Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 205-217 https://ebsina.
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php/jkki eISSN 2503-2801, pISSN 2985-3435 Health System Guidance as Nursing Intervention for Ineffective Health Management in Aggregate Adults with Hypertension Rahma MarAoatus Sholikhah1*.
Niken Asih Laras Ati2 .
Fahruddin Kurdi2 .
Ni Ketut Ardhani3 1 Faculty of Nursing.
Universitas Jember.
Indonesia 2 Department of Community.
Family and Gerontic Nursing.
Faculty of Nursing.
Universitas Jember.
Indonesia 3 Health Office of Jember.
Indonesia Article History Submitted: 27-06-2024 Revised: 28-07-2024 Accepted: 16-08-2024 org/10.
58545/jkki.
Copyright .
2024 Authors This is an open-access article under the CC-BY-SA License.
Abstract Introduction: Hypertension is a type of non-communicable disease that can significantly cause morbidity and mortality of sufferers.
Adult age is a risk factor that has a great influence on hypertension.
Interventions that can be given to the community are Health System Guidance to identify hypertension problems in the community and develop the ability to overcome existing health problems, namely hypertension Objective: To determine the effectiveness of nursing interventions for health system guidance.
Method: Descriptive and analytical research design with a sample of 50 productive age who have hypertension in the RW 08 area of Patrang Village and 5 health cadre.
This research carried out implementation in the form of primary prevention .
ealth educatio.
, secondary prevention .
ypertension screening and cadre empowermen.
and tertiary prevention .
ducation and demonstration of giving star fruit juic.
Data collection used respondent characteristic instruments, hypertension knowledge questionnaire, hypertension diet questionnaire, standart operating procedure for blood pressure measurement, standart operating procedure for making star fruit juice.
Data analysis used paired sample t-test, wilcoxon test, and mann whitney test.
Results: There was a significant difference between knowledge before health education and after health education .
= 0.
In cadre empowerment, there was an increase in the percentage of cadre ability and the mean of cadre In tertiary prevention, there was a significant difference between blood pressure after giving star fruit juice therapy between the intervention and control groups .
< 0.
Conclusion: Health system guidance is effective in improving health management of hypertension.
Keywords: Hypertension.
Health System Guidance.
Ineffective Health Management Correspondence Rahma MarAoatus Sholikhah Faculty of Nursing.
Universitas Jember Jl.
Kalimantan No.
Sumbersari.
Kabupaten Jember.
East Java 68121 Indonesia Email: msholikhah404@gmail.
How to cite:
Sholikhah.
Ati.
Kurdi.
& Ardhani.
Health System Guidance as Nursing Intervention for Ineffective Health Management in Aggregate Adults with Hypertension.
Jurnal Kesehatan Komunitas Indonesia, 4.
, 205217.
https://doi.
org/10.
58545/jkki.
Sholikhah .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 205-217 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 that is not properly controlled will tend to BACKGROUND increase in old age (Rizqullah et al.
, 2.
communicable disease (NCD) that can Lack of knowledge and awareness related significantly cause morbidity and mortality to hypertension, lack of interest in seeking in sufferers (Calano et al.
, 2.
Productive information from various media and health people are a risk group that is prone to workers and the increasing application of hypertension, because as they age and the unhealthy lifestyles, these factors have a body's abilities decrease, as well as the significant contribution to the high habit of implementing an unhealthy incidence of hypertension in productive lifestyle (Ekarini et al.
, 2.
Acording to age (Faisal et al.
, 2.
A person who the World Health Organization, about 1.
experiences ineffective health management billion adults aged 30-79 years worldwide will show difficulty following a treatment are diagnosed with hypertension.
Of these, program, failing to reduce risk factors, not it is estimated that around 46% are implementing a treatment program or unaware that they have hypertension treatment in daily life, as well as not being (WHO, 2.
The results of the 2018 Basic successful in using daily activities to Health achieve health goals (PPNI, 2.
If left prevalence of hypertension nationally is untreated, hypertension can cause serious 11% or million more health problems because it interferes with Indonesians suffer from hypertension activities and has the potential to cause (Kemenkes RI, 2.
In 2020.
East Java dangerous complications if not treated and ranked second highest in the prevalence anticipated from the beginning.
Advanced rate of hypertension among provinces in symptoms that may arise include stroke.
Indonesia, reaching 36.
In Jember vision problems, pain, enlarged muscles in Regency, the heart, dizziness, and kidney problems Hypertension Research (Riskesda.
, hypertension reaches 39.
18%, making it one (Faisal et al.
, 2.
of the districts with the third highest The focus assessment related to hypertension rate in East Java province hypertension carried out on the total total (Dinkes Jawa Timur, 2.
number of productive adult age aggregates, namely 431 residents, showed that as many productive age can increase the risk of 6% had blood pressure of >140/90 health problems later in life.
Blood pressure mmHg when blood pressure was checked.
Suffering Health System Guidance for Ineffective Health Management in Aggregate Adults with Hypertension Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 205-217 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 as many as 50.
7% of residents often any symptoms or complaints when their complained of dizziness, as many as 39.
high blood pressure recurs.
So that of residents had a history of hypertension residents are not worried about their from the family, as many as 51.
9% of condition and do not take any action to residents had smoking habits and 45.
7% of control blood pressure.
residents had the habit of consuming foods The "community as partner" model in with high salt content.
Health cadres said hypertension is a community nursing that the implementation of blood pressure model that focuses on working with the checks is usually carried out after the community as a partner or partner, to address hypertension problems in the service post (Posyand.
for toddlers, but community, improve health and prevent the community who participated was only nursing problems in the community a few (< 10 peopl.
, due to low public environment (Susanto et al.
, 2.
Interventions that can be provided are examination, busy community activities in Health System Guidance to identify the morning or long distances for people in hypertension problems that exist in the RT 1 and 4 to come to the Posyandu located community and develop the ability to in RT 3.
The Regional Nurse said that the overcome existing health problems, namely implementation of an integrated guidance hypertension problems post for the early detection and prevention Providing intensive guidance in adulthood of NonAecommunicable diseases (NCD.
of hypertensive patients can provide called AuPosbindu PTMAy is carried out once changes in their behavior and ability to a year in each Posyandu.
The Chairman of RW 08 said that the implementation of hypertension independently (Arfan et al.
health education about hypertension in the These activities include providing RW 08 area is still not optimal in its information about the causes and effects of implementation and the role of health hypertension factors, developing skills cadres is not optimal in activities related to necessary for a healthy life in hypertension hypertension in the RW 08 area.
Health Health system guidance is an effort officials said that the majority of residents to empower the community by identifying, consider hypertension complaints to be facilitating, involving, and guiding the commonplace, and sometimes do not feel entire community to maintain and improve (PPNI, 2.
Sholikhah .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 205-217 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 their health.
This empowerment process This study was conducted with a sample of 50 productive age .
years old emotional, and physical skills in dealing residents who have hypertension in the with certain health problems, especially in RW 08 area of Patrang Village, 5 health the context of hypertension (Wirakhmi & cadres, 10 residents for the intervention Novitasari, 2.
group and 10 residents for the control to improve Based on this background, the This researcher will carry out community implementation in the form of primary nursing care by providing intervention and prevention .
ealth educatio.
, secondary prevention .
ypertension screening and hypertension adults RW 08 Patrang Village.
Patrang Village Working Area of prevention .
ducation and demonstration the Patrang Health Center through Health of giving star fruit juice as an anti- System hypertension drin.
Data collection used Guidance the aim improving health management with the criteria of the results of taking actions to hypertension knowledge questionnaire, hypertension diet questionnaire.
SPO
(Standard Operating Procedur.
pressure measurement.
SPO (Standard activities to meet health goals increasing Operating Procedur.
for star fruit juice Data analysis used paired sample undergoing treatment/treatment programs t-test, wilcoxon test, and mann whitney
METHODS
This research is a case study with a descriptive and analytical research design
RESULTS
The results obtained in this study in the management area, namely RT 1, 2, 3 and 4 RW 08.
Patrang Village.
Patrang.
Jember.
This process will be carried out hypertension diet, hypertension screening from May 2024 to July 2024, covering the results, knowledge and ability to empower stages of data collection to data reporting.
cadres, and demonstration of star fruit Health System Guidance for Ineffective Health Management in Aggregate Adults with Hypertension Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 205-217 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 juice as an anti-hypertension drink, as carried out on 50 hypertension patients in presented in the following table.
The RW 08, presented in table 1.
following are the results of the screening Table 1.
Distribution of Characteristics of Hypertension Respondents in Adult Age Aggregate .
Characteristics of Respondents Age Weight Characteristics of Respondents Gender Man Woman Genetic History Yes Not Smoking Behavior Yes Not Excessive Salt Consumption Yes Not Physical Activity Yes Not Hypertension Medication Consumption Yes Not Blood Pressure Systolic Blood Pressure Diastolic Blood Pressure Median Mean (SD) 48,58 .
65,00 .
Number .
Percentage (%) Mean (SD) .
146,1 .
93,3 .
Min-Max
130 Ae 180
80 - 120
The results of the aggregate screening female as many as 64%, as many as 50% of adults amounted to 50 respondents, it have a genetic history of hypertension, 34% was known that the aggregate of adults in who smoke behavior, 84% consume RW 08 who experienced hypertension had excessive salt, 44% do not do physical an average age of 48.
58 years and a weight activity, 66% do not take hypertension The results of the screening that The results of the screening have been carried out include an aggregate were found that the average blood pressure of 50 adults, it is known that the most of adults totaling 50 was known to be people who experience hypertension are 146/93 mmHg.
Sholikhah .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 205-217 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 Table 2.
Distribution of Hypertension Knowledge in Aggregate Adults with Hypertension .
Variable Knowledge before Health Education Knowledge after Health Education Median .
in-ma.
0 Ae 83.
6 Ae .
Mean (SD) 05 .
p-value Based on table 2.
It was found that there is a significant influence on the health there was a significant difference between education provided to all respondents .
= knowledge before health education and after health education.
This shows that Table 3.
Distribution of Hypertension Diet Knowledge in Aggregate Adults with Hypertension .
Variable Knowledge before Health Education Knowledge after Health Education Median .
in-ma.
6 Ae 83.
6 Ae .
Based on table 3.
The results were Mean (SD) 13 .
p-value These activities include providing obtained that the significance value of the Wilcoxon test was .
= 0.
which continued skill training on procedures for means that there was an influence of measuring and reading blood pressure hypertension diet health education on public knowledge.
calculating BMI and measuring abdominal The next secondary prevention is related to the empowerment of health Cadre's Knowledge Cadre's Ability Pre-Test Post-Test Figure 1.
Cadres Knowledge Distribution related to hypertension .
Health System Guidance for Ineffective Health Management in Aggregate Adults with Hypertension Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 205-217 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 Based on figure 1, it was found that health empowerment.
This shows that there was a significant increase in the there is an increase in the average level of knowledge and ability of health cadres knowledge of health cadres before and after before health empowerment and after health education.
Table 4.
Differences in blood pressure after treatment in the intervention group and the control group Intervention Median Min-max Blood pressure Systolic Diastolic Control Median p-Value Min-max From table 4, the analysis of Mann- cadres, lowering blood pressure through Whitney statistical test shows that the p- demonstration activities of giving star fruit value for systolic blood pressure is 0.
juice as an anti-hypertension drink.
and for diastolic blood pressure is 0.
Based on the results of the study, the These two values were smaller than the majority of respondents experienced an significance value of =5% .
< 0.
increase in knowledge about hypertension suggesting that there was a significant difference between blood pressure after administration of sweet star fruit juice education programs and hypertensive diets therapy between the intervention group on public knowledge.
Patient knowledge and the control group.
and awareness about hypertension is a crucial factor in achieving blood pressure control (Elisa & Rispawati, 2.
Health
DISCUSSION