|The purpose of this quasi-experimental research was to determine the effects of health education with a reminder system using the health conception pattern to change perception based on conception of health, health care behaviors and BP control of hypertensive patients. The subjects were essential hypertensive patients receiving hypertensive medication during December 2007 – April 2008. The subjects were selected by the criteria of the attended primary care unit and divided into the experimental group (187 patients) and the control group (151 patients). The experimental group consisted of the patients who attended the hypertension clinic at Nongkae primary care unit and received health education with the reminder system 3 times; the control group consisted of the patients who attended the hypertension clinic at Laosaukoke Primary care unit and received the routine care procedure from staffs. Questionnaires were used to collect data on the health perception and behavior of essential hypertensive patients and satisfaction of the experimental group that received health education with the reminder system. The statistical methods used in data analysis included Chi-square test, , T-test, Paired T-test, multiple linear regression and logistic regression.
In the multivariate analyses, the covariates of gender, age, marital status, occupation, income, education level, superintendent of patients, health insurance status, duration of illness, concomitant disease, quantity of hypertensive medicine received, score of pre-experimental health conception perception, score of pre-experimental health care behavior and pre-experimental average blood pressure level were controlled in the model. The results showed that the experimental group positively changed their perception of the severity of hyperventilation and complicacy (B = -1.180, p = 0.001), perception of risk (B=0.795, p = 0.006), perception of benefit (B = 1.513, p < 0.001) and overall perception (B = 2.011, p = 0.042) significantly more than those in the control group did. However, the barrier perception of the experimental group did not significantly differ from that of the control group. Moreover, the experimental group positively changed their health behavior in terms of exercising and stress relieving significantly more than the control group did (B = -0.615, p < 0.001 and B = -0.319, p = 0.046 respectively). However, the health behavior in terms of diet, medicine use and overall behavior of the experimental group did not significantly differ from those in the control group. In addition, the treatment outcome analyses indicated that the blood pressure level of the experimental group did not differ from that of control group. In contrast, the proportion of subjects who had normal blood pressure level of the experimental group was significantly larger than that of the control group (OR = 1.868, p = 0.022) but the average blood pressure of the experimental group did not significantly differ from that of the control group. Furthermore, the experimental group showed satisfaction with the education and reminding system ranking on these topics= reminding letter, tape cassette education, stress-relief and exercise techniques, food model, medicine use on score board, and blood pressure knowledge on VCD.
In conclusion, these results indicated that the health education with a reminder system significantly improved the perception of severity, risk, benefits, and overall perception, exercising behavior, stress relief behavior, and proportion of subjects with normal blood pressure level. Therefore, this intervention ought to be maintained and this study results might be applied to the other primary care units.