The effect of a family-centered empowerment model with traditional Chinese medicine health education on self-management in community-dwelling older adult hypertensive patients with a chance health locus of control.

BACKGROUND: Despite much evidence showing the effectiveness of structured self-management education for patients with hypertension (HTN), poor blood pressure control remains a challenge among chance health locus of control (CHLC) older adults with HTN. OBJECTIVE: We explored the effect of a health education intervention based on the Family-Centered Empowerment Model (FCEM) on the self-management of opportunistic older adults with HTN in Lanzhou, China. METHODS: We conducted a 2-armed, randomized controlled trial using a multistage sampling method in China, Lanzhou, from May 2023 to January 2024. A total of 60 patients were randomly assigned to receive either community nurse-led HTN education based on the FCEM or general community HTN education. Blood pressure, Body Mass Index (BMI), and multidimensional health locus of control (MHLC) Scale Scores, and HTN self-management scores were compared at baseline and at 3 and 6 months after the intervention. RESULTS: Analyses were conducted on the 58 patients completing follow-up. In the experimental group, the systolic blood pressure (SBP) (t = -3.325, P = 0.002), diastolic blood pressure (DBP) (t = -5.110, P < 0.001), and the Chance control dimension of MHLC Scale scores (t = -4.781, P < 0.05) decreased; the scores on internal control dimensions (t = 8.493, P < 0.001) and self-management scores (t = 4.406, P < 0.001)improved compared with the control group at 6 months postintervention. There was a decrease in patients' BMI (t = -1.207, P = 0.232), but the difference was not statistically significant. CONCLUSIONS: This study found that education based on the FCEM was associated with greater improvements in HTN self-management and blood pressure control compared with general health education among CHLC older adults with HTN. CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=194623, identifier: ChiCTR2300070940.