A dual-module person-centered nursing self-care bundle for hypertension management: development and expert validation

Sustained hypertension self-care is central to long-term blood pressure control, but it often remains suboptimal in primary care because patients may experience difficulties with daily monitoring, lifestyle modification, medication adherence, family support, and routine follow-up. Existing self-management materials commonly provide education or monitoring support, but fewer are designed to connect patients' daily home-based self-care records with structured nurse-led review during routine primary care visits. This study aimed to develop and validate a dual-module person-centered nursing-based self-care bundle for hypertension management in primary care.

This was a sequential intervention-development and expert-validation study with qualitative and quantitative components. Phase I examined the contextual relevance of four predefined self-care domains, conducted focus group discussions with patients, family caregivers, and healthcare providers, and integrated stakeholder and preliminary expert input into patient and nurse modules. Phase II involved seven experts who assessed content, presentation, language, graphic design, and suitability as health-promotion media. For content, I-CVI and S-CVI/Ave were interpreted as content-validity indices; the same proportional calculations summarized domain-specific expert agreement for the four non-content domains. Qualitative comments guided module refinement.

The patient module was structured as a self-care guide, daily record, checklist, and communication tool; the nurse module included guidance for education, record review, monitoring, individualized feedback, documentation, and follow-up. Content-domain S-CVI/Ave values were 0.89 for the patient module and 0.91 for the nurse module. Domain-average agreement for presentation, language, graphic design, and media suitability ranged from 0.93 to 1.00, while overall multidomain agreement was 0.94 and 0.95, respectively. Three items below the prespecified 0.86 threshold were revised. Experts confirmed that the requested changes had been addressed; no repeat ratings or post-revision CVI estimates were obtained.

Expert validation indicated acceptable content validity and high expert agreement across the four non-content domains for the assessed module versions; these non-content ratings reflect expert judgment rather than target-user usability. Further studies should examine feasibility, implementation fidelity, patient usability, nurse adherence, and preliminary effects on self-care behavior and blood pressure control.

Not applicable.