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Family Management of Hypertension in Brazil: A Cross-Sectional Study
Paloma Cesar de Sales1, Margaret M McCarthy2, Victoria Vaughan Dickson3
1Faculdades Metropolitanas Unidas, School of Nursing, São Paulo, São Paulo, Brazil.
Insights
Family caregivers of individuals with hypertension (HTN) experience significant stress and barriers to managing their own health. Interventions are needed to support these caregivers and improve hypertension management.
Area of Science:
- Public Health
- Cardiovascular Health
- Caregiver Studies
Background:
- Family members are primary support for individuals with hypertension (HTN) in Brazil.
- Caregiving for HTN patients can negatively impact caregiver health, causing stress and hindering HTN management.
- Limited research exists on the effects of caregiving on family members of HTN patients.
Purpose of the Study:
- To determine blood pressure (BP) control prevalence in family members of HTN patients.
- To explore family members' views on facilitators and barriers to HTN management.
- To assess influences on family member functioning, including stress, quality of life (QOL), and caregiver burden.
Main Methods:
- Descriptive, cross-sectional study involving 213 family members.
- Random sampling from three Family Health Strategy units.
- Data collected on demographics, BP control, facilitators/barriers to HTN management, stress, QOL, and caregiver burden.
Main Results:
- Most family members were female (67.1%), with a mean age of 60.1 years; 42.6% had less than a high school education.
- Key facilitators and barriers related to medication, medical visits, diet, physical activity, and stress.
- Normal BP was observed in 56.3% of family members; however, 88.8% reported moderate-to-high stress levels.
- Family members provided low support for self-care maintenance and management but had adequate self-care confidence.
- Despite high stress, good physical and mental QOL and low caregiver burden were reported.
Conclusions:
- Family members face challenges in HTN management and experience high stress, impacting their well-being.
- Contextual and sociocultural factors influence caregiver outcomes.
- Urgent need for family-based interventions to improve HTN management and support caregivers.
Abstract:
In Brazil, research indicates that primary family members are the main source of support for individuals with chronic conditions such as hypertension (HTN). The burden of caregiving not only hinders effective HTN management but can also cause stress and anxiety, potentially leading to HTN in caregivers. Despite this, few studies have explored the impact of caregiving on these family members. Aims of the study were to: (1) Describe the prevalence of blood pressure (BP) control in family members of individuals with HTN; (2) identify family member perspectives on facilitators and barriers to HTN management; and (3) identify influences that help or interfere with family member functioning (levels of stress, quality of life [QOL], and caregiver burden). This descriptive, cross-sectional study included 213 family members randomly selected from 3 Family Health Strategy units. Family members were largely female (n = 143; 67.1%); the mean age was 60.1 years (SD ± 17.02) and 42.6% (n = 96) had less than a high school education. The three most important facilitators and barriers were related to medication, medical visits, healthy eating, physical activity, and stress. The mean systolic BP was 132.7 (SD ± 21.9) mmHg and a diastolic BP of 85.9 (SD ± 18.1) mmHg with 120 (56.3%) of family members classified as having normal BP. In regard to family member contributions to the self-care of the individual with HTN, family members displayed low levels of self-care maintenance (n = 148; 69.4%) and management (n = 47; 71.2%) support, while a slight majority (n = 114; 53.5%) had adequate levels of self-care confidence in supporting the individual with HTN. Family members (n = 189; 88.8%) showed moderate-to-high levels of perceived stress, but good physical (n = 189; 88.7%) and mental QOL (n = 196; 92%) and low levels of caregiver burden (n = 113; 53.1%). A variety of contextual sociocultural influences were associated with the outcomes under study. Family-based interventions are urgently needed to address the inadequate management of HTN.
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