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"Assessment of nurses Knowledge Regarding management of Hypertension in

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DOI: 10.9790/1959-0906050815

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IOSR Journal of Nursing and Health Science (IOSR-JNHS)
e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 9, Issue 6 Ser. V (Nov. – Dec. 2020), PP 08-15
www.iosrjournals.org

“Assessment of nurses Knowledge Regarding management of

Hypertension in National Heart Foundation Hospital & Research
Institute Mirpur- 2 , Dhaka Bangladesh”
Abul kalam
Rn Bsn MPH(Hospital Management)
Former Director, Royal Nursing and Midwifery College Gazipur.
Former CEO at Race Nursing Institute- Kapashia Gazipur.
Ex, Asset professor TMMC Nursing College, Board Bazar Gazipur..
Nursing Officer, Shaheed Ahsan Ullah Master General Hospital, Tongi Gazipur

Abstract: Nurses have a vital role in management of hypertension prevention of complications and promotion
of patient’s safety. A descriptive type of cross sectional study was carried out in National Heart foundation &
Research institute mirpur-2 Dhaka Bangladesh to assessment of nurses Knowledge Regarding management of
Hypertension. The study was conducted where 100 responded were interviewed. The aim of the present study
was to assess nurse’s knowledge, attitude, practice and performance concerning management of hypertensive
patients in hospital. None of the nurses had negative attitude towards given care for hypertensive patients. A
KAP questionnaire was designed to assess their knowledge, attitude and practice. An observation checklist was
designed to check their knowledge attitude and practice. Sample size was 105 out of 300. study population at
national Heart Foundation Hospital. and research institute Mirpur-2 Dhaka . Informed consent was taken by
the respondent.The result of the present study revealed that 80% of the respondents have excellent knowledge
about various aspects of hypertension where as 5% of the respondents have poor knowledge about management
of Hypertension. According to the findings, it can be concluded that the nurse need to be equipped with
knowledge on different aspects of management of hypertension including treatment and preventive measure. In
order to improving nurse’s knowledge on management of HTN some recommendation like in service training,
organize short course, seminar, symposium, and other suitable training can be initiated.
Materials and Methods: (10) It was a descriptive type of study with Cross Sectional.
Research design is the overall arrangement of linking the theoretical research problems to relevant and realistic
empirical research (Ghaur i & Gronhaug, 2005, p. 56). It is also useful for researcher to make rational choices
and prioritize the preferred method of collecting and analyzing research data. However, Sau nders et al (2007,
p. 131) describe the research design as a general plan that shows how the researcher answer the research
question or problem.The study was conducted at the national Heart Foundation Hospital and Research
institute, Mirpur-2 Dhaka 1216.
Results: In this study socio-demographic characteristics were age, gender, marital status, education,
occupation, living status family income, A total 105 respondent were included in this study of which 97% were
female & 2.9% were male (table-1) The mean age group of the study population was 2.0952 which ranging
from 0-85 years. Table 1shows that distribution of the age according to class interval age of the respondent are
categorized into (3) three groups as group 1 (0-15) years, group-2 (16-30) years group-3 (31-45) years. Table 1
shows that the represented the high of the study population was group-2 (n=77) and lowest of the group are
group 1(n=9) . This information is well depicted in the above table-1

Table-1 shows that, 97.1% of the respondents were female & only 2.9 % were female Table:2 found that the
mean age of the respondents were 38.74  0.883years with a range from 18-55 years. It is found from table
that 41.9%, 34.3, 18.1%, 3.8%, 1.9% of the respondents belonged to age group 41-50 years, 31-40 years, 21-
30 years, ≤ 20 years & 51-60years respectively.Table-3 tableshows that, majority 49.5%, were married ,40.0%,
were unmarried 8.6% were widow and only 1.9% were divorced respectively. table-4shows that, 53.3,
was Muslim, 23.8, was Hindu, 13.3%, were Hindu 7.6%were Christian, and 1.9% of the respondents
belonged to the religion , respectively.table shows that, majority 49.5, were diploma Nurse, 21.9, were
Msc/MPH , level, 20.0%, Hsc level , 6.7% were BSc Nurse and & 1.9% of the respondents belonged to the ssc
educational respectively.(table-5)Table-6 :The above table shows that, 40.0, were Private nurse , 35.2,
were Govt nurse, 22.9%, were student nurse 1.0% & 1.0% of the respondent were Ngo and others
respectively.table -7shows that, 53.3 respondent were lived at urban and 46.7% were lived at rural area
respectively.Table-8 :The above table found that majority respondent 54.3%, family member were 2 person,
25.7%, family member were 5-6 person, 10.5% family member were 7-8 person, & 9.5% respondent family
DOI: 10.9790/1959-0906050815 www.iosrjournals.org 8 | Page
 “Assessment of nurses Knowledge Regarding management of Hypertension in ..
member were 2 person respectively.Table 9 : (n=108) The above table shows that 39.0% respondent had good
knowledge and 61% had poor knowledge about the definition of Hypertension.Table 10 . (n=108): The above
Table found that 65.7% respondent were good knowledge & 34.3% respondent were poor knowledge about
types of Hypertension.
Table11 : Table reveals that 40.0 %, 23.8%, 20.0%, 16.2% of the respondents noticed that the causes of
hypertension were Smoking Stress, Sedentary Life style, & Obesity respectively. Table 12: Table reveals that
69.5 %, 13.3%, 12.4%, 2.9%, 1.9% of the respondents noticed that the preventive measure of Hypertension were
Maintain Sodium Level , Free from anxiety and tension, Avoid Tobacco, Jadda, Gul, Alcohol, Control Blood
pressure Level & Regular exercise respectively. Table13: (n=105) Table shows that, Most of (61.0%) the
respondent know the discharge care plan of Hypertension. 35.2 percent respondent did not know the discharge
care plan of hypertension pt, Table14: Distribution of the respondents by uncontrolled Hypertension can lead
(n=105) shows that, 77.1% respondent described that uncontrolled Hypertension control by avoid harmful drug
intake. Table 15 : (n=105) Table reveals that 55.2% respondents were replied that regular blood pressure
checkup is necessary and 44.8 percent were replied that not necessary. Table 16: (n=105).Table reveals
that77.1 %, were replied that reduction in salt intake, 15.2%, regular physical activity are necessary, 7.6%
were replied regarding to reduction of body weight regarding to lifestyle modification to reduce hypertension.
Table 17 : Distribution of the respondents byassociation between age group of the respondents & religion of the
2
respondents (n=105) P value obtained from Pearson Chi-square ( x ) test finds that P- value was 0.024which
was less than 0.05 that was statistically significant association between age group of the respondents &
religion of the respondents.
Table 18: Distribution of the respondents byassociation between age group of the respondents & family
2
members of the respondents(n=105) P value obtained from Pearson Chi-square ( x ) test, finds that P- value
was 0.002 which was less than 0.05 that was statistically highly significant association between age group of the
respondents & family member of the respondents.,Table19 : Distribution of the respondents byassociation
between age group of the respondents &Regular Blood pressure checkup is necessary of the respondents
2
(n=105) P value obtained from Pearson Chi-square ( x ) test,finds that P- value was 0.051 which was less than
0.05 that was statistically significant association between age group of the respondents &regular Blood
pressure checkup is necessary.,Table 20: Distribution of the respondents byassociation between family members
2
of the respondents & religion of the respondents (n=105) P value obtained from Pearson Chi-square ( x ) test,
Table finds that P- value was 0.000 which was less than 0.05 that was statistically significant association
between family members of the respondents & religion of the respondents. Table21 : Distribution of the
respondents byassociation between family members of the respondents & type of hypertension(n=105) P value
2
obtained from Pearson Chi-square ( x ) test, shows that P- value was 0.040 which was less than 0.05 that was
statistically significant association between family members of the respondents & type of hypertension. Table
22: Distribution of the respondents byassociation between family members of the respondents & Marital status
2
of the respondent (n=105) P value obtained from Pearson Chi-square ( x ) test, Table finds that P- value was
0.000 which was less than 0.05 that was statistically significant association between family members of the
respondents &marital status of the respondent. Table 23: Distribution of the respondents byassociation between
family members of the respondents & regular Blood pressure checkup is necessary (n=105) P value obtained
2
from Pearson Chi-square ( x ) test,finds that P- value was 0.030 which was less than 0.05 that was statistically
significant association between family members of the respondents &Regular Blood pressure checkup is
necessary. Table24 : Distribution of the respondents byassociation between Preventive measures of
2
Hypertension& Marital status of the respondent (n=105),P value obtained from Pearson Chi-square ( x )
testTable finds that P- value was 0.001 which was less than 0.05 that was statistically highly significant
association between Preventive measures of Hypertension&marital status of the respondent. Table 25:
Distribution of the respondents byassociation between Preventive measures of Hypertension& Occupational
2
status of the respondent (n=105) P value obtained from Pearson Chi-square ( x ) test, finds that P- value was
0.015 which was less than 0.05 that was statistically significant association between Preventive measures of
Hypertension&occupational status of the respondent.
Table26 : Distribution of the respondents byassociation between Preventive measures of Hypertension& group
age of the respondent (n=105) finds that P- value was 0.002 which was less than 0.05 that was statistically
highly significant association between Preventive measures of Hypertension&group age of the respondent.
Table 27: Distribution of the respondents byassociation between Preventive measures of Hypertension& family
2
members of the respondent (n=105) P value obtained from Pearson Chi-square ( x ) test finds that P- value

DOI: 10.9790/1959-0906050815 www.iosrjournals.org 9 | Page

 “Assessment of nurses Knowledge Regarding management of Hypertension in ..
was 0.004 which was less than 0.05 that was statistically highly significant association between Preventive
measures of Hypertension&family members of the respondent.
Table 28 : Distribution of the respondents byassociation between Preventive measures of Hypertension& Living
2
status of the respondent (n=105) P value obtained from Pearson Chi-square ( x ) test Table finds that P- value
was 0.023 which was less than 0.05 that was statistically significant association between Preventive measures of
Hypertension&Living status of the respondent.
Key Word: Hospital, inpatient, patient satisfaction.
----------------------------------------------------------------------------------------------------------------------------- ----------
Date of Submission: 29-11-2020 Date of acceptance: 14-12-2020
----------------------------------------------------------------------------------------------------------------------------- ----------

I. Introduction
Hypertension is a major contributor to the global disease burden. It poses an important public health
challenge to both economically developing and developed countries, including Asia.Hypertension is a common
clinical problem in the emergency in our population. Established hypertension is blood pressure above 95 th
centile regarding children’s age , gender, and body weight. Diastolic pressure are aimed at establishing blood
pressure levels, identifying secondary causes of hypertension and evaluating the possible cardiovascular risk
factors. Therapeutic intervention includes both lifestyle changes and pharmacologic therapy. The goal of the
therapy is to reduce blood pressure to levels lower than the 90 th percen6tile for both systolic and diastolic blood
pressure for similar, gender age and group. By reducing blood pressure to to normal range, long-term
cardiovascular morbidity, and mortality may be in disciplinary process, which includes regional experts to draw
up recommendations specifically directed toward the management of patients at the local level.
Non-fatal and fatal CVD events, including CHD and stroke, as well as renal diseases and all cause
mortality, increase progressively with higher levels of both SBP and DBP. However unawareness of elevated
BP and inadequate control of hypertension are frequent. Kastarinen et al (2000) found that 6.8% of hypertension
men aged 25-64 years were untreated and un ware of their hypertension , 9.4% were aware but untreated and
12.3% were treated with drugs while 71.5% of men were normotensive in 1997. The corresponding prevalence
in women were 2.9% , 5.8% 10.1% and 81.25 in 1997 during 1982-1997 thee proportion of subjects not aware
of their hypertension decreased consistently for both sexes.
The proportion in adult population having hypertension or taking antihypertensive medication varies
with (1) race, being higher in blacks, (32.4%) and lower in whites (23.3%) and Mexican Americans (22.6%), (2)
age because in the industrialized countries , systolic Bp Continues to rise throughout life, whereas diastolic BP
rises until age 55 to 60 years, and thus the greater increase in the prevalence of hypertension is mainly due to
systolic hypertension, 93) geographic patterns because hypertension is more prevalent in the southeastern
united states , (4) gender because hypertension is more prevalent in men (through menopause tends to abolish
this difference, and (5) socioeconomic status which is an indicator of life style attributes and inversely related to
the prevalence morbidity and mortality rates of hypertension(carretero & Oparil 2000).
The main focus of primary prevention of cardiovascular diseases. Although many studies have been
concluded worldwide only fes studies have been published on risk factors for poor control among hypertensive
patients in Sri Lanka. According to Heymann et al it has been suggested that patients knowledge on
hypertension and its management as well as physician counseling on a healthy lifestyle ans self-care have an
independent effect on hypertensive patients compliance with the recommended lifestyle behaviors. Meanwhile
factors associated with poor control of hypertension are modifiable through tailored, culturally appropriate
patient education and treatment strategies. Increasing awareness of hypertension and more effective treatment of
patients is

II. Material And Methods

Type of study: It was a descriptive type of study with Cross Sectional. Research design is the overall
arrangement of linking the theoretical research problems to relevant and realistic empirical research (Ghaur i &
Gronhaug, 2005, p. 56). It is also useful for researcher to make rational choices and prioritize the preferred
method of collecting and analyzing research data. However, Sau nders et al (2007, p. 131) describe the research
design as a general plan that shows how the researcher answer the research question or problem.
Research Period:One year 1st January 2011 to 31th December 2011 .
Study Population:The nurse who are agreed in this interview. The study population are 300 senior staff nurse
of National Heart foundation Hospital & Research institute Mirpur 2 Dhaka.

Inclusion Criteria
2. Willing to provide the answer to the interview.
3. the staff who has experience more than 03 years’ min relevant field
DOI: 10.9790/1959-0906050815 www.iosrjournals.org 10 | Page
 “Assessment of nurses Knowledge Regarding management of Hypertension in ..
Exclusion Criteria
1. the nurse who were not agreed or not interested in this study interview.
2. Below experience 01 year.
3. Staff who are leave sick.

Sample Size:105 staff Nurse ofnational Heart Foundation Hospital and Research institute, Mirpur-2
Dhaka 1216.
Sampling Method:The study population are 300 we and decide the sample size 100 with divided by the 3 and
then we done lottery from 1,2,3 and decide first (2) two within 3 first sample is 2 after then each next interval &
choice the hundred sample accordingly.
Data Collection instrument: a structured interview schedule was developed both open and close ended
questionnaire which used for collection of information. The questionnaire were prepared and pre tested on a
small number of respondent s in national Heart foundation Hospital and Research institute, Mirpur-2
Dhaka 1216. Other form are
- Using available information
- Observing
- Administering written questionnaires.

Data collection Procedure: before conducting of the study written permission from the authority of hospital
before collecting the relevant information the purpose of this study was descrived to the nurses. Data were
collected from the respondent through face to face interview using and open and close ended questionnaire. One
questionnaire is used for individual respondent.
Research Instruments:Questionnaire, pen, computer
5 points likert scales are used for satisfaction level measured.
Data analysis: after collected data were cleaned, edited, manually and then entered into computer. Questions
from interview guide were coded before data entry. Data entry was done using Epi Info software. Statistical
analysis was done both manual and using SPSS version 16.0 computerizing. Microsoft Excel & word.
Ethical Consideration
- Maintained all ethical issues regarding research, regarding data collection, maintain confidentiality of data
etc.
- Justice: Refers to the ethical obligation to treat each person in accordance with what is normally right &
proper.
- Privacy was maintained regarding their identity and their information

Limitation:
- time limitation to take a large sample size
- only 1 hospital was included in the study which does not reflect the situation
of whole city or nation.
- only outpatient department was considered in the study which may not reflect the service provided by
hospital as a whole.

Types of questions: Both close & open ended question& in form of Bengali & English.
Utilization of results: for future research reference and will benefit for human and SCHS authority.

Tab. 1. Distribution of Socio-Demographic Characteristics of Patients

s.no Sociodemographic factors Frequency (N=105)
1 Gender Male-03
Female- 102
2 Age ≤ 20 years- 4
21-30 years- 19
31-40 years- 36
41-50 years- 44
51-60years- 2
3 Marital status Married-52
Unmarried-42
Widow-09 Divorced 02
4 Religion Hindu-25
Muslim-56
Chraistian-14
Buddisht-08 others-02
5 Education Ssc level -02
Hsc level -21
Diploma -52

DOI: 10.9790/1959-0906050815 www.iosrjournals.org 11 | Page

 “Assessment of nurses Knowledge Regarding management of Hypertension in ..
Bsc Nursing-07
Msc/MPH-23
6 Occupation Occupation
Govt service-37
Private service-42
Student nurse-24
Ngo Nurse-01
Others 01
7 Living status Rural -49
urban- 56
8 family members Person-10
3-4Person-67
5-6 Person-27
7-8 Person-11

1.3 Rational and Justification

This study is designed to find out the senior staff nurses Knowledge Regarding Management of
hypertension of National Heart Foundation Research Institute and Hospital Mirpur 2 Dhaka.
Hypertension management is one of the more important tasks of the senior staff nurses in the hospital
as well as giving preventive care about the risk factor of hypertension. Effective management of hypertension
can reduce the risk of developing stroke, and will reduce further disability or even risk of death of the client &
helps them promotion of their illness restoration of health etc.
This study will provide base line information about the present level of knowledge regarding
management of hypertension among the nurses that will help them in future to design appropriate education
information program me for nurse’s in view to improve their knowledge & equipped them necessary skills
consequently nurses would be able to impact information & creating awareness among the people about
preventive & treatment of hypertension.
Adults over 18 years should have their blood pressure checked regularly. Lifestyle changes may help
to control blood pressure.

III. Results &Discussion

DISTRIBUTION OF THE RESPONDENTS BY

RELIGION (N Hindu
=105)
25
12%

Total Muslim
105 56
50% 27%

Others
Buddhist
Christian
2 8 14
1% 4% 6%

the above table shows that, 53.3, was Muslim, 23.8, was Hindu, 13.3%, were Hindu 7.6%were Christian,
and 1.9% of the respondents belonged to the religion , respectively.

DOI: 10.9790/1959-0906050815 www.iosrjournals.org 12 | Page

 “Assessment of nurses Knowledge Regarding management of Hypertension in ..

The above Table found that 65.7% respondent were good knowledge & 34.3% respondent were poor
knowledge about types of Hypertension.

Table 17 : Distribution of the respondents byassociation between age group of the respondents & religion
of the respondents (n=105)
Age Group Religion of the respondent Chi-square P-value
Islam Hindu Buddish Christian Others Total 2
(x )
≤ 20 Yrs 2 2 0 0 0 4
21-30 Yrs 14 5 0 0 0 19
31-40 Yrs 17 12 0 7 0 36 26.199 0.051
41-50 Yrs 21 6 8 7 2 44
51-60 Yrs 2 0 0 0 0 2
Total 56 25 8 14 2 105
2
P value obtained from Pearson Chi-square ( x ) test

Table finds that P- value was 0.024which was less than 0.05 that was statistically significant association
between age group of the respondents & religion of the respondents.

Table 18: Distribution of the respondents byassociation between age group of the respondents & family
members of the respondents (n=105)
Age Group Religion of the respondent Chi-square P-value
2 person 3-4 person 5-6 person 7-8 Total 2
person (x )
≤ 20 Yrs 1 2 1 0 4
21-30 Yrs 7 9 2 1 19
31-40 Yrs 2 22 7 5 36 31.750 0.002
41-50 Yrs 0 24 15 5 44
51-60 Yrs 0 0 2 0 2
Total 10 57 27 11 105
2
P value obtained from Pearson Chi-square ( x ) test

Table finds that P- value was 0.002 which was less than 0.05 that was statistically highly significant association
between age group of the respondents & family member of the respondents.

DOI: 10.9790/1959-0906050815 www.iosrjournals.org 13 | Page

 “Assessment of nurses Knowledge Regarding management of Hypertension in ..
Table19 : Distribution of the respondents byassociation between age group of the respondents &Regular
Blood pressure checkup is necessary of the respondents (n=105)
Age Group Regular Blood pressure checkup is necessary Chi-square P-value
2
(x )
Yes No Total
≤ 20 Yrs 0 4 4
21-30 Yrs 13 6 19
31-40 Yrs 16 20 36
41-50 Yrs 18 26 44 9.429 0.051
51-60 Yrs 0 2 2
Total 47 58 105
2
P value obtained from Pearson Chi-square ( x ) test

Table finds that P- value was 0.051 which was less than 0.05 that was statistically significant association
between age group of the respondents &regular Blood pressure checkup is necessary.

association between family members of

the respondents & regular Blood pressure
checkup is necessary (n=105)
150
100
50 P-value
0

Regular Blood pressure checkup is…

0-50 50-100 100-150

2
P value obtained from Pearson Chi-square ( x ) test

Table finds that P- value was 0.030 which was less than 0.05 that was statistically significant association
between family members of the respondents &Regular Blood pressure checkup is necessary.

Table 28 : Distribution of the respondents byassociation between Preventive measures of Hypertension&

Living status of the respondent (n=105)
Preventive measures of Hypertension Living status of the respondent Chi-square P-value
2
(x )
Rural Urban Total
Control BP level 2 1 3
Maintain Sodium level 32 40 73
Avoid tobacco, jadda, Gul, alcohol 2 11 13
Free from tension and anxiety 11 3 14 11.391 0.023
Regular exercise 1 1 2

Total 49 56 105
2
P value obtained from Pearson Chi-square ( x ) test

Table finds that P- value was 0.023 which was less than 0.05 that was statistically significant association
between Preventive measures of Hypertension& Living status of the respondent.

Conclusion (11 Bold)Patients with hypertension had inadequate knowledge on the disease, its
complications and management strategies. Knowledge on salt intake, tobacco Consumption, body weight
maintenance and fruits and vegetable consumptions was particularly low. Health care providers need to
DOI: 10.9790/1959-0906050815 www.iosrjournals.org 14 | Page
 “Assessment of nurses Knowledge Regarding management of Hypertension in ..
deliver appropriate knowledge to patients with hypertension on control measures, adverse consequences
of Hypertension and management strategies.

Limitation:
 As study areas were selected purposively & the study was conducted only admitted patient, the results may
not be generalized overall scenario of patient’s satisfaction in Bangladesh.
 This academic study was conducted with shortage of time and shortage of financial support and location.

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Abul kalam. “Assessment of nurses Knowledge Regarding management of Hypertension in

National Heart Foundation Hospital & Research Institute Mirpur- 2 , Dhaka Bangladesh.” IOSR
Journal of Nursing and Health Science (IOSR-JNHS), 9(6), 2020, pp. 08-15.

DOI: 10.9790/1959-0906050815 www.iosrjournals.org 15 | Page

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