Assessment of Hypertension Self-Management Behavior and Its Predictors in Three Provinces, Indonesia: A Cross-sectional Study

Background Effective self-management can reduce the costs, morbidity, and mortality from the complications caused by hypertension. Despite efforts to improve self-management behavior, adherence rate remained low. Yet, the key factors contributing to this behavior remain unclear, particularly in the Indonesian setting. This study aimed to assess the self-management behavior and its determinants in three provinces in Indonesia. Methods A cross-sectional design was used in this study. The target population was patients with hypertension registered in three provinces in Indonesia: West Java, East Java, and Aceh. A total of 607 patients with hypertension participated in this study. The Hypertension Self-Management Behavior Questionnaire was used to measure the dependent variable. Spearman’s rank test and multinomial logistic regression were used to analyze the factors contributing to self-management behavior. Results The multivariate analysis showed that marital status, blood pressure category, and smoking behavior were associated factors of hypertension self-management behavior. The multinomial logistic regression model demonstrated a statistically significant improvement in fit compared with the intercept-only model (χ 2 = 356.51, p < 0.001; Nagelkerke pseudo-R 2 = 0.538). Conclusion This study identified three factors that are contributing to hypertension self-management. Recognizing the three factors is important for community health nurses to assist in improving their patients’ effective hypertension self-management. Future research can use a prospective longitudinal design to determine the temporal and causal links between the stages of hypertension, life-stage events, social support, health literacy, cultural beliefs, healthcare system factors, and the implementation of self-management activities.