Health Behaviors Of Patients Research Articles

Understanding attitudes, concerns, and health behaviors of patients with inflammatory bowel disease during the coronavirus disease 2019 pandemic.

Background and AimThe coronavirus disease 2019 (COVID‐19) pandemic has led to a rapid shift in care delivery models for patients with inflammatory bowel disease (IBD); however, little is known about patient perceptions during this period. We aimed to prospectively evaluate the attitudes, concerns, and health behavior of IBD patients during COVID‐19.MethodsAn online survey was sent to patients from a tertiary IBD Service. The survey included demographic information and questions about the impact of COVID‐19, levels of concern caused by COVID‐19, perceived risk of IBD medications, medication cessation, and care delivery preferences.ResultsOf 97 respondents (39%), 95 (98%) reported concern about the impact of COVID‐19 on their health, and 43% felt their risk of contracting COVID‐19 was above average; 62% reported concern about medication‐induced COVID‐19 risk, and 11% stopped medications because of COVID‐19. Patients considered all medications to increase the risk of COVID‐19 susceptibility and severity; 45% preferred telehealth while 16% preferred face‐to‐face clinic reviews. Preference for IBD monitoring tools in decreasing order was blood testing, stool collection, gastrointestinal ultrasound, magnetic resonance enterography, and then colonoscopy.ConclusionsPatients with IBD are demonstrated to experience concern related to their diagnosis and medications. The insights provided by the survey are informative for a possible “second‐wave” of COVID‐19 and routine care, including acceptance of telemedicine, preference for non‐invasive investigations, and a need for dissemination of information and education.

Improving health behaviors in patients with peripheral arterial disease – A pilot study of supported self-management

This pilot study reports the feasibility of a future randomized controlled trial (RCT) investigating the effect of supported self-management through low-intensity psychological intervention in patients with peripheral arterial disease (PAD) resulting in claudication. The study protocol, measurement instrument, data collection, and analysis were evaluated. Clinical outcome measures include depression and anxiety scores, smoking cessation, activity (step count), weight, and quality of life. Both Quantitative and Qualitative data were collected to evaluate participant experience and the clinical impact of a supported self-management intervention delivered in a routine clinical setting. Participants received an initial one to one assessment with a health psychologist. Demographic data and baseline clinical outcome measures were recorded. These included Hospital Anxiety and Depression Scale score (HADS), health-related quality of life questionnaire (EQ-5D-3L), number of cigarettes smoked daily, weight/BMI, and daily step count. Participants each received an activity tracker to record daily step count and were followed up weekly to provide psychological input, including goal setting, overcoming barriers, and preventing relapse. Quantitative data collection was scheduled at baseline, 3 and 6 months (final follow-up). At the final follow-up, participants provided qualitative feedback reflecting upon their experience of the intervention and its impact. Descriptive statistical analysis and simple paired samples t-test were employed in data evaluation. The sample size was small (n=30). Twenty-three participants were followed up to 6 months. Depression scores improved with statistical significance from baseline to 6-month follow-up. Eight participants stopped smoking (47% reduction); a further 9 greatly reduced their intake. A borderline statistically significant increase of daily step count was achieved between baseline and 6-month follow-up. In addition, positive weight loss trends were observed in a predominantly obese or overweight cohort. The qualitative feedback highlighted participants understood and embraced the information delivered regarding the importance of health behavior change. Participants were able to link tailored action plans with what mattered to them with the help of the Health Psychologist. This study embraces the contemporary ideology of enabling self-management of long-term conditions to improve clinical outcomes. As a pilot study, we have shown that an expanded, randomized controlled trial is both safe and feasible. A positive trend in clinical outcomes suggests this patient group may benefit from supported self-management through low-intensity psychological intervention, where other forms of early intervention have historically faltered.

The Impact of COVID-19 on the State of Clinical and Laboratory Research Globally in Transplantation in May 2020.

The Impact of COVID-19 on the State of Clinical and Laboratory Research Globally in Transplantation in May 2020.

Influence of Affect on Physical Activity: An Integrative Review.

Affective states, such as feelings of anger and excitement, are linked to health outcomes and behaviors. The benefits of physical activity for individual affect is known; however, how affect influences physical activity participation is less understood. Using Whittemore and Knafl's framework, this integrative review examines the influence of affect on adult physical activity. using six databases, 19 articles published between 1997 and 2019. Themes found include support for the influence of positive affect on increased physical activity, a temporal aspect of affect, a variety of measurement tools, and varying uses of theoretical frameworks across studies. Advanced practice nurses and registered nurses may improve patient health behaviors, such as physical activity, by incorporating affect-focused assessments. Review findings support consideration of affect in physical activity counseling. Further research using theory-driven methods and consistent affect assessments is needed to test the complex relationship between affect and physical activity.

Implications of COVID-19 for HIV Research: data sources, indicators and longitudinal analyses.

Implications of COVID-19 for HIV Research: data sources, indicators and longitudinal analyses.

The Impact of the COVID-19 Pandemic on the Health and Coping Behaviors of Patients With Treatment-Resistant Depression

The COVID-19 pandemic has had a disastrous impact globally. For the general public and for people with mental illnesses, this pandemic may cause mental/physical stress and major life impacts. This study was designed to explore the related changes in daily life and impacts on the well-being of a group of patients with chronic treatment-resistant depression (TRD) during the COVID-19 pandemic. This study was a part of a long-term, follow-up study of a cohort of patients with TRD collected in 2018. All of the subjects who were diagnosed with major depression and fit the inclusion criteria were referred by the psychiatrists from two teaching hospitals. Structured interviews were used to collect data on physical and psychological changes during the pandemic period between January and May 2020. The researchers organized the key points by recording or note taking. Thematic analysis was used to summarize and classify themes and units. The 116 respondents revealed that the COVID-19 pandemic affected their health in the biological, psychological, and social dimensions. The three emerging themes included: The threatening of homogeneity in the whole person's health, the interaction between bio-psycho-social aspects, and positive growth of individuals with TRD. Although the participants had confidence in the prevention strategies of the government related to COVID-19, they expressed feelings of distress and restlessness with regard to COVID-19-related news reports. The COVID-19 pandemic has affected the health of patients with TRD in both positive and negative ways. As the goal of government preventive strategies is to protect and promote public health, regular attention should be paid to the negative effects of long-term exposure to pandemic-related news on this vulnerable population.

Factors Associated With Oral Health Status and Oral Hygiene Behavior in Patients With Stroke

Studies have shown that oral health is closely related to systemic diseases. Poor oral hygiene may lead to dental caries and periodontal disease and also increase the risk of cardiovascular disease. Patients with stroke have a possibility of recurrence, and good oral health is expected to benefit their general health. Nevertheless, nursing research exploring the oral health and oral hygiene behaviors of stroke patients has been rare. To explore the factors significantly associated with oral health status and oral hygiene behaviors in patients with stroke. A cross-sectional research design with convenient sampling was used. Information on health promoting behaviors and oral health status was collected in a teaching hospital in southern Taiwan. A multivariate linear regression model was applied to explore the factors associated with oral health status in patients with stroke. One hundred and eight-five patients with stroke were enrolled in this study. The average number of real teeth was 11.3 and the average score for oral health status was 4. The univariate analysis showed that being 65 years of age or older, having an education level below primary school, having a lower Barthel index score, having a higher modified Rankin scale score, not brushing and flossing, not having a regular tooth cleaning, having a lower of health promotion score, and having insufficient water intake levels were all associated with a worse oral health status. The stepwise regression analysis showed that factors affecting oral health status include health promotion behaviors, age, tooth brushing, and water intake, which, together, accounted for 28.5% of the total variance. The findings indicate that oral health status, oral hygiene behaviors, and health promoting behaviors are inadequate among patients with stroke. Clinicians should promote health-related behaviors early to their patients with stroke, specifically in terms of implementing proper oral hygiene behaviors in daily routine care.

A Role-Playing Activity for Medical Students Demonstrates Economic Factors Affecting Health in Underprivileged Communities.

BackgroundInnovative teaching-learning strategies are necessary to promote community orientation and foster awareness of the social determinants of health among millennial learners in the health professions.MethodsThe authors designed a role-playing simulation activity that aims to highlight the multidimensional nature of health and develop in students an appreciation of the day-to-day experiences of underserved populations. The current investigation aimed to evaluate the utility of the role-playing activity and guided reflection in terms of the students’ appreciation of economic factors that affect health and health-seeking behavior of patients and their recognition of the role of healthcare professionals with respect to issues related to poverty and health. Thematic analyses of the insights and observations of the students immediately after the activity and the anonymized reflection papers were done to identify recurring ideas that made an impression on them.ResultsThe students were able to identify that in a setting with limited employment opportunities and low-income potential, the residents prioritized food and shelter over everything else. They also chose cheaper products over healthier options. Practically everyone forewent out-of-pocket healthcare expenditure in order to minimize its disruptive consequences. In these settings, the students highlighted the role of society and government in the provision of services and in community development. The students also emphasized the necessity for competition among a number of providers of goods and services to reduce prices. When asked if healthcare professionals are contributing to the widening gap between rich and poor, 70% agreed, 9% disagreed, 14% did not give a direct answer, and 7% said that healthcare professionals contributed in some ways and alleviated in other ways. The most commonly cited behavior that contribute to this disparity are the decision to seek highly specialized training, the congregation of practitioners in highly urbanized centers, and inattention to the economic difficulties of most patients. Those who disagreed with the statement cited systemic problems as the driving force that widens the disparity. In particular, these students cited the commodification of healthcare and related services, inappropriate policies, and insufficient funding specifically for services and health human resources.ConclusionThe evolving landscape in healthcare financing requires more preparation among our medical students and trainees. Innovative strategies such as role-playing activities and guided reflection are useful in demonstrating economic factors that influence health and promote better understanding of externalities that shape the health status of individuals and communities.

Training physicians in motivational communication to improve behaviour change counselling competency: A behavioural medicine approach to NCD prevention and management

Abstract Background Despite the importance of changing health behaviours in the context of preventing and managing non-communicable chronic diseases (NCD's), physician use of evidence-based behaviour change counselling (BCC) is low, and BCC skills competency is generally poor. Motivational communication (MC) is a patient-centred, evidence-based BCC approach used by healthcare providers, designed to increase patient motivation to adopt a healthy lifestyle. MC-based approaches improved a range of health behaviours (smoking, diet, physical activity) in patients with NCDs, leading to increased demand for physician training. Despite the widespread dissemination of training programs, data on their efficacy in achieving competency among physicians is limited. This is likely due to a lack of consensus on the core communication competencies to be achieved, and in the absence of acceptable, valid and reliable tools to measure skill acquisition. Results Using an integrated knowledge translation (iKT) approach that engaged 199 international physicians, behaviour change experts and health administrators, we have identified 11 core evidence-based communication competencies that physicians should acquire in the context of NCD prevention/management. They have been incorporated into a basic 4 hr face-to-face MC training program called “LEARN THE BASICs”. To assess MC competency, we have also developed a reliable, engaging, efficient, 'user-friendly' case-based digital assessment tool called the MC-Competency Assessment Test (MC-CAT). Conclusions Strategies for optimizing and tailoring this program, including finding the most cost-effective training dose, the impact of supplemental training components (e.g., in person vs. digital coaching; booster sessions), and delivery modes (e.g., face-to-face vs digital/online), will be discussed in the context of optimizing implementation success.

LITERATURE REVIEW: EFFECTIVENESS OF CARDIAC REHABILITATION IN PATIENTS WITH CORONARY HEART DISEASE

Background: Cardiac rehabilitation is an evidence-based intervention that includes physical exercise, health education, and modification of health behavior in patients with cardiovascular disease. Cardiac rehabilitation is considered as secondary prevention after acute coronary syndrome and improves treatment outcomes in patients with coronary heart disease. This literature review aimed to evaluate the effectiveness of cardiac rehabilitation in coronary heart disease patients. Methods: This present study was a literature review discussing cardiac rehabilitation for coronary heart disease patients. Results: The result showed that the functional capacity of the CR group was more increased compared to non-CR (p <0.001; α <0.05), left ventricular ejection fraction (LVEF) significantly increased in the CR group (p < 0.05; α <0.05), the medical cost of CR group was lower significantly (p=0.042; α <0.05), and the risk of recurrence rate was significantly lower in CR group (p=0.004; α <0.05). Conclusions: Cardiac rehabilitation is known to increase functional capacity, increase left ventricular ejection fraction (LVEF), reduce medical costs, and reduce the recurrence rate of patients with CHD.

Factors influencing physical activity in patients with colorectal cancer.

Physical activity (PA) is a modifiable health behaviour in patients with colorectal cancer (CRC). Knowing the possible predictors of PA will contribute to producing physical and psychological benefits for CRC patients. To investigate the factors that influence PA in patients with CRC. This cross-sectional study was conducted with 47 participants with CRC. Demographic and clinical characteristics, neuropathic pain (Douleur Neuropathique 4 (DN4)), peripheral muscle strength (knee extensor and flexor, hip extensor and flexor, and ankle dorsiflexor muscle strength), balance (Balance Master System (BMS) and Berg Balance Scale (BBS)), fatigue (Brief Fatigue Inventory (BFI)), PA (International PA Questionnaire Short Form (IPAQ-SF)), and quality of life (36-item Short Form Health Survey (SF-36)) were evaluated. Multiple linear regression analysis was used to determine the variables that have the greatest influence on PA. IPAQ-SF score had moderate correlations with knee extensor muscle strength (r = 0.310, p = 0.034), BBS (r = 0.361, p = 0.013), and limit of stability test (movement velocity) score (r = 0.385, p = 0.008), BFI- severity of fatigue (r = - 0.488, p = 0.001), impact of fatigue on daily functioning (r = - 0.421, p = 0.003), and the SF-36 sub-parameters (role limitations due to physical health problems, physical functioning, general health perceptions and vitality) (p < 0.05). Role limitations due to physical problems, knee extensor muscle strength, and severity of fatigue had the greatest influence on PA in patients with CRC with explaining 43% of the variance in PA. This study suggests that quality of life, knee extensor muscle strength, and fatigue have the greatest influence on PA in patients with CRC.

Changing the Health Behavior of Patients With Cardiovascular Disease Through an Electronic Health Intervention in Three Different Countries: Cost-Effectiveness Study in the Do Cardiac Health: Advanced New Generation Ecosystem (Do CHANGE) 2 Randomized Controlled Trial.

BackgroundDuring the last few decades, preventing the development of cardiovascular disease has become a mainstay for reducing cardiovascular morbidity and mortality. It has been suggested that interventions should focus more on committed approaches of self-care, such as electronic health techniques.ObjectiveThis study aimed to provide evidence to understand the financial consequences of implementing the “Do Cardiac Health: Advanced New Generation Ecosystem” (Do CHANGE 2) intervention, which was evaluated in a multisite randomized controlled trial to change the health behavior of patients with cardiovascular disease.MethodsThe cost-effectiveness analysis of the Do CHANGE 2 intervention was performed with the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing tool, based on a Markov model of five health states. The following two types of costs were considered for both study groups: (1) health care costs (ie, costs associated with the time spent by health care professionals on service provision, including consultations, and associated unplanned hospitalizations, etc) and (2) societal costs (ie, costs attributed to the time spent by patients and informal caregivers on care activities).ResultsThe Do CHANGE 2 intervention was less costly in Spain (incremental cost was −€2514.90) and more costly in the Netherlands and Taiwan (incremental costs were €1373.59 and €1062.54, respectively). Compared with treatment as usual, the effectiveness of the Do CHANGE 2 program in terms of an increase in quality-adjusted life-year gains was slightly higher in the Netherlands and lower in Spain and Taiwan.ConclusionsIn general, we found that the incremental cost-effectiveness ratio strongly varied depending on the country where the intervention was applied. The Do CHANGE 2 intervention showed a positive cost-effectiveness ratio only when implemented in Spain, indicating that it saved financial costs in relation to the effect of the intervention.Trial RegistrationClinicalTrials.gov NCT03178305; https://clinicaltrials.gov/ct2/show/NCT03178305

Physical activity of patients with a primary open angle glaucoma.

To assess physical activity (PA) including its intensity in primary open angle glaucoma (POAG). PA was characterized by the use of questionnaires: Seven-Day Physical Activity Recall and Historical Leisure Activity Questionnaire. A questionnaire of 36 questions, developed by the authors, was used to assess the level of knowledge about glaucoma. The study was conducted among 625 adults. The study group comprised 312 POAG patients aged over 40y, including 238 women (76%) and 74 men (24%). The control group consisted of 313 adults (>40 years old), including 202 (65%) women and 111 men (35%). The duration of current PA with an intensity of 4 metabolic equivalents (METs) was significantly shorter among people with POAG. PA in the past was significantly lower among people from the study group, regardless of gender. The level of glaucoma knowledge in patients with POAG was poor and significantly lower in men. Regular PA is an important and underestimated factor predisposing to the progression of POAG. There is a necessity to undertake educational and preventive actions with a view to modify the health behavior of glaucoma patients.

Effectiveness of an Instructional Program Concerning Non-Pharmacological Guideline on Controlling Essential Hypertension among Patients at AL-Sader Hospital in AL-Najaf AL-Ashraf City

Objective: The aims of present study to detect the effectiveness of instruction program of non-pharmacological guideline on blood pressure and laboratory test.&#x0D; &#x0D; Methodology: A pre-experimental study was conducted in Al-Sader Teaching Hospital from 8th of September 2019 to 25th of May 2020, in order to find out the effectiveness of instruction program concerning non-pharmacological guideline on controlling essential hypertension among patients. A non- probability (purposive sample) of 50 patients with essential hypertension is selected. Those patients are already diagnosed with Essential Hypertension and had already used the medication and they visited the hospitals for treatment or follow-up or both. A questionnaire is constructed to assess the effectiveness of the instruction program for controlling essential hypertension which consist of four part&#x0D; Part one: It is concerned with the patients’ socio-demographic data which include (gender, age, level of education, marital status, economic status, and occupation)&#x0D; Part two: Consist of patient health behavior which as exercise, weight, height and assessing of BP. &#x0D; Part three: included list of Laboratory test&#x0D; Part four: deals two domain related to patient's knowledge about hypertension which as 15 items and Second domain related to DASH regimen which as 13 items.&#x0D; The validity of the questionnaire and the instructional program had been achieved by 10 panel of experts, the descriptive and inferential statistics was used to data analysis of the results.&#x0D; Results: The results of the study indicated that the stage of hypertension according to category of hypertension was 44% stage 3 the pre-test and their hypertension was improved in the post-test where become 26% prehypertension, and 22% norm tension.&#x0D; Recommendations: The study recommended that the instructional guideline (DASH) should be used and applied to all patients' to health institutions with essential hypertension by the Ministry of Health and health care centers.

Systematic review of the effect of training interventions on the skills of health professionals in promoting health behaviour, with meta-analysis of subsequent effects on patient health behaviours

BackgroundWe aimed to identify, synthesise and evaluate randomised control trial evidence on the effects of healthcare professional training on the delivery quality of health behaviour change interventions and, subsequently, on patient health behaviours.MethodsSystematic review with narrative synthesis of effects on delivery quality and meta-analysis of health behaviour outcomes. We searched: Medline, EMBASE, PsychInfo, AMED, CINAHL Plus and the Cochrane Central Register of Control Trials up to March 2019. Studies were included if they were in English and included intervention delivery quality as an outcome. The systematic review was registered on PROSPERO (registration: CRD42019124502).ResultsTwelve-studies were identified as suitable for inclusion. All studies were judged as being high risk of bias with respect to training quality outcomes. However with respect to behavioural outcomes, only two of the six studies included in the meta-analysis had a high risk and four had some concerns. Educational elements (e.g. presentations) were used in all studies and nine included additional practical learning tasks. In eight studies reporting delivery quality, 54% of healthcare professional communication outcomes and 55% of content delivery outcomes improved in the intervention arm compared to controls. Training that included both educational and practical elements tended to be more effective. Meta-analysis of patient health behavioural outcomes in six-studies found significant improvements (Standardised mean difference (SMD): 0.20, 95% confidence interval: 0.11 to 0.28, P < 0.0001, I2 = 0%). No significant difference was found between short (≤6-months) and long-term (> 6-months) outcomes (SMD: 0.25 vs 0.15; P = 0.31).ConclusionsDelivery quality of health behaviour change interventions appears to improve following training and consequently to improve health behaviours. Future studies should develop more concise /integrated measures of delivery quality and develop optimal methods of training delivery.

Perspectives to social media usage of depressed patients and caregivers affecting to change the health behavior of patients in terms of information and perceived privacy risks

It has been confirmed that the use of social media (SM) can affect the mental health of users. However, there is no explanation for its impact on health behavior. This study focuses on the perspectives of depressed patients and caregivers on social media usage and how it can change their health behavior. A questionnaire designed according to the framework of the I-Change Model (ICM) is used to collect data from a sample group. This group consists of 214 patients diagnosed with major depressive disorders, and 110 caregivers. The data is used to analyze causal relationships with the help of structural equation modeling. The results showed that from the patient's perspective it is essential to be aware of the content and volume of social media usage. An awareness of the perceived risk to privacy is also essentially a motivating factor in patients' decisions to use social media. The views of caregivers suggest that content valence has an essential role to play in their use of social media. After viewing content on social media patients change their behavior. The perceived privacy risk also plays a critical role in patients' decisions to use social media.

Factors that Predict Hospital Pharmacy Practice in Vietnam

Background: Hospital pharmacy practice has emerged as a prerequisite to improving the health behaviors of patients given that adhering to this requirement enhances health care outcomes. Correspondingly, this study determined the factors that predict the aforementioned practice in Southern Vietnam. Methods: This cross-sectional study was conducted from April to July 2019 in 35 hospitals located in Southern Vietnam. Multiple linear regression was performed to investigate the factors that predict hospital pharmacy practice (total score based on Basel Statement-driven evaluation). The factors were classified under managerial competency, work-related quality of life, and hospital characteristics (independent variables). Results: The association between hospital pharmacy practice and the independent variables was determined through the following equation: total score in the Basel Statement-based assessment = –33.916 + 9.056 × strategic management + 7.326 × job and career satisfaction + 0.798 × number of hospital beds. No statistically significant associations were found between hospital pharmacy practice and hospital location, hospital level, type of hospital, age, gender, and other issues related to managerial competency and quality of work life. Conclusion: The competence of pharmacy department heads in strategic management, the job and career satisfaction of hospital pharmacists, and the number of beds in hospitals were significant predictors of hospital pharmacy practice.

Modified diabetes oral health assessment tool （M‐DiOHATⓒ） for nurses and their association with efficacy beliefs and outcome expectancies in patients with diabetes

Background : Bidirectional relationships exist between diabetes and periodontal disease. Fostering timely oral health assessments of patients with diabetes, the modified diabetes oral health assessment tool (M-DiOHATⓒ) for nurses was studied. The DiOHATⓒ has four factors, namely oral health conditions, oral hygiene behaviors, perception and knowledge, and health record sharing. It was modified as the M-DiOHATⓒ scale. To change people's health behaviors, “efficacy and “outcome are important. However, no studies have been reported that addressed efficacy beliefs and outcome expectancies of oral health conditions and behaviors of patients with diabetes. Objective : To clarify the oral health conditions and behaviors of patients with diabetes using the M-DiOHATⓒ, and to describe their associations with the Self-Efficacy Scale for Self-Care (SESS)/the Outcome Expectancy Scale for Self-Care (OESS). Methods : Twenty-eight patients with diabetes participated in the study. Their personal characteristics were determined from the items of self-efficacy for brushing of the teeth (SE-B), self-efficacy for dental consultations (SE-DC), OESS that are comprised of three factors, namely, the social outcome expectancy (OE-Social), oral outcome expectancy (OE-Oral), and self-evaluative outcome expectancy (OE-Self), and the M-DiOHATⓒ. Results : Forty-three percent of patients had retained their expected number of present and 68% of them had dental problems. The scores of health record sharing were low, and patients who were under 65 years old had fewer “expected number of present teeth, and lower SE-B/oral health conditions scores than those patients aged over 65 years. The scores of oral hygiene behaviors were significantly correlated with the SE-B scores, SE-DC, OE-Oral, and OE-Self. However, the oral health conditions showed no correlation with SE-B, SE-DC, OESS. Conclusion : The findings suggest that nursing interventions to promote SE-B, SE-DC, and OESS could be effective in enhancing patients' oral hygiene behaviors. However, severity of patients' periodontal disease require different types of dental self-efficacy procedures.

Health Behavior and Medication Adherence in Hypertensive Client

Hypertension as Non-Communicable Diseases (NCD) is the largest contributor to the causes of death in the world. Complications of hypertension account for the majority of deaths globally. Uncontrolled health behavior in patients with hypertension is closely related to an increase in morbidity rates due to complications from hypertension each year. Medication adherence is one of an effort to form positive health behaviors to prevent hypertension complications. This study aims to identify the relationship between health behavior with medication adherence in hypertensive clients in Cipayung District, East Jakarta. This study using cross sectional design, approach with 109 participants, who were selected by purposive sampling, are choosen primary hypertensive clients of middle adulthood. The results of the chi square test showed that there was a relationship between health behavior and medication adherence (p value: 0.024) 90% CI. The results of the study it can be concluded that the more positive the health behavior, the higher the adherence to taking medication in hypertensive clients. Community nurses have an important role in modifying the behavior of hypertensive patients with a variety of approaches both as individuals, families, and the public can maintain their health well-being.&#x0D; Keywords: hypertension; health behavior; medication adherence

Information behavior and social control: Toward an understanding of conflictual information behavior in families managing chronic illness

AbstractThe relationship between information and control interests social scientists; however, much prior work has focused on organizations rather than families. Work on interactive information behaviors has also focused on organizations and on collaboration rather than conflict. Therefore, in families managing chronic illness, we investigated information behaviors in the context of health‐related social control and the impact of control on patient health behavior. We conducted a qualitative analysis of interviews with 38 family groups and 97 individuals over 2 years. Findings revealed conflictual information behavior, which led to competitions for control and influence between family members and patients. In response to perceived patient health behavior‐related problems, family members sought, shared, and used information for social control of patients by enforcing norms, leveraging expertise, performing surveillance, and structuring the environment. These behaviors clashed with patients' interests and perspectives drawn from their own information acquisition. Patients responded by assessing family‐presented information and using information to resist or appease norm enforcement, refute or agree with expertise, and permit or block surveillance. Over time, some patient behaviors changed; alternatively, patients blocked family access to information about themselves, or family members retreated. The results challenge presumptions of benefit and harmony that have characterized much prior information behavior research.