JKEP (JURNAL KEPERAWATAN)
Vol 9.
No 2.
November 2024 ISSN: 2354-6042 (Prin.
ISSN: 2354-6050 .
Health Volunteers and E-Booklet Impact on Knowledge and Treatment Adherence in Hypertension Patient Muhtarul Anam1*.
Juliana Christina1.
Fauziah Rudhiati1.
Tri Hapsari Retno A2.
Nandang A.
Waluya2 Fakultas Ilmu dan Teknologi Kesehatan.
Unjani Cimahi.
Indonesia Poltekkes Kemenkes Bandung.
Indonesia *email: anammuhtarul7@gmail.
Article history Posted.
Aug 22th, 2024 Reviewed.
Oct 28th, 2024 Received.
Nov 20th, 2024 Copyright A 2024 Authors This work is licensed under a Creative Commons Attribution-ShareAlike 4.
International License.
ABSTRACT
Hypertension is a disease with a global prevalence of 1.
3 billion cases in 2019, which is the leading cause of cardiovascular morbidity and mortality.
The prevalence of hypertension in Indonesia is 34.
1% among the adult population, with a mortality rate of 427,218.
The failure of hypertension patient management is mostly due to a lack of awareness of the importance of adherence to hypertension treatment and a lack of knowledge.
This study aims to determine the effect of health education by health volunteers using e-booklet on the knowledge and adherence to treatment of hypertensive patients at Batujajar Health Center area.
This study used a quasi-experimental design with intervention and control groups.
The sample in this study consisted of 32 respondents, who were selected using the purposive sampling technique.
The results showed that health education by health volunteers using e-booklet significantly increased the mean knowledge of hypertensive patients, with the mean value of knowledge rising from 75.
6 to 86.
8 after the intervention.
Patients' adherence to treatment also increased, with the mean value rising from 4.
4 to 6.
The results showed a significant positive effect on both variables, with a p-value of 0.
016 for knowledge and 0.
001 for treatment adherence.
Based on the findings, health education conducted by health volunteers using ebooklets significantly impacts the knowledge and medication adherence of hypertension patients in the Batujajar Health Center area.
It is recommended that health volunteer training be conducted periodically by healthcare professional and that the e-booklet be utilized as an educational tool at the health center and as a credible reference source for the community.
Keywords: Adherence.
E-Booklet.
Health Volunteers.
Health Education.
Hypertension.
Knowledge JKEP (Jurnal Keperawata.
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ABSTRAK
Hipertensi menjadi penyakit dengan prevalensi global 1,3 miliar kasus pada 2019 yang merupakan penyebab utama morbiditas dan mortalitas kardiovaskular.
Di Indonesia, prevalensi hipertensi sebesar 34,1% diantara populasi dewasa dengan angka kematian mencapai 427.
Kegagalan manajemen pasien hipertensi mayoritas dikarenakan kurangnya kesadaran pentingnya patuh terhadap pengobatan hipertensi dan kurangnya pengetahuan.
Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan kesehatan oleh kader menggunakan ebooklet terhadap pengetahuan dan kepatuhan pengobatan pasien hipertensi di wilayah Puskesmas Batujajar.
Penelitian ini menggunakan desain quasi eksperimental dengan kelompok intervensi dan kontrol.
Sampel dalam penelitian ini sebanyak 32 responden yang dipilih melalui teknik purposive sampling.
Hasil penelitian ini menunjukan pendidikan kesehatan oleh kader menggunakan e-booklet secara signifikan meningkatkan rerata pengetahuan pasien hipertensi, dengan nilai rerata pengetahuan naik dari 75,6 menjadi 86,8.
Kepatuhan pengobatan pasien juga meningkat, dengan nilai rerata naik dari 4,4 menjadi 6.
Hasil penelitian menunjukkan pengaruh positif signifikan pada kedua variabel, dengan masingmasing p-value 0,016 untuk pengetahuan dan 0,001 untuk kepatuhan pengobatan.
Sehingga dapat disimpulkan bahwa pendidikan kesehatan oleh kader dengan media e-booklet memberikan pengaruh signifikan terhadap pengetahuan dan kepatuhan pengobatan pasien hipertensi di wilayah Puskesmas Batujajar.
Disarankan agar pelatihan kader dapat dilakukan secara berkala oleh petugas puskesmas dan memanfaatkan e-booklet ini sebagai alat pendidikan di puskesmas serta sumber referensi yang kredibel bagi masyarakat.
Kata Kunci: E-Booklet.
Hipertensi.
Kader.
Kepatuhan.
Pendidikan Kesehatan.
Pengetahuan INTRODUCTION Hypertension is a highly significant global two years (Open Data Jabar, 2.
Puskesmas Batujajar, hypertension is the exceeding one billion cases worldwide non-communicable disease with the highest (Mills et al.
, 2.
From 1990 to 2019, the prevalence, increasing from 1,244 cases in number of people 2022 to 1,717 cases in 2023 (Puskesmas doubled, reaching 1.
3 billion people.
Batujajar Profile, 2.
representing 31% of the global adult population (WHO, 2.
In Indonesia, in 2018 there were approximately 63,309,620 people with hypertension, represent for 1% of the adult population, with hypertension mortality reaching 427,218 people (Riskesdas, 2.
In the West Java region, the annual mean of hypertension patients accessing health services reached 3,627,479.
75 people, while West Bandung Regency reported 80,543 cases in the last The incidence of hypertension is influenced by various factors, both genetic and Factors such as heredity, coffee, and daily activity patterns have an important role in the development of hypertension (Ayu et al.
, 2022.
Irawan et al.
Modifiable environmental factors, such as obesity, salt intake, physical contribute significantly to the risk of JKEP (Jurnal Keperawata.
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9 No.
2 November 2024 hlm 232- 242 (Mills treatment and take preventive measures to Uncontrolled hypertension can lead to a (Anshari.
Conversely, a lack of understanding can heart failure, result in treatment non-adherence, with less stroke, and coronary heart disease, and knowledgeable patients having a 1.
accounts for 10.
4 million global deaths times greater risk of not adhering to (Kotruchin et al.
, 2021.
Lukitaningtyas & antihypertensive treatment (Fauziah & Cahyono, 2023.
Rodrigues et al.
, 2.
Mulyani.
Indonesia, hypertension causes 1.
5% of hypertensive patients are unaware of the coronary heart disease cases and 12.
1% of early symptoms of hypertension and often stroke cases (Susanti et al.
, 2.
consider them trivial, which reduces their motivation to follow the recommended In an effort to reduce the incidence of noncommunicable Communicable Posbindu Diseases therapy (Lewis in Syukkur et al.
, 2.
Non- Health centers have a key role in hypertension prevention through health developed, which is an integral part of the health care system and includes various volunteerto improve community knowledge promotive and preventive efforts.
The and adherence to hypertension treatment.
development of a community-based non- Health cadres, who are part of the community have a role in health counseling through Posbindu is a form of community and motivating the community to lead a participation in efforts to control risk factors healthy lifestyle (Kemenkes RI, 2019.
Putri independently and continuously (Ministry & Suhartiningsih, 2.
However, many of Health Indonesia, 2.
However, the health volunteerdo not have a history of utilization of Posbindu by the community is health education, which can hinder the still not optimal, which is caused by several factors including knowledge (Nurhayati.
Therefore, it is important to improve cadres' knowledge through effective health Translated with DeepL.
ree versio.
The use of e-booklets as a health Knowledge about hypertension is essential in preventing and managing this disease.
enhance the knowledge and adherence of Patients who have good knowledge about hypertensive patients (Muwakhidah et al.
hypertension are more likely to adhere to Okiningrum & Handayani, 2.
(Hidayati.
JKEP (Jurnal Keperawata.
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2 November 2024 hlm 232- 242 This study aims to evaluate the effect of antihypertensive drugs, understood and able health education by health volunteerusing e- to read Indonesian, had a cell phone with booklets on the level of knowledge and specifications capable of opening PDF files and an internet connection, and willing to patients at the Batujajar Health Center.
voluntarily participate in a series of study Referring to Imogene King's theory of activities by signing an informed-consent interaction as an open system, this study seeks to show how e-booklets can improve hypertensive patients with an age of more than 60 years and pregnant women.
This hypertension patients.
The training of health study was conducted from May to June volunteerand the provision of e-booklet, it is 2024 in the Galanggang Village area of the expected to enhance the quality of life and Batujajar Health Center.
In the initial phase, life expectancy of hypertensive patients, as the researchers selected health volunteer to well as reduce the risk of complications and be trained in health education based on mortality due to hypertension (Rofii et al.
specific criteria and clusters.
The clustering Syukkur et al.
, 2.
process identified six health volunteer, who The were then trained to conduct health
METHOD
education over one day.
The training was The design in this study used a quasi- delivered by a certified expert with a TPK experimental design with an intervention To ensure consistent perceptions group and a control group.
Respondents in between the trainer and the researchers, an the intervention group were given health inter-rater reliability test was conducted.
education treatment by health volunteer Once with e-booklet media while respondents in competency standards, they proceeded to control group were not given special conduct health education to the intervention The number of samples in this group using an e-booklet.
At the start of the study 32 respondents, with each group health education session, a pre-test was The selection technique in this study used Following the pre-test, the health purposive sampling and cluster random volunteer conducted the health education session using the e-booklet for 15 minutes.
respondent from each area (RW).
The After the session, respondents were given inclusion criteria in this study were access to the e-booklet on their mobile phones for any time and anywhere access as JKEP (Jurnal Keperawata.
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In addition to these two conducted 3 days after the intervention, instruments, this study also used e-booklets while a follow-up post-test for adherence .
he average test score from all experts is e-booklet validation forms, health volunteer training modules, health education SAP, and health The standardized instruments that have been tested for validity and reliability used were HKLS knowledge .
n is greater than r table 0.
537 and Cronbach alpha = 0.
and MMAS to measure medication adherence .
ll question are valid.
Spearman Rank Order -0.
p: 0.
218 and Cronbach education SOP outside the Puskesmas Data analysis used univariate and bivariate analysis with the help of the SPSS.
29 application.
Univariate was used to determine the characteristics of respondents and bivariate was used to compare between two variables.
The bivariate tests used were t-test.
Wilcoxon, and Mann-Whitney.
RESULT
Table 1 Frequency Distribution of Respondent Demographic Data Frequency Intervention Control Characteristics Age Early Adulthood .
Late Adulthood .
Educational Background Low (SD-SMP) Middle (SMA-Academ.
Gender Female Demographic Data background was in the low category Table 1 shows the frequency distribution of .
5%) in the intervention group and respondent data based on age, education .
75%) in the control group, and all respondents were female.
The respondents were in the age range of 41-60 years .
73%) in the intervention group The Effect of Health Education on the and .
5%) in the control group.
The Mean Knowledge of the Intervention Group JKEP (Jurnal Keperawata.
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2 November 2024 hlm 232- 242 Based on Table 2, the mean value of Therefore, it is concluded that there is a knowledge before the intervention was difference in the mean value of knowledge 69, while the mean value of knowledge of hypertensive patients before and after after the intervention was 86.
81 with a p- health volunteer conducted health education value=0.
016<=0.
05, then Ho was rejected.
using e-booklet media.
Table 2 Wilcoxon Statistical Test Results Mean Knowledge of Intervention Group Respondents Intervention Group Pre-Test Post-Test Mean Min-Max p-value Table 3 Paired T-Test Statistical Test Results Mean Adherence of Intervention Group Respondents Intervention Group Pre-Test Post-Test Mean Std.
Error of Mean Std.
Deviation p-value The Effect of Health Education on the level of knowledge was 72.
87 (Standard Mean Adherence of the Intervention Deviation 14.
, while the measurement Group after the mean value of the level of Based on Table 3, the mean value of knowledge was 73.
75, (Standard Deviation adherence before the intervention was 4.
with a p-value = 0.
245> = 0.
(Standard Deviation 1.
, while after the then Ho is accepted.
Therefore, before and intervention the mean value of adherence after showed no difference in the mean 05 (Standard Deviation 1.
with a p-value = 0.
001 < = 0.
05, then Ho is hypertension in the control group.
Therefore, it is concluded that there is a difference in the mean treatment adherence of hypertensive patients before and after health education conducted by health volunteert hrough e-booklet media.
Mean Adherence to Treatment of Control Group Respondents Based on Table 5, the results of the measurement before the mean value of treatment adherence was 5.
11 (Standard Mean Knowledge of Control Group Deviation 1.
, while the measurement Based on Table 4, the results of the after the mean value of treatment adherence measurement before the mean value of the 28 (Standard Deviation 1.
with a JKEP (Jurnal Keperawata.
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258> = 0.
05, then Ho is showed no difference in mean adherence in Therefore, before and after the control group.
Table 4 Results of Paired T-Test Statistical Test of Mean Knowledge of Control Group Respondents Control Group Pre-Test Post-Test Mean Std.
Error of Mean Std.
Deviation p-value Table 5 Paired T-Test Statistical Test Results Mean Adherence of Control Group Respondents Control Group Pre-Test Post-Test Mean Std.
Error of Mean Std.
Deviation p-value Table 6 Results of Mann-Whitney Statistical Test and Unpaired T-Test of Mean Knowledge and Compliance Between Intervention and Control Group Respondents Variable Knowledge Adherence Group Post Intervention Post Control Post Intervention Post Control Mean p-value Mean Difference in Knowledge and mean value of 5.
The results of the non- Adherence Between Intervention and parametric test of 2 unpaired groups on the Control Groups variables of knowledge and adherence both Based on Table 6, the results of measuring obtained a p-value = 0.
004 < = 0.
05, so Ho knowledge variables with the Mann- is rejected.
Therefore, it can be concluded Whitney that between the intervention and control respondents obtained a mean value of 21.
groups, there are differences in knowledge and control group respondents obtained a mean value of 11.
The results of hypertensive patients after health volunteer measuring adherence variables with the conduct health education through e-booklet Unpaired T-Test test on intervention group respondents obtained an mean value of 6.
and control group respondents obtained an JKEP (Jurnal Keperawata.
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DISCUSSION
in-depth and sustainable manner (Chuang et The majority of respondents were in the age , 2.
range of 41-60 years .
73%) in the intervention group and .
5%) in the control group.
Handayani .
, blood pressure continues to increase with age.
average person will begin to experience an increase in blood pressure at the age of 40 years or even earlier.
The results of the field found that the average patient with hypertension is in the age range of The study further found that medication adherence of patients in the intervention group increased significantly from a mean value of 4.
43 before the intervention to 6.
after the intervention.
On the other hand, the control group showed almost unchanged mean values of 5.
11 before and 5.
28 after the intervention, indicating no significant increase in adherence.
adulthood to late adulthood.
The study showed that health education intervention using e-booklet significantly improved the knowledge of hypertensive patients in the intervention group.
The mean value of knowledge increased from 75.
before the intervention to 86.
81 after the In contrast, the control group did not experience any significant change in their knowledge, with the mean value remaining at around 72.
87 before and 73.
The low adherence in the control group could be attributed to the lack of knowledge hypertension treatment (Kartikasari et al.
Mahardika & Ayu Made Adyani.
Limited knowledge often leads patients to feel that there is no need to continue treatment if they do not feel obvious symptoms.
In addition, they are also concerned about the side effects of long-term drug use.
Previous studies have after measurement.
shown that clear and continuous education These findings are consistent with previous can improve medication adherence by providing the necessary information to structured educational methods, such as the understand the importance of long-term use of e-booklets, can significantly improve treatment (Langston et al.
, 2019.
Lukitasari patients' health knowledge (Anggraini et al.
et al.
, 2.
Sari & Werdiharini, 2.
Ebooklets conduct easy access to wellorganized information, allowing patients to learn and understand information in a more Statistical analysis revealed a significant difference in both knowledge and adherence to treatment between the intervention group and the control group, with p-values of JKEP (Jurnal Keperawata.
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001, respectively.
These results These findings emphasize the importance of indicate that the intervention using the e- interactive educational approaches and booklet had a more significant impact support from health health volunteer in compared to no intervention.
Correlation hypertension management and can be used tests (Pearson and Spearma.
demonstrated as a basis for the development of more that other confounding factors, such as age and education level, did not significantly education methods in the community.
affect patients' knowledge and adherence.
This reinforces the finding that educational interventions by health volunteer using the e-booklet are a key factor in improving health outcomes for hypertensive patients.
CONCLUSION
The mean knowledge of patients about hypertension before health education by health volunteer with e-booklet media tends to be sufficient and the mean knowledge of Health volunteer, as part of the community, patients about hypertension after health can build closer relationships with patients, education by health volunteer with e- improving communication and adherence booklet media tends to have a significant (Iseghem et al.
, 2023.
Jumaroh & Nafi'ah, increase with a good category.
Trained health volunteer can conduct information for patients, and support them in overcoming challenges in hypertension Overall, the health education intervention by health volunteer with ebooklet improvement in knowledge and medication adherence of hypertensive patients.
The ebooklet provided organized and easily accessible information, which contributed to increased patient understanding and engagement in their care.
Health education by health volunteer was also shown to be adherence, thanks to their ability to build close social relationships with patients.
The mean patient medication adherence before health education by health volunteer with e-booklet media tends to be low and the mean patient medication adherence after health education by health volunteerwith ebooklet media tends to have a significant increase with the category of adherence and moderate adherence.
There is an effect of health education by health volunteer with e-booklet media on the mean knowledge and treatment adherence of hypertension patients in the Batujajar Health Center West Bandung Regency in the form of a significant increase in the mean value of knowledge and treatment compliance.
JKEP (Jurnal Keperawata.
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REFERENCES