a correlation between complications and hypertension but no correlation on lifestyle management. Statistical associations were determined by using the Spearman test on a 95% confidence interval between various variables. The normal descriptive statistical analysis was completed. The implication of the results of this study is that high blood pressure can affect young and old people. Recommendations consist of on going health promotion and continuous education that include both old and young people. / AFRIKAANSE OPSOMMING: Hipertensie is aan die toeneem onder die pasiënte soos gevind in die maandelikse roetine-verslag.Die skokkende syfers soos gerapporteer in die maandelikse roetine-verslag,wys dat die aantal pasiënte met hipertensie by Kayamandi-kliniek van Januarie 2009 tot Desember 2009 was 5 754. Dit is verder geidentifiseer in die maandelikse roetine-verslag dat al hoe meer jong mense tussen die ouderdomsgroep van 18 to 40 jaar oud wat die kliniek vir ander siektetoestande besoek, met hipertensie en verwante komplikasies gediagnoseer word. Die voorkomssyfer van jongmense met hipertensie wissel tussen 151 tot 340 per maand. Dit is sorgwekkend dat sommige van die pasiënte nadat hulle met hipertensie gediagnoseer is, nie terugkeer na die kliniek vir verdere opvolgbesoeke nie en daardeur blootgestel word aan uitmêrgelende komplikasies in hul latere leeftyd wat voorkombaar is. Die doelwitte van die studie is om jong volwasse pasiënte se kennis vas te stel ten opsigte van: • hipertensie • die behandeling van hipertensie • die komplikasies van hipertensie. Die studie neem die vorm van ʼn beskrywende, verkennende ontwerp met ʼn kwantitatiewe benadering aan. Die navorsingsvraag bepaal die navorsingsontwerp of benaderring. In hierdie geval is ʼn breë oorsig nodig van die kennis van jong volwassenes by Kayamandi-kliniek oor die onderwerp aangaande hipertensie. Dit dien dan as basis vir verdere indringende studies rakende hierdie fenomeen. ʼn Ja/nee skaal is gebruik om data te versamel. Die vraelys is ontwerp op ʼn manier sodat die deelnemers dit kan verstaan. Die uitleg van die vraelys is eenvoudig en die vrae maklik. Die vraelys is geskryf in Engels,Xhosa en Afrikaans.Na die vertaling van die vraelys,is dit deur ʼn tweede person wat ook Xhosa magtig is nagegaan om die korrektheid van die vraelys te verseker. ʼn Tolk het gehelp met die vraelys ten tye van data-insamelling in die Xhosa- sprekende gemeenskap, waar taal ʼn moontlike probleem kon wees. Die Cronbach alpha- toets was gedoen om die betroubaarheid van die vraelys te toets. Ingeligte toestemming was verkry van elke deelnemer. Toestemming was verkry van die Universiteit deur middel van die Gesondheids Navorsings Etiese Kommitee (GNEK). Toestemming was ook verkry van die Direkteur: Departement van Gesondheid, Wes Kaap Provinsie en die owerhede van die Kaap Wynland streek. ʼn Statistiekus van die Universiteit van Stellenbosch was geraadpleeg aangaande die data analise. Data was geartikuleer in die vorm van frekwensies in tabelle en histogramme. Die Spearman-toets is gebruik om die korrelasie tussen variante vas te stel .10% van die deelnemers wat vir die loodprojek gebruik is, is van Cloetesville-kliniek. 21% van die deelnemers wat vir die hoofstudie gebruik is, is van die Kayamandi-kliniek , dus ʼn total van n=210 deelnemers. Die studie het bewys dat vir n=172 deelnemers wat aan die studie deelgeneem het, daar ʼn korrelasie tussen die komplikasies en die hipertensie toestand is, maar geen korrelasie met leefstylgewoontes is gevind nie. Statistiese assosiasies is bepaal deur gebruik te maak van die Spearman-toets op ʼn 95%-interval tussen verskeie variante. Die normale, beskrywende statistiese analise is voltooi. Die implikasie van die resultate van die studie, is dat hoë bloeddruk jonk en ouer mense affekteer. Aanbevelings dui op aanhoudende gesondheids promosies en voortdurende opvoeding wat jonk en ouer persone insluit.

M.A. (Psychology) / Please refer to full text to view abstract

Evidence suggests that the prevalence of certain non-communicable diseases, such as hypertension, is increasing rapidly, and that patients with these diseases are making significant demands on the health services of the nations in sub-Saharan Africa. However, these countries also face other health-related challenges such as communicable diseases and underdevelopmentrelated diseases. Developing countries like South Africa have limited resources, in terms of man power and financial capital, to address the challenges that they are facing. Non-communicable diseases cannot be ignored and since health care providers cannot meet the challenges, it is worthwhile to empower patients to be involved in the management of their conditions. Patient education is a tool that can be used to enable patients to manage their chronic conditions and thereby reduce the morbidity and mortality rates of these conditions. The aim of this study was to investigate the effect of a patient education intervention on participants’ levels of knowledge about hypertension and its therapy, beliefs about medicines and adherence to anti-hypertensive therapy. The intervention consisted of talks and discussions with all the participants as one group and as individuals. There was also written information given to the participants. Their levels of knowledge about hypertension and its therapy were measured using one-on-one interviews and self-administered questionnaires. Beliefs about medicines were measured using the Beliefs about Medicines Questionnaire (BMQ) whilst adherence levels were measured using pill counts, elf-reports and prescription refill records. The participants’ blood pressure readings and body mass indices were also recorded throughout the study. The parameters before and after the educational intervention were compared using statistical analyses. The participants’ levels of knowledge about hypertension and its therapy significantly increased whilst their beliefs about medicines were positively modified after the educational intervention. There were also increases, though not statistically significant, in the participants’ levels of adherence to anti-hypertensive therapy. Unexpectedly, the blood pressure readings and body mass indices increased significantly. The participants gave positive feedback regarding the educational intervention and indicated a desire for similar programmes to be run continuously. They also suggested that such programmes be implemented for other common chronic conditions such as asthma and diabetes. This study proved that patient education programmes can be implemented to modify patients’ levels of knowledge about their conditions and the therapy, beliefs about medicines and adherence to therapy. However, such programmes need to be conducted over a long period of time since changes involving behaviour take a long time.