Self-care, treatment adherence and frailty in hypertensive individuals aged 65 and over: A cross-sectional study

This study aimed to determine the level of of self-care, treatment adherence, and frailty in hypertensive individuals aged 65 and over and examine the relationship between these variables. This cross-sectional study was conducted in Geriatrics Outpatient Clinics of the University of Health Sciences Gulhane Training and Research Hospital between November 30, 2022, and September 30, 2023. The study sample consisted of individuals with hypertension aged 65 and over (n=224). "Participant Information Form", "Hypertension Self-Care Scale", "Hill-Bone Hypertension Treatment Adherence Scale" and "Edmonton Frailty Scale" were applied face-to-face. Data were analyzed using mean, standard deviation, minimum, maximum, median, independent sample t-test, Mann Whitney-U, ANOVA test, Kruskal Wallis test, multiple logistic regression analysis and structural equation model. 66.5% of the individuals were female, with a mean age of 75.61±6.03 years. 92% of the individuals had inadequate (0-69 points) self-care levels, and all of those had non-adherence to treatment, 20.5% of them were mild and 6.7% were severely frail. Self-care scores were higher in those who measured their blood pressure regularly at home, noticed the changes in blood pressure, and received hypertension training (p<0.05). The study revealed that female, single, primary school graduates and unemployed individuals were more frail (p<0.05). As the level of self-care increased, noncompliance with treatment and vulnerability decreased (p<0.05). According to the structural equation model, self-care had a direct effect (R2=-0,379) on frailty, and medication adherence showed a direct effect (R2=-0,516) on self-care. The model explained 26.6% of the change in variance of Edmonton Frailty Scale scores. Nurses should closely monitor hypertensive individuals aged 65 and over in terms of self-care and adherence to treatment and routinely assess for frailty. Further studies are suggested to improve self-care and explain other variables that may affect frailty.