Adherence to Hypertension Management Recommendations for Patient Follow- Up Care and Lifestyle Modifications Made by Military Healthcare Providers

摘要

The purpose of this study was to describe military healthcare providers adherence to nationally recognized hypertensive patient guidelines concerning lifestyle modifications and follow-up instructions after an initial diagnosis of hypertension. The importance of monitoring high blood pressure (follow-up) and maintaining blood pressure control was examined. Research has shown that while hypertension follow-up is being performed, physicians are not following established guidelines aggressively enough in identifying situations in which more robust management may be appreciated. Neuman's Systems Model was used as the conceptual framework to guide this study. Data was collected utilizing a checklist developed by the researcher according to national treatment recommendations. Using a descriptive quantitative design, eight research questions were investigated during a retrospective chart review on a convenience sample of 35 medical records at an Air Force medical treatment facility located in the northeast United States. Military Healthcare Providers fared well (94%) in maintaining oversight of their hypertensive patients by providing excellent follow-up management. However, lifestyle modification prescriptions to their patients, were less favorable. There was a low compliance with weight loss instruction (36%), the limitation of alcohol use (57%), and need to increase physical activity (38%), reduce sodium intake (6%), and maintain adequate potassium (3%), calcium (9%), and magnesium (0%). Patients in this study were also not provided with adequate information about decreasing dietary fat (17%). However, Military Healthcare Providers were exceptional in both identifying and counseling cigarette smokers (100%). This thesis revealed a better compliance to JNC VI (1997) guidelines by Advanced Nurse Practitioners than physicians did in all areas of instructions.