Abstract
The aim of this study is to explore predictor of health outcomes among Malaysian hypertensive patients attending a standard hypertension intervention programme. Among the psychological predictors studied are illness perception, health locus of control, and self-efficacy. Quality of life, anxiety and depression and demographic variables are among the predictors included in the study. Two series of studies were conducted to answer the research question formulated for each study. Study 1 aims to determine the psychological predictor of health outcomes among Malaysian hypertensive patient. This Study 1 examines the differences in physical and medical indices as well as psychological predictor across three periods of time (baseline, after intervention complete and at six month upon completion of the initial intervention) between intervention and waiting list control group. Study 2 explored the determinant of successful control of hypertension among Malaysian patients. This study aims to explore patients' knowledge and understanding of their condition and illness; factors that facilitate patients to change and barrier to change and patients' views of current intervention. In order to adequately answer the research question posted by both studies, both quantitative and qualitative modes of study were selected and patients were recruited from two selected community health centers located in Malaysia. The finding of the Study 1 highlight the physical and medical indices (weight, BMI, SBP, DBP, creatinine level and urea) of the intervention group did significantly change (P<.05) over three times period with a medium to large change seen at Time to Time3 with effect size ranged between -.41 to -.85. Total cholesterol and HDL-C associated with Chance subscales of MHLC Form C (p<.05); and creatinine change with Chance subscales of MHLC Form C (p<.05). However, this finding has unable to provide answer to the question of why some patients undergone an intervention and do well while others do not still remain a question. The findings of the Study 2 highlight the similarities and differences of successful and unsuccessful control of hypertension participant's view on the determinant of successful controlled of hypertension from Malaysian patients perspective. The content analysis conducted on the six interviews revealed both successful and unsuccessful control of hypertension participants shared similar views on the three aspects (i.e. knowledge of condition; factors motivate lifestyle change or barrier to change; and view on current intervention programme) covered during interview. But, both group had slightly different view about control and lifestyle change and it's due to insufficient knowledge of the aspect discuss during interview or some participant felt satisfied with their condition and they feel it is sufficient for them to ensure that they are cure or some felt not ready to commit to any change. Another possible reason for these differences because they just had been few months diagnosed with hypertension. In conclusion, the findings of this research project highlight the importance of further studying the contributing factors which create a gap or discrepancy among those hypertensive patients who has been attending intervention programme. This discrepancy may comes in various form which either from the patient themselves or health care provider or the environment. The study outcome also highlighted the importance for the health care provider to discuss the actual fact about the patient's condition every time patient's attending follow-up clinic. The implication of this practice will limit the patient with whatever knowledge they have on their illness without perceiving illness control should be practiced as a whole. In other words, all the control measures include compliance to medication, controlling diet, regular exercising, and live stressful lifestyle should be perceived as inter-related and not to be selected based on any preference as to ensure positive health outcome. (Abstract shortened by ProQuest.).