Self-efficacy, Self-management and Their Impact on Hypertensive Patients’ Outcomes: A Study from Primary Health Centers in Indonesia

Self-management in hypertensive patient outcomes is considered cost-effective treatment with self-efficacy support. Factors correlated with self-efficacy and self-management are complex interactions of intrinsic and extrinsic factors. This study explored the factors related to self-efficacy and self-management and their impact on blood pressure and health-related quality of life (HRQoL) of hypertensive patients in primary health centers. A cross-sectional study from ten primary health centers from South Sumatera province with 407 participants used a questionnaire and medical records. The data were analyzed descriptively, bivariate (chi-square) and multivariate logistic regression backward method. Factors correlated to self-efficacy include disease knowledge (OR = 5.538, P=0.000), social support (OR=4.330, P=0,000), disease courses (OR=2.807, P=0.000) and unemployed/retired (OR=2.174, P=0.002), while the factor correlated to self-management are disease knowledge (OR=2.223, P=0.002), unemployed/retired (OR=1.712, P=0.037), self-efficacy (OR=1.631, P=0.046), age (OR=1.594, P=0.023), and social support (OR=1.461, P=0.099). Self-management is correlated with blood pressure (OR=5.045, P=0.000) and HRQoL (OR=0.541, P=0.005). Blood pressure is correlated with HRQoL (OR=1.703, R=0.027). Hypertensive patients with higher disease knowledge, higher social support, longer disease courses, and unemployed/retired were significantly more likely to have good self-efficacy. Thus, the higher disease knowledge, unemployed/retired, patients with good self-efficacy, older age, and higher social support are more likely to have better self-management. Disease knowledge is the most correlated variable with self-efficacy and self-management in this study. Self-management has a positive effect on blood pressure and HRQoL. Controlled blood pressure is known to have a positive HRQoL. This study provides an overview for the government and health care professionals in recognizing strong predictors and implementing effective strategies in self-management interventions in hypertensive patients.