Effectiveness of a Family-Centered Empowerment Model on Self-Efficacy in Patients with Hypertension: A Randomized...

Hypertension is a major public health challenge, and low self-efficacy undermines adherence to lifestyle change and treatment. Family-centered empowerment may strengthen self-efficacy, yet evidence in Iranian patients with hypertension is limited. This study evaluated the effect of a family-centered empowerment program on self-efficacy in adults with hypertension.

In this randomized clinical trial (Zahedan, Iran; November 2020-September 2021), 70 patients were randomized 1:1 to intervention (four weekly 60-min family-centered empowerment sessions with a primary caregiver) or usual care. The primary outcome was hypertension self-efficacy (17-item validated scale) measured at baseline, immediately post-intervention, 1 month, and 3 months. Repeated-measures analysis of variance (ANOVA) tested time, group, and time × group effects; partial eta squared (η ² p) and Cohen's d complemented p values.

Groups were comparable at baseline (all p > 0.05). Repeated-measures ANOVA showed a significant time × group interaction for total self-efficacy (F = 148.72, p < 0.001; η ² p ≈ 0.69). The intervention group improved across all time points, whereas the control group remained largely stable. At 3 months, total self-efficacy was 53.40 (2.87) (intervention) versus 46.48 (3.64) (control; p < 0.001; Cohen's d = 2.11). Similar patterns were observed for dietary adherence (32.22 (1.30) vs 28.45 (2.13); p < 0.001; d = 2.14), treatment adherence (12.88 (1.45) vs 11.65 (1.69); p < 0.001; d = 0.78), and disease management (8.28 (0.98) vs 6.37 (1.00); p < 0.001; d = 1.93).

A structured family-centered empowerment program meaningfully increased self-efficacy in patients with hypertension over 3 months, with large effect sizes across total and domain scores. Given its cultural fit and low resource needs, integrating this model into routine nursing practice may enhance hypertension self-management.