JKEP (JURNAL KEPERAWATAN)
Vol 9.
No 2.
November 2024 ISSN: 2354-6042 (Prin.
ISSN: 2354-6050 .
Increasing The Ability to Manage Hypertension Care in The Elderly Using a Pocket Book Mia Fatma Ekasari*.
Aan Nurhasanah.
Eros Siti Suryati.
Siti Badriah.
Puspita Hanggit Lestari.
Dzia Ulhaq Rohadatul Aisy.
Pudjiati.
Tien Hartini Poltekkes Kemenkes Jakarta i.
Indonesia *email: miafatma74@gmail.
Article history Posted.
Sept 02th, 2024 Reviewed.
Oct 02th, 2024 Received.
Nov 20th, 2024 Copyright A 2024 Authors This work is licensed under a Creative Commons Attribution-ShareAlike 4.
International License.
ABSTRACT
Family support is very influential in the success of hypertension care management through health education or information education about hypertension care, one of which is by using a pocket book containing information about hypertension care management for the elderly.
The aim of the research was to determine the family's ability to manage hypertension in the elderly using a pocket book.
This research uses a quasi-experimental design with a pre-test and post-test control group design approach.
of 70 families selected by purposive sampling.
Data was collected using a pretest in the treatment group and control group to determine the basic values used to determine the influence of the independent variables.
The treatment group was given intervention through the provision of pocket books.
while the control group received a booklet about high blood pressure.
The results of data collection were analyzed using univariate and bivariate using the t test.
The results of this study found that after the intervention was implemented in the intervention group there were differences in knowledge, attitudes and skills between the intervention group and the control group.
Researchers suggest using pocket books as a medium to increase the family's ability to manage hypertension in the Keywords: Elderly.
Hypertension .
Pocket books.
ABSTRAK
Dukungan keluarga sangat berpengaruh dalam keberhasilan penatalaksanaan perawatan hipertensi melalui pendidikan kesehatan atau edukasi informasi tentang perawatan hipertensi salah satunya dengan menggunakan buku saku yang berisi informasi tentang penatalaksanaan perawatan hipertensi lansia.
Tujuan penelitian ingin mengetahui kemampuan keluarga mengelola hipertensi pada lansia menggunakan buku saku.
Penelitian ini menggunakan desain quasi eksperimen dengan pendekatan pre-test dan post-test control group design.
JKEP (Jurnal Keperawata.
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2 November 2024 hlm 243- 256 keluarga yang dipilih secara purposif sampling.
Data dikumpulkan menggunakan Pretest pada kelompok perlakuan dan kelompok kontrol untuk mengetahui nilai dasar yang digunakan untuk mengetahui pengaruh variabel independen.
Kelompok perlakuan diberikan intervensi melalui pemberian buku saku.
sedangkan Kelompok kontrol mendapat booklet tentang tekanan darah Hasil pengumpulan data dianalisis menggunakan univariate, dan bivariate menggunakn uji t test.
Hasil penelitian terdapat perbedaan pengetahuan, sikap, dan keterampilan antara kelompok intervensi dan kelompok kontrol.
Peneliti menyarankan agar penggunaan buku saku sebagai media dalam meningkatkan kemampuan keluarga dalam mengelola hipertensi pada lansia.
Kata Kunci: Lansia.
Hipertensi.
Buku saku
INTRODUCTION
implementation based on Evidence Based The number of elderly people is increasing Nursing Practice (EBNP) on hypertensive from year to year, this is due to one of the clients showed that providing hypertension reasons for the increasingly advanced health self-care management education with a Globally, there were 727 million hypertension control book was considered people aged 65 years or more in 2020 effective in increasing knowledge of self- (Martono, 2.
This number is projected care management in families to overcome to double to 1.
5 billion by 2050.
Over the last fifty years, the percentage of the elderly population in Indonesia has increased from 5 percent in 1971 to around 10.
7 percent in 2020 (Tobe, 2.
This figure is projected to continue to increase until it reaches 19.
The role of family and community is very important in improving the health status and quality of life of the elderly, namely through changing behavior towards clean and healthy living behavior in family and percent in 2045.
As they age, the majority of elderly suffer .
hysical, from non-communicable diseases because socio-cultural, provide health services through promotive, (Kemenkes.
RI, 2.
Non-communicable strategies, and participating in the process diseases (NCD.
experienced by the elderly are degenerative, namely heart disease, diabetes mellitus, stroke, rheumatism and (Madanih, 2.
(Muttaqin, 2.
The injury (BPS, 2.
most important thing about health services is the awareness of each individual to The results of research by Irawati Novita1, et al .
concluded that the results of maintain health and prepare for old age as JKEP (Jurnal Keperawata.
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2 November 2024 hlm 243- 256 well and as early as possible (Erna.
The family is a support system that helps 2.
(Hassanah, 2.
maintain the health of the elderly.
The role Based on the results of Riskesdas in 2018, of a family nurse includes the family's the most common disease among the elderly ability to recognize health problems in the was hypertension at 63.
5% (Kemenkes.
RI,
elderly, make decisions about elderly Hypertension is the main cause of health problems, care for family or sick premature death in the world (Kemenkes RI, elderly people, and provide appropriate responses to changes in the elderly, using hypertension, further complications are Proven likely to occur, kidney disease, myocardial influence elderly behavior in preventing infarction (MI), heart failure, and stroke, hypertension complications (Sharon L.
Lewis.
Margaret M.
Jeffrey Devianto and Intan Sari, 2.
Kwong, 2.
The higher the blood Family support is very influential in the pressure, the greater the risk of suffering successful management of hypertension from other diseases (Hardi.
K & Huda.
Family This is not in line with efforts to control hypertension which continue to be The greater the family support promoted by the government (Kementerian for elderly people with high blood pressure.
Kesehatan RI, 2.
the better their behavior in preventing (Primasari.
Families can help elderly The hypertension is only 4% and uncontrolled 4% (Kemenkes RI, 2019.
The reason is because elderly people do not follow healthy living behavior, including not controlling it regularly, not doing the right diet, sleeping irregularly, lack of exercise.
and stress (WHO, 2.
High blood pressure can be people to develop a healthier lifestyle and can take the time to check their blood pressure regularly (Pratiwi.
Bayhakki and Zukhara, 2.
Family support influences hypertension medication and improves the elderly's quality of life (Sasmita.
Utomo and Nauli, 2.
controlled through a healthy lifestyle.
However, there are still many patients who Factors needed to strengthen family do not practice healthy behavior, and the support to encourage elderly compliance in frequency of high blood pressure is managing hypertension care are health increasing (Sekunda.
Tokan and Owa, 2.
education about hypertension treatment and feedback after obtaining information JKEP (Jurnal Keperawata.
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9 No.
2 November 2024 hlm 243- 256 about hypertension (Widiandari.
Widiani completed a posttest.
The results of the and Rosdiana, 2.
Information support pretest and posttest after the intervention, has an important contribution in improving as well as the results of the treatment and the quality of life of hypertensive elderly control groups were then compared.
This (Astuti, 2.
research was conducted in the target area of Cakung District.
East Jakarta.
The sample Based on the above phenomenon, research was conducted as an effort to carry out health promotion activities for the elderly to improve the health of elderly people with hypertension health problems.
Researchers information regarding the management of hypertension elderly care.
This pocket book is designed not only as a medium of information and education for the elderly but also as a medium used to guide the elderly in managing daily hypertension care.
In this in this study was 70 for the intervention group and 70 for the control group.
Samples are determined based on the method purposive sampling with inclusion criteria: All elderly .
-74 year.
, with family .
usband, wife, children, inlaws, grandchildre.
, able to use writing tools, able to speak Indonesian and communicate well, able to read and write, able to do activities, not bed rest, not experiencing visual or hearing problems and willing to be respondents.
study, researchers measured the effect of using pocket books on the management of DISCUSSION hypertension care in the elderly in the DKI Description of the Characteristics of Jakarta area.
the Elderly The results of the analysis of the METHOD characteristics of the elderly in the two This research uses quasi experimental design groups based on age and duration of illness with approach pre test-post test with control are as follows:
group design.
A pre-test was carried out on the intervention group and control group to determine the value baseline used and to independent variables.
The intervention group was given a pocket book.
Meanwhile, the control group received pamphlet media.
At the end of the study, both groups Table 1 provides an overview of the characteristics of the intervention and control groups.
The majority are aged between 65 and 74 years.
both groups were educated women, the majority had primary education, and the jobs in the intervention and control groups were civil servants.
JKEP (Jurnal Keperawata.
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2 November 2024 hlm 243- 256 the other hand, the majority of the Likewise, the skills variable shows a significant difference in the use of pocket Sundanese.
books in the intervention group before and Differences in knowledge, attitudes and after the intervention .
-value = 0.
which shows that there is a difference in the intervention with the use of pocket mean value of control for increasing skill The mean difference in scores for Analysis results Table 2.
There is a the intervention group was 7.
257, while the significant difference in the knowledge mean difference in scores for the control variable of the intervention group and the group was 0.
The results of the analysis in table 3 show intervention using pocket books and the that there is a difference in knowledge difference in grades mean the increase in about the results of the analysis in Table 3 knowledge is a p-value = 0,000.
Value mean show that there is a difference in score The difference in the average score of knowledge about the elderly between the the intervention group was 3.
157 and the intervention group and the control group difference in the average score was 0.
after the intervention on the use of pocket addition, the results of the attitude variable books .
=0.
Likewise, there were analysis showed that there were significant differences in the attitudes of the elderly differences between the intervention group between the intervention and control before and after the intervention paperback groups .
= 0.
Likewise, after the .
value = 0.
, and there is a difference in pocket book use intervention, there were the average increase in attitude scores.
The differences in elderly skills between the difference in scores in the intervention group intervention and control groups .
= is quite large .
alue difference = 6.
, and the average difference in scores in the intervention group is 0.
Table 1.
Distribution of Elderly Characteristics Based on Age.
Gender.
Education.
Occupation.
Ethnic Origin Nation.
Duration of illness Variable Ex.
Intervention Ex.
Control Total Elderly Age < 65 years JKEP (Jurnal Keperawata.
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Intervention Ex.
Control Total Male Female Entrepreneur Labor Java Betawi Sundanese Sumatra One year Two years Three > 65 years Gender Education Primary Junior high Senior high Academy/PT Pekerjaan Government Employees Private Ethnic Group Duration Hypertension Five years Table 2.
Analysis of Knowledge.
Attitude and Skill Scores Before and After the Pocket Book Use Intervention JKEP (Jurnal Keperawata.
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Intervention Knowledge Mean
95% CI
P value Before 5,39 1,739 --3.
After 8,54 1,304 Difference -3,157 Ex.
Kontrol Before After Difference Ex.
Intervention Attitude Before After Difference Ex.
Kontrol Before --035- After Difference --0410.
Ex.
Intervention Skills Before After Difference Ex.
Kontrol Before After Difference Table 3.
Analysis of knowledge, attitudes and skills scores after the Pocket Book Use Variabel Knowledge Attitude Skills Group Mean Intervention Control Intervention Control Intervention 8,54 33,14 0,018 JKEP (Jurnal Keperawata.
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Control
RESULT
elderly person's health may worsen.
The age characteristics of the elderly in this Additionally, age-related hormonal and study for intervention were Ou 67.
14 years and metabolic changes may increase the risk of for control 66.
83 years.
This age is the chronic diseases.
Lifestyle factors such as elderly category (Kemenkes RI, 2019.
The unhealthy eating habits, lack of physical differences in the age characteristics of activity, and stress also worsen the health respondents in the intervention group and the control group indicate that this is normal and vulnerable and susceptible to infectious natural, because the respondents come from and non-communicable diseases (Pratiwi, various regions and each respondent has a Untari and Robiyanto, 2.
one of them is different mother who gave birth to them at a different time.
Age is the period of time since a person existed and can be measured using time units from a chronological perspective.
Normal individuals can be seen to have the same degree of anatomical and physiological development (Sonang et al.
, 2.
Age describes the same chronology and degree of anatomical and physiological development (Sonang.
Purba and Pardede, 2.
person's level of maturity can be seen from increasing age.
Likewise, his level of maturity and strength in thinking become more mature.
This causes elderly people to think about improving their health level.
Hypertension increases with age due to the presence of collagen in the muscle layer which thickens the walls of the arteries, thereby causing a decrease in the elasticity of the blood vessels, making them stiff.
we age, the body experiences natural changes that can increase the risk of The elasticity of blood vessels decreases so they become stiff and In addition, decreased kidney function can disrupt the regulation of fluid and electrolyte balance in the body, thereby contributing to an increase in blood As age increases, the physiological functions Hormonal changes that occur in women of the human body naturally decrease.
This during menopause can also be a risk factor.
weakens the immune system and makes the When elderly more susceptible to various diseases.
lifestyle, namely unhealthy eating patterns When organs do not function properly, an and lack of exercise, these factors further JKEP (Jurnal Keperawata.
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elderly people ( Anwar and Masnina, 2.
HDL has the function of removing excess Gender cholesterol from the blood and returning it to the liver for processing.
Therefore.
HDL helps prevent plaque formation on artery (Kusumawardana.
Tamtomo and Sugiarto.
Therefore, high HDL levels are considered a protective factor against heart disease (Setyaningrum, 2.
Gender is one of the factors that influences the increase in blood pressure which causes HDL cholesterol, often referred to as "good hypertension, this is because women who cholesterol", has an important role in have gone through menopause experience a protecting the body from atherosclerosis.
decrease in estrogen levels.
This is in line HDL helps prevent plaque buildup on with the theory put forward by Podungge artery walls which is a hallmark of .
which states that women who have not yet reached menopause are protected by the hormone estrogen which plays a role in increasing High Density Lipoprotein (HDL) High HDL cholesterol levels are a protective factor in preventing the process of (Riyadina.
Podungge, 2.
Research conducted by Everet and Zajacova .
5 in Falah, 2.
shows that men have higher levels of hypertension than women but Men have a lower level of awareness of hypertension than women.
Hypertension in women can A decrease in the hormone estrogen means there is no protection for blood vessels.
The hormone estrogen plays a protective role in the cardiovascular system, especially in premenopausal women.
One of these protective mechanisms is to increase The majority of education levels in this study were elementary school education, both for the control group .
1%) and for the intervention group 36 .
4%).
Education is the main foundation in forming a person's knowledge.
Through a structured learning process, individuals obtain information , skills, and a broad understanding of various fields of science.
Education allows individuals to connect various information, solve problems, and develop new ideas.
The higher a person's level of education, generally the broader their knowledge and insight.
Whether behavior is good or bad is influenced by a person's level of education in receiving and processing information that will have an impact on their health JKEP (Jurnal Keperawata.
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2 November 2024 hlm 243- 256 use of pocket books as a component in A person's good knowledge intervention can help provide information regarding the causes, risk factors, signs and in written form and assist patients in symptoms of hypertension as well as the documenting activities and habits in limits of stable and unstable blood pressure, managing hypertension.
Approach self-care education can be used (Notoatmodjo, 2.
as a self-regulation medium so that People with low education tend to lack hypertensive elderly carry out the treatment program obediently.
The use of a pocket book in managing hypertension provides enormous benefits because vital signs, lifestyles such as healthy diet, exercise and especially blood pressure, are clearly maintaining an ideal body weight.
monitored as well as other aspects.
Media is a means of providing health The education with the aim of clarifying the respondents was working, either control information provided and can also facilitate 3%, or intervention with 85.
the delivery of information, one example is a Elderly work is an activity that can affect pocket book.
Pocket book sa process of the physical aspects of the elderly and their support and education self care management quality of life (Rebokh.
Rayanti and Self care management is a Natawirarindry, 2.
procedure for individuals to regulate their own behavior.
Which can encourage patients to use existing resources to manage the disease they are experiencing.
Self care management for hypertension sufferers includes controlling blood pressure and preventing future complications occurred (Sakinah.
Ratu.
, & Weraman, ,2.
This is in line with the results of research by Irawati Novita.
Halina Rahayu.
Amandus in 2023 which proves that the The results of the analysis show that there are significant differences in knowledge, attitudes and skills in the intervention group and the control group before and after the intervention in using the Pocket Book.
This shows that family knowledge regarding hypertension management has increased, which has led to changes in attitudes and behavior.
Hypertension education using booklets or books is more effective than counseling in increasing hypertension diet compliance (Mohammed JKEP (Jurnal Keperawata.
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, 2.
Health education using Differences in knowledge, attitude and pocket book media resulted in an increase in skill scores between groups using pocket the average diet compliance score before and The results of the study showed that after (Lestari.
Cantika Audia and Sriyati there was a difference in knowledge among Sipora, 2.
the elderly .
= 0.
between the intervention group and the control group Health education requires learning media.
Learning media acts as a very effective tool in the health education process.
By utilizing various types of media, such as visual, audio, or a combination of both, the learning process becomes more interesting and Learning functions to convey information more after the Pocket Book Use intervention.
There were also differences in the attitudes of the elderly between the intervention group and the control group .
= 0.
Likewise, after the intervention, there were differences in elderly skills .
= 0.
between the intervention group and the control group.
clearly and easily understood, but is also able to foster interest and motivation to learn.
Pocket books are a type of print media that Using the right media, educational messages can be used for health education.
Books are can be conveyed more effectively.
Apart intended to generate interest in educational from that, learning media can also provide subjects, provide incentives to achieve stimulation that stimulates students' thinking goals, and ensure that messages are and creativity, so that they are more actively involved in the learning process (Lestari, (Kurniawan and Yani, 2.
Pocket books Cantika Audia and Sriyati Sipora, 2.
contain a collection of information about Pocket books are a means of health something as the main source and can be The pocket book contains filled in by the user in the form of daily information about hypertension, meaning events or activities.
The pocket book is an effort to keep the elderly healthy, active hypertension, decreased function of body due to and productive.
degenerative processes (Cherfan et al.
, 2.
One effective way to control hypertension is by providing health education using various interesting media, one of which is a pocket book.
Pocket information are printed media for health The pocket book is filled in by the user in the form of daily events or Pocket books not only contain JKEP (Jurnal Keperawata.
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knowledge can be obtained through the senses of sight and others.
This book provides examples of daily menus for hypertension sufferers, types of food and portion sizes, sodium intake and food sources, as well as monitoring diet patterns for hypertension sufferers.
CONCLUSION
The average age of respondents in the intervention group was 67.
14 years, while in the control group the average age of the elderly was 66.
83 years.
There were differences in knowledge, attitudes and skills between the intervention group and the control group after the intervention was carried out in the intervention group.
It is hoped that the results of this research can be developed further as a means of increasing the family's ability to care for elderly people with hypertension.
Health
workers can distribute pocket books to hypertension, thereby increasing the family's ability to care for elderly people with ACKNOWLEDGEMENT
The researcher would like to thank several REFERENCES