Effect of the training program structured based on the roper, logan and tierney activities of daily life model and supported with mindfulness on self-care, medication adherence and healthy lifestyle behaviors in hypertensive individuals

This randomized controlled study aimed to evaluate the effect of a education program based on the Roper, Logan, and Tierney model of daily living activities supported with mindfulness on self care, treatment adherence, and healthy lifestyle behaviors in hypertensive individuals. Individuals diagnosed with stage I hypertension and monitored at the Cardiology outpatient clinic of the Ankara Training and Research Hospital, Ministry of Health, were assigned to intervention (n=35) and control (n=35) groups through stratified randomization between March 2023 and May 2024. The intervention group received an online education program based on the Roper, Logan, and Tierney model of daily living activities and supported by mindfulness once a week, each lasting 45 minutes sessions, for eight weeks. The control group received routine care without any additional intervention. Data were collected face-to-face at the cardiology outpatient clinic using the Participant Information Form, Hypertension Follow-up Form, Metabolic Control Variables Monitoring Form, Hypertension Self-Care Profile Scale, Hill-Bone Hypertension Treatment Adherence Scale, Healthy Lifestyle Behaviors Scale II, Mindfulness Scale, and Hypertension Knowledge Evaluation Form. Statistical analyses included the student t-test, Mann-Whitney U test, paired t-test, and Friedman test. The results showed that the intervention group had significantly lower systolic and diastolic blood pressure values, and higher self-care, treatment adherence, healthy lifestyle behaviors, and mindfulness scores at 8th and 12th weeks compared to the control group (p<0.05). Additionally, the intervention group had significantly lower fasting blood glucose, low-density lipoprotein, serum sodium levels and higher high-density lipoprotein and potassium values compared to the control group at week 8 (p<0.05). Lastly, hypertension knowledge levels were higher in the intervention group compared to the control group at week 8. The findings indicate that hypertension self management education program based on the daily living activities model and supported by mindfulness contributes to hypertension knowledge, systolic and diastolic blood pressure, self care, treatment adherence, and healthy life style behaivours. In line with these findings, it is necessary to increase the programs offered based on nursing theories to support the management of hypertension in clinical practices. Furthermore, it is recommended to design further clinical studies targeting long-term follow-up with larger sample groups to increase adherence to hypertension treatment and gain targeted healthy lifestyle behaviors.