Abstract

This study looks at the barriers/challenges faced by nurses in the management of hypertension at the regional hospital Buea. Hypertension is a ‘silent killer’ and a threat to human life. This research project challenges faced by nurses in the management of hypertension in the REGIONAL HOSPITAL BUEA, aimed at determining nurses’ knowledge of hypertension and the challenges they face when dealing with hypertensive patients.

The research was a descriptive study design that made use of a structured questionnaire in which data was collected with the sample size of 20 Nurses. The information collected was later used by the researcher to analyse and obtained results that were represented on, bar charts and pie charts.  Of the 20 participants, 75 %( 15) were female and 25 %( 5) were male with the majority 17(85%) have age between 30 and 40.

A good majority of the participants had the basic knowledge on hypertension and the factors causing hypertension with a small percentage having doubts the challenges identified were grouped into the pharmacological and non-pharmacological challenges with the greatest problems faced with the management of hypertension coming from the pharmacological sector. More studies should therefore be carried out on this topic and with a larger sample size to better evaluate these challenges.

CHAPTER ONE

INTRODUCTION

1.1 Introduction/background

Hypertension is one of the most common chronic diseases and one of the most critical health problems causing death as a single contributor in developed and developing countries (Bromfield, S 2013). In most cases of hypertension, the primary cause was not detected, and these cases are known as essential hypertension. Essential hypertension is not curable, but with medication, the blood pressure (BP) can be controlled to that of the physiological level. Nevertheless, as hypertension itself usually does not present with symptoms, it can remain undiagnosed for a long time. Hypertension is also known as a “silent killer” disease, which is often diagnosed incidentally.

If a hypertensive patient remains untreated, it can lead to serious life-threatening complications of vital organs such as the brain, eye, heart, and kidney, resulting in death or serious patient disability (Ezzati M et al., 2002). It is believed to be one of the main risk factors for peripheral vascular, cerebrovascular and cardiovascular diseases (CVD) which include stroke, coronary disease, peripheral artery disease, renal disease and heart failure (Iadecola, C et al., 2008). Obesity, sedentary behaviours, and other individual risks for one of these cardiovascular illnesses could be increased by two to three times due to hypertension (Mensah G.A.et al., 2002).

The cost of antihypertensive medicine is very high and takes up a large and rising share of healthcare resources (Arboix, Aet al.,2015). A study conducted in Douala- Cameroon to check the burden of HTN and related risk factors in urban sub-Saharan Africa, revealed a prevalence of 20.5% (Cappuccio, FP et al.,2004).  In Malaysia, hypertension is quite prevalent among adult and elderly population; the age-adjusted prevalence for 2007–2011 was 42.0% (CI: 40.9–43.2), which was higher in males or overweight and obese people (Abdul-Razak S et al.,2016). Its care is inadequate because the detection and treatment of hypertension are less than satisfactory (Warren, TY et al., 2015). High BP detection and control are seriously vital for decreasing the risk of strokes and heart attacks (Akil, Let al., 2011).

The prevalence of hypertension has not declined, although the enhancement in BP control is encouraging. Nowadays, continuing health education in Cameroon through mass media is the results of good basic understanding on hypertension in the general population, while the limited detailed understanding indicates the urge to develop more specific health education programs. Moreover, limited motivation to implement healthy lifestyles indicates the urge to further develop an atmosphere conducive to healthy lifestyles (Thorpe K.E.et al., 2005).

There are some barriers to hypertension control, such as physician turn over, non-adherence to a fix protocol or guideline, prescribing antihypertensive drugs from one category or choosing two drugs from the same category as beta-blockers, the side effects of combining several drugs inappropriately such as bradycardia, the cost of medications, and not having a fixed physician (Eshkoor, SA et al., 2016). Besides, prescribed medication regimen for most hypertensive patients is not based on a standard protocol, thus the regimen is not effective for hypertension management and resulting in side effects and noncompliance (. Kearney, P et al., 2005).

It is necessary to focus more on education about hypertension and its management for physician and other related health care providers. This problem ought to be highlighted as the prevalence of hypertension keeps increasing and will continue to worsen unless suitable preventive measures are implemented (MufundaJ et al., 2006).

Despite all these measures to reduce the prevalence of hypertension in our recourses poor settings, very little study has been carried out about the challenges nurses face in the management of these patients. It is based on this background that this study seeks to identify the challenges faced by nurses in the management of hypertension in the regional hospital Buea, in a bit to improve patient management by overcoming these challenges.

1.2 Problem statement

 It is predicted that by 2025, the prevalence of hypertension (HTN) will increase by 60% to a total of 1.56 billion worldwide, suggesting that HTN remains a major public health problem. HTN in Sub-Saharan Africa (SSA) has also been on the rise with reports indicating higher values in urban settings compared to rural settings (Mufunda, Jet al., 2006).

The prevalence of HTN in SSA ranges between 14.5% in rural areas, 32.9% in semi-urban Ghana and 40.1% in urban South Africa  Likewise, adequate blood pressure (BP) control has been on the decline, ranging between 1.7% in rural Ghana, 4% in urban slum dwellers in Nigeria and 21.5% in urban Kenya (Cappuccio, F et al., 2006).  In Cameroon, the prevalence of HTN spans from 5.7% in rural settings through 21.9% in semiurban to 47.5% in an urban milieu with a national average survey of 31.0% (Atashili J et al., 2010). Despite the relatively better BP control in urban over rural settings, levels of adequate BP control is as low as 2% to 27.5% (in men) and 38.7% (in women) as reported in urban settings, (Mbanya, Jet al., 2006).

1.3 Research questions

1. What are the barriers faced by nurses in the non-pharmaceutical management of hypertension?
2. What are the barriers faced by nurses in the pharmaceutical management of hypertension?
3. What are the measures used by nurses to overcome these barriers?
4. What are the nurses’ levels of understanding of hypertension?

1.4 Objectives

1.4.1 General objective

1. To identify the various barriers faced by nurses in the management of Hypertension in the Buea Regional Hospital.

1.4.2 Specific objectives

1. Identify nurses’ knowledge of hypertension.
2. Identify barriers associated with pharmaceutical management of Hypertension.
3. Identify barriers associated with non-pharmaceutical management of hypertension.
4. Identify measures used to overcome these barriers.

the barriers/challenges faced by nurses in the management of hypertension at the regional hospital Buea

the barriers/challenges faced by nurses in the management of hypertension at the regional hospital Buea

the barriers/challenges faced by nurses in the management of hypertension at the regional hospital Buea

the barriers/challenges faced by nurses in the management of hypertension at the regional hospital Buea

the barriers/challenges faced by nurses in the management of hypertension at the regional hospital Buea