Family-Centered Education for Older Adults with Hypertension: A Scoping Review
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Abstract
Background: Older adults are the most hypertensive population compared to other age groups. The purpose of this study was to determine an education model involving the family and the outcomes of the program.
Methods: Studies conducted in 2023. The search terms "Aged or Older Adult or Elderly and Family-centered or Family Nursing and Hypertension or High Blood Pressure" were used to conduct a scoping review in the journals PROQUEST, SCOPUS, MEDLINE, COCHRANE, and PubMed until 2022. The flowchart for the PRISMA Scoping review shows the search and selection procedure. Tools from the Joanna Briggs Institute (JBI) for Randomized Controlled Trials and Quasi-Experimental Studies are used to critically evaluate a few chosen papers.
Results: There were 11 articles found out of 2,355 articles in the search results. To increase perceived threat, self-efficacy, and self-confidence, the family-involved education intervention is implemented in phases. Knowledge, family involvement, blood pressure, cholesterol, uric acid, quality of life, and behavioral changes were among the outcomes that were evaluated.
Conclusion: Education involving families of the elderly with hypertension can affect a decrease in blood pressure, an increase in self-efficacy and good behavioral change, an increase in self-esteem, improved life quality, and family empowerment.Older adults
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2. Kario K, Okura A, Hoshide S, et al (2024). The WHO Global report 2023 on hypertension warning the emerging hypertension burden in globe and its treatment strategy. Hypertens Res, 47(5): 1099-1102.
3. Ministry of Health Republic of Indonesia (2018). Indonesian basic health research. Availabel from: https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/
4. Flint AC, Conell C, Ren X, et al (2019). Effect of systolic and diastolic blood pressure on cardiovascular outcomes. N Engl J Med, 381(3):243–51.
5. Ranjith N, Myeni NN, Sartorius B, et al (2017). Association Between Hyperuricemia and Major Adverse Cardiac Events in Patients with Acute Myocardial Infarction. Metab Syndr Relat Disord, 15(1):18–25.
6. Zhou D, Xi B, Zhao M, et al (2018). Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study. Sci Rep, 8(1): 9418.
7. Wang C, Yuan Y, Zheng M, et al (2020). Association of age of onset of hypertension with cardiovascular diseases and mortality. J Am Coll Cardiol, 75(23): 2921–2930.
8. Thomopoulos C, Parati G, Zanchetti A (2018). Effects of blood pressure-lowering treatment on cardiovascular outcomes and mortality: 14–effects of different classes of antihypertensive drugs in older and younger patients: overview and meta-analysis. J Hypertens, 36(8): 1637–1647.
9. Ciumărnean L, Milaciu MV, Negrean V, et al (2021). Cardiovascular risk factors and physical activity for the prevention of cardiovascular diseases in the elderly. Int J Environ Res Public Health, 19(1): 207.
10. Niessen LW, Mohan D, Akuoku JK, et al (2018). Tackling socioeconomic inequalities and non-communicable diseases in low-income and middle-income countries under the Sustainable Development agenda. Lancet, 391(10134):2036–2046.
11. Saiz LC, Gorricho J, Garjón J, et al (2020). Blood pressure targets for the treatment of people with hypertension and cardiovascular disease. Cochrane Database Syst Rev, 9(9):CD010315.
12. Fuchs FD, Whelton PK (2020). High Blood Pressure and Cardiovascular Disease. Hypertension, 75(2): 285–292.
13. Han HR, Kim MT, Rose L, et al (2006). Effects of stressful life events in young black men with high blood pressure. Ethn Dis, 16(1): 64–70.
14. Smeltzer SC, Bare BG, Hinkle JL, et al (2008). Brunner and Suddarth’s textbook of medicalsurgical nursing 10th edition. Philadelphia: Lipincott Williams & Wilkins, pp: 719-750.
15. CDC AW(2020). Centers for disease control and prevention. 2020. Available from: https://www.cdc.gov/high-blood-pressure/
16. Zamandi M, Daroudi R, Sari AA (2023). Direct Costs of Hypertension Treatment in Iran. Iran J Public Health, 52(9):1973-83.
17. Fryar CD, Ostchega Y, Hales CM, et al (2017). Hypertension prevalence and control among adults: United States, 2015-2016. NCHS Data Brief, (289):1-8.
18. Smeltzer SC, Bare BG, Hinkle J, et al (2010). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing Twelfth Edition. Vol. 1, Wolter Kluwer Health/Lippincott Williams & Wilkins, pp.: 2010. 461–480.
19. Isnaini N, Ratnasari R (2018). Faktor risiko mempengaruhi kejadian Diabetes mellitus tipe dua. J Kebidanan dan Keperawatan Aisyiyah, 14(1):59– 68.
20. Iezadi S, Gholipour K, Sherbafi J, et al (2024). Service quality : perspective of people with type 2 diabetes mellitus and hypertension in rural and urban public primary healthcare centers in Iran. BMC Health Serv Res, 24(1): 727.
21. Zheng Y, Liu Y, Xue D, et al (2024). Research on the control rate of hypertension under family physician-contracted service. BMC Prim Care, 25(1): 47.
22. Bludorn J, Railey K (2024). Hypertension Guidelines and Interventions. Prim Care, 51(1):41–52.
23. Zhang X, Zheng Y, Qiu C, et al (2020). Well-being mediates the effects of social support and family function on self-management in elderly patients with hypertension. Psychol Health Med, 25(5): 559-571.
24. Nasrabadi H, Nikraftar F, Gholami M, et al (2021). Effect of Family: Centered empowerment model on eating habits, weight, hemoglobin A1C, and blood glucose in iranian patients with type 2 diabetes. Evid Based Care J, 11(1): 25–34.
25. Simamane M, Constantinou D, Watson E (2023). The Family Involvement Role in Assisting with Hypertension Management: A Qualitative Study. Re-searchsquare. Available from: https://www.researchsquare.com/article/rs-2910950/v1
26. Friedman M (1997). Teaching about and for family diversity in nursing. Journal of Family Nursing, 3(3): 280-294.
27. Isnaini N, Aprilina RSHD(2021). The Influence of Family Support on Self Efficacy of Chronic Kidney Disease. In: 4th International Conference on Sustainable Innovation 2020. Health Science and Nursing. Atlantis Press, 17(25): 26–35.
28. Bahari G, Scafide K, Krall J, et al (2019). Mediating role of self-efficacy in the relationship between family social support and hypertension self-care behaviours: A cross-sectional study of Saudi men with hypertension. Int J Nurs Pract, 25(6): e12785.
29. Zhao J, Hu Y, Zhang X, et al (2020). Efficacy of empowerment strategies for patients with hypertension: A systematic review and meta-analysis. Patient Educ Couns, 103(5): 898–907.
30. Kokorelias KM, Gignac MAM, Naglie G, et al (2019). Towards a universal model of family centered care: A scoping review. BMC Health Serv Res, 19(1): 564.
31. Kaakinen, J. R, Coehlo, D.P, et al (2018). Family health care nursing : Theory practice and research. 6th ed. FA Davis, Philadelphia, pp: 113–146.
32. Ouzzani M, Hammady H, Fedorowicz Z, et al.(2016). Rayyan-a web and mobile app for systematic reviews. Syst Rev, 5(1): 210.
33. Santos WM dos, Secoli SR, Püschel VA de A (2018). The Joanna Briggs Institute approach for systematic reviews. Rev Lat Am Enfermagem, 26 : e3074.
34. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372:n71.
35. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med, 169(7): 467–473.
36. Leili Rabiei, Firoozeh Mostafavi, Reza Masoudi’ AH (2013). The effect of family-based intervention on empowerment of the elders. J Educ Health Promot, 2: 24.
37. Hedayati B (2015). The effect of implementation of family-centered empowerment model on the self-esteem of the old people with hypertension. J Educ Health Promot, 4: 74.
38. Keshvari M, Hedayati B, Moeini M, et al (2015). A survey on the effect of implementation of a family-centered empowerment model on blood pressure and empowerment dimensions in the elderly people with hypertension. J Educ Health Promot, 4: 94.
39. Hedayati B (2018). Effect of family-based empowerment model on the self-efficacy of hypertensive elderly people. Iran J Ageing, 13(1): 86–97.
40. Maslakpak MH, Rezaei B, Parizad N (2018). Does family involvement in patient education improve hypertension management? A single-blind randomized, parallel group, controlled trial. Cogent Med, 5(1): 1537063.
41. Someia NM, Atri SB, Areshtanab HN, et al (2020). Effectiveness of education based on family-centered empowerment model on health-promoting behaviors and some metabolic biomarkers in elderly women: A stratified randomized clinical trial. J Educ Health Promot, 9: 331.
42. Marlina, Badaruddin, Zuska F, et al (2018). The family health empowerment in the stroke prevention in the puskesmas of Ulee Kareng, Banda Aceh, Indonesia. Asian J Microbiol Biotechnol Environ Sci, 20(2): 291–295.
43. Shaafi MS, Hosseini N, Akbartabar Toori M, et al (2020). Comparing the Effects of Group and Family-Centered Education in the Elderly Lifestyle. J Clin Care Skills, 1(3): 109–114.
44. Boonyathee S, Seangpraw K, Ong-Artborirak P, et al (2021). Effects of a social support family caregiver training program on changing blood pressure and lipid levels among elderly at risk of hypertension in a northern Thai community. PLoS One, 16(11): e0259697.
45. Mahsa Asadollahi Hamedani AS and FK (2021). Effect of family-centered empowerment model on quality of life in patients with hypertension. J Maz Univ Med Sci, 25(127): e117259.
46. Suharno Usman AMI and RA (2023). Family involvement in low-salt diet for hypertensive older adults. Work with Older People. Working with Older People, 27(1): 1-14
47. Simonetti V, Comparcini D, Tomietto M, et al (2021). Effectiveness of a family nurse‐led programme on accuracy of blood pressure self‐measurement: A randomised controlled trial. J Clin Nurs, 30(15–16): 2409–2419.
48. Bennich BB, Munch L, Overgaard D, et al (2020). Experience of family function, family involvement, and self‐management in adult patients with type 2 diabetes: A thematic analysis. J Adv Nurs, 76(2): 621–631.
49. Thongtaeng P, Seesawang J (2022). Barriers and Facilitators to Successful Hypertension Management in Older Adults from the Perspectives of Community Health Nurses. Nurs Sci J Thailand, 40(1): 35–49.
50. Dhakal A, K C T, Neupane M (2022). Adherence to lifestyle modifications and its associated factors in hypertensive patients. J Clin Nurs, 31(15-16): 2181–2188.
51. Isnaini N, Lestari IG (2018). Pengaruh self management terhadap tekanan darah lansia yang mengalami hipertensi. Indones J Heal Sci, 2(1): 7–18.
52. Yeh HY, Ma WF, Huang JL, et al (2016). Evaluating the effectiveness of a family empowerment program on family function and pulmonary function of children with asthma: A randomized control trial. Int J Nurs Stud, 60: 133–144.
53. Hamidi Y, Hazavehei SMM, Karimi-Shahanjarini A, et al (2019). Health promoting hospitals in Iran: a review of the current status, challenges, and future prospects. Med J Islam Repub Iran, 33:47.
2. Kario K, Okura A, Hoshide S, et al (2024). The WHO Global report 2023 on hypertension warning the emerging hypertension burden in globe and its treatment strategy. Hypertens Res, 47(5): 1099-1102.
3. Ministry of Health Republic of Indonesia (2018). Indonesian basic health research. Availabel from: https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/
4. Flint AC, Conell C, Ren X, et al (2019). Effect of systolic and diastolic blood pressure on cardiovascular outcomes. N Engl J Med, 381(3):243–51.
5. Ranjith N, Myeni NN, Sartorius B, et al (2017). Association Between Hyperuricemia and Major Adverse Cardiac Events in Patients with Acute Myocardial Infarction. Metab Syndr Relat Disord, 15(1):18–25.
6. Zhou D, Xi B, Zhao M, et al (2018). Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study. Sci Rep, 8(1): 9418.
7. Wang C, Yuan Y, Zheng M, et al (2020). Association of age of onset of hypertension with cardiovascular diseases and mortality. J Am Coll Cardiol, 75(23): 2921–2930.
8. Thomopoulos C, Parati G, Zanchetti A (2018). Effects of blood pressure-lowering treatment on cardiovascular outcomes and mortality: 14–effects of different classes of antihypertensive drugs in older and younger patients: overview and meta-analysis. J Hypertens, 36(8): 1637–1647.
9. Ciumărnean L, Milaciu MV, Negrean V, et al (2021). Cardiovascular risk factors and physical activity for the prevention of cardiovascular diseases in the elderly. Int J Environ Res Public Health, 19(1): 207.
10. Niessen LW, Mohan D, Akuoku JK, et al (2018). Tackling socioeconomic inequalities and non-communicable diseases in low-income and middle-income countries under the Sustainable Development agenda. Lancet, 391(10134):2036–2046.
11. Saiz LC, Gorricho J, Garjón J, et al (2020). Blood pressure targets for the treatment of people with hypertension and cardiovascular disease. Cochrane Database Syst Rev, 9(9):CD010315.
12. Fuchs FD, Whelton PK (2020). High Blood Pressure and Cardiovascular Disease. Hypertension, 75(2): 285–292.
13. Han HR, Kim MT, Rose L, et al (2006). Effects of stressful life events in young black men with high blood pressure. Ethn Dis, 16(1): 64–70.
14. Smeltzer SC, Bare BG, Hinkle JL, et al (2008). Brunner and Suddarth’s textbook of medicalsurgical nursing 10th edition. Philadelphia: Lipincott Williams & Wilkins, pp: 719-750.
15. CDC AW(2020). Centers for disease control and prevention. 2020. Available from: https://www.cdc.gov/high-blood-pressure/
16. Zamandi M, Daroudi R, Sari AA (2023). Direct Costs of Hypertension Treatment in Iran. Iran J Public Health, 52(9):1973-83.
17. Fryar CD, Ostchega Y, Hales CM, et al (2017). Hypertension prevalence and control among adults: United States, 2015-2016. NCHS Data Brief, (289):1-8.
18. Smeltzer SC, Bare BG, Hinkle J, et al (2010). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing Twelfth Edition. Vol. 1, Wolter Kluwer Health/Lippincott Williams & Wilkins, pp.: 2010. 461–480.
19. Isnaini N, Ratnasari R (2018). Faktor risiko mempengaruhi kejadian Diabetes mellitus tipe dua. J Kebidanan dan Keperawatan Aisyiyah, 14(1):59– 68.
20. Iezadi S, Gholipour K, Sherbafi J, et al (2024). Service quality : perspective of people with type 2 diabetes mellitus and hypertension in rural and urban public primary healthcare centers in Iran. BMC Health Serv Res, 24(1): 727.
21. Zheng Y, Liu Y, Xue D, et al (2024). Research on the control rate of hypertension under family physician-contracted service. BMC Prim Care, 25(1): 47.
22. Bludorn J, Railey K (2024). Hypertension Guidelines and Interventions. Prim Care, 51(1):41–52.
23. Zhang X, Zheng Y, Qiu C, et al (2020). Well-being mediates the effects of social support and family function on self-management in elderly patients with hypertension. Psychol Health Med, 25(5): 559-571.
24. Nasrabadi H, Nikraftar F, Gholami M, et al (2021). Effect of Family: Centered empowerment model on eating habits, weight, hemoglobin A1C, and blood glucose in iranian patients with type 2 diabetes. Evid Based Care J, 11(1): 25–34.
25. Simamane M, Constantinou D, Watson E (2023). The Family Involvement Role in Assisting with Hypertension Management: A Qualitative Study. Re-searchsquare. Available from: https://www.researchsquare.com/article/rs-2910950/v1
26. Friedman M (1997). Teaching about and for family diversity in nursing. Journal of Family Nursing, 3(3): 280-294.
27. Isnaini N, Aprilina RSHD(2021). The Influence of Family Support on Self Efficacy of Chronic Kidney Disease. In: 4th International Conference on Sustainable Innovation 2020. Health Science and Nursing. Atlantis Press, 17(25): 26–35.
28. Bahari G, Scafide K, Krall J, et al (2019). Mediating role of self-efficacy in the relationship between family social support and hypertension self-care behaviours: A cross-sectional study of Saudi men with hypertension. Int J Nurs Pract, 25(6): e12785.
29. Zhao J, Hu Y, Zhang X, et al (2020). Efficacy of empowerment strategies for patients with hypertension: A systematic review and meta-analysis. Patient Educ Couns, 103(5): 898–907.
30. Kokorelias KM, Gignac MAM, Naglie G, et al (2019). Towards a universal model of family centered care: A scoping review. BMC Health Serv Res, 19(1): 564.
31. Kaakinen, J. R, Coehlo, D.P, et al (2018). Family health care nursing : Theory practice and research. 6th ed. FA Davis, Philadelphia, pp: 113–146.
32. Ouzzani M, Hammady H, Fedorowicz Z, et al.(2016). Rayyan-a web and mobile app for systematic reviews. Syst Rev, 5(1): 210.
33. Santos WM dos, Secoli SR, Püschel VA de A (2018). The Joanna Briggs Institute approach for systematic reviews. Rev Lat Am Enfermagem, 26 : e3074.
34. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372:n71.
35. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med, 169(7): 467–473.
36. Leili Rabiei, Firoozeh Mostafavi, Reza Masoudi’ AH (2013). The effect of family-based intervention on empowerment of the elders. J Educ Health Promot, 2: 24.
37. Hedayati B (2015). The effect of implementation of family-centered empowerment model on the self-esteem of the old people with hypertension. J Educ Health Promot, 4: 74.
38. Keshvari M, Hedayati B, Moeini M, et al (2015). A survey on the effect of implementation of a family-centered empowerment model on blood pressure and empowerment dimensions in the elderly people with hypertension. J Educ Health Promot, 4: 94.
39. Hedayati B (2018). Effect of family-based empowerment model on the self-efficacy of hypertensive elderly people. Iran J Ageing, 13(1): 86–97.
40. Maslakpak MH, Rezaei B, Parizad N (2018). Does family involvement in patient education improve hypertension management? A single-blind randomized, parallel group, controlled trial. Cogent Med, 5(1): 1537063.
41. Someia NM, Atri SB, Areshtanab HN, et al (2020). Effectiveness of education based on family-centered empowerment model on health-promoting behaviors and some metabolic biomarkers in elderly women: A stratified randomized clinical trial. J Educ Health Promot, 9: 331.
42. Marlina, Badaruddin, Zuska F, et al (2018). The family health empowerment in the stroke prevention in the puskesmas of Ulee Kareng, Banda Aceh, Indonesia. Asian J Microbiol Biotechnol Environ Sci, 20(2): 291–295.
43. Shaafi MS, Hosseini N, Akbartabar Toori M, et al (2020). Comparing the Effects of Group and Family-Centered Education in the Elderly Lifestyle. J Clin Care Skills, 1(3): 109–114.
44. Boonyathee S, Seangpraw K, Ong-Artborirak P, et al (2021). Effects of a social support family caregiver training program on changing blood pressure and lipid levels among elderly at risk of hypertension in a northern Thai community. PLoS One, 16(11): e0259697.
45. Mahsa Asadollahi Hamedani AS and FK (2021). Effect of family-centered empowerment model on quality of life in patients with hypertension. J Maz Univ Med Sci, 25(127): e117259.
46. Suharno Usman AMI and RA (2023). Family involvement in low-salt diet for hypertensive older adults. Work with Older People. Working with Older People, 27(1): 1-14
47. Simonetti V, Comparcini D, Tomietto M, et al (2021). Effectiveness of a family nurse‐led programme on accuracy of blood pressure self‐measurement: A randomised controlled trial. J Clin Nurs, 30(15–16): 2409–2419.
48. Bennich BB, Munch L, Overgaard D, et al (2020). Experience of family function, family involvement, and self‐management in adult patients with type 2 diabetes: A thematic analysis. J Adv Nurs, 76(2): 621–631.
49. Thongtaeng P, Seesawang J (2022). Barriers and Facilitators to Successful Hypertension Management in Older Adults from the Perspectives of Community Health Nurses. Nurs Sci J Thailand, 40(1): 35–49.
50. Dhakal A, K C T, Neupane M (2022). Adherence to lifestyle modifications and its associated factors in hypertensive patients. J Clin Nurs, 31(15-16): 2181–2188.
51. Isnaini N, Lestari IG (2018). Pengaruh self management terhadap tekanan darah lansia yang mengalami hipertensi. Indones J Heal Sci, 2(1): 7–18.
52. Yeh HY, Ma WF, Huang JL, et al (2016). Evaluating the effectiveness of a family empowerment program on family function and pulmonary function of children with asthma: A randomized control trial. Int J Nurs Stud, 60: 133–144.
53. Hamidi Y, Hazavehei SMM, Karimi-Shahanjarini A, et al (2019). Health promoting hospitals in Iran: a review of the current status, challenges, and future prospects. Med J Islam Repub Iran, 33:47.
| Files | ||
| Issue | Vol 54 No 1 (2025) | |
| Section | Review Article(s) | |
| Keywords | ||
| Older adults Hypertension Family-centered Scoping review | ||
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How to Cite
1.
Isnaini N, Tetra Dewi F, Madyaningrum E, Noviana U. Family-Centered Education for Older Adults with Hypertension: A Scoping Review. Iran J Public Health. 2025;54(1):36-47.
