The effect of multimodal interventions based on integrative nursing principles on blood pressure, stress, and treatment adherence in individuals with uncontrolled hypertension: A randomized controlled trial

Objective: The aim of this study is to evaluate the effects of multimodal interventions "Uncontrolled Hypertensives for Integrative Nursing-based Multimodal Interventions (UHTINuM)" based on integrative nursing principles on blood pressure (BP), stress, and compliance levels to hypertension treatment in individuals with uncontrolled BP. Method: The study is a randomized controlled trial a single-blind (participant), active control group. The group where UHTINuM interventions were applied was taken as the intervention group (n:24) and the group where health recommendations were given was taken as the active control group (n:24). This study was conducted with adult individuals aged 50-65 in Hayat Park located in Konyaaltı, Antalya. Multimodal interventions including 12-week meditation and breathing techniques, yoga, hypertension treatment compliance training and home BP measurement training were applied to the intervention group, and the active control group was directed to a specialist doctor by giving information notes and Ministry of Health brochures. The primary outcomes were measured using aneroid BP device, Hill-Bone Hypertension Treatment Adherence Scale, Perceived Stress Scale. Results: The BP and stress level of the UHTINuM group decreased significantly compared to the active control group, and the level of adherence to hypertensive treatment increased. The systolic and diastolic BP differences of the groups from baseline were --21.75±9.58 mmHg (p<0.01) in the UHTINuM group, -4.70±12.36 mmHg (p>0.05) in the active control group, diastolic BP 11.37±8.00 mmHg (p<0.01) and +0.33±9.24 mmHg (p>0.05), respectively) was found. In comparison between groups, the UHTINuM group showed significantly more improvement in perceived stress (4.54/1.12 points) and adherence to hypertensive treatment (2.83/1.58 points) than the active control group. Conclusion: The UHTINuM program had a positive effect on reducing blood pressure and stress and increasing compliance with hypertensive treatment in hypertensive individuals whose blood pressure was not under control.