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Research: faith community nursing focusing on blood pressure management.

Parish nurses have been active in helping congregations manage health issues for over 20 years. In a survey completed by the IPNRC several years ago, blood pressure screening was identified by 91% of the respondents as a service provided congregations. This focus has been spurred on by the realization that the leading causes of death, heart disease and stroke are impacted by an elevated blood pressure.

High blood pressure is known as the "silent killer' and a major risk factor for coronary heart disease (CHD), stroke, and heart failure. About 70 million Americans fall into the newly recognized blood pressure risk category of "prehypertenion" and are in danger of developing hypertension and its associated complications.

In a progress review of Health People 2010 published by the Department of Health and Human Services in 2007, 26 percent of the total U.S. population aged 20 years and older had high blood pressure. One of the target goals for blood pressure is for 68 percent of the total population to have their blood pressure under control. This goal has not been achieved. (Health People 2010)

Several years ago the IPNRC brought together parish nurses interested in discussing research foci in faith community nursing. One identified focus was evaluating interventions dealing with blood pressure. As a result of this discussion, a group of parish nurses from across the United Stated formed a research group to develop a study. This group has been working on a proposal for a study that will be conducted across the country. The purpose of this pilot study is to compare the effectiveness of health screening and education to reduce risk factors for coronary heart disease and stroke in congregations with faith community nurses to congregations that do not have faith community nurses.

A quasi-experimental design using the untreated control group with pretest and post-test is the design chosen for this study. Faith communities with and without faith community nurses provide the settings for this study. A nonprobability convenience sample of participants will comprise membership in the intervention and control group.

The conceptual framework for this study is the Outcomes Model for Community-Based Settings (OMCBS) (Cohen, Saylor, Holzemer & Gorenberg, 2000). This model examines the relationships among structure, process and outcomes related to the dimensions of client, provider, and setting for assessment of client outcomes. Pender's (1996, 2002) Health Promotion Model will be used by the faith community nurses to guide their interventions.

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The target population sample will be comprised of men and women 25 to 65 years of age who are prehypertensive with a systolic blood pressure 120-139 and/ or diastolic blood pressure 80-90. Persons who use antihypertensive medications or weight-loss drugs or have a history of cardiovascular event, congestive heart failure or angina will be excluded. A total of 100 subjects will be recruited for the study with 50 intervention group subjects and 50 control subjects.

Study participants in the control congregation will receive education on reduction of risk factors for hypertension and referral to a health care provider as deemed prudent by the faith community nurse. Study participants from the intervention congregations will receive education on reduction risk factors for hypertension, referral to a health care provider as needed and select interventions to reduce the risk factors for hypertension in collaboration with the faith community nurse. These study participants will set personal short-term (monthly) and long-term (six month) goals for reduction of risk factors for hypertension. The faith community nurse will make follow-up phone calls monthly and provide support to study participants as needed. The Health Promoting Lifestyle Profile II will be used as a pretest and post-test measure for both groups of study participants, in addition to a blood pressure screening form developed by the research committee to screen for the evidence-based risk factors for hypertension including height, weight, waist measurement, BMI, tobacco use, medications that can affect blood pressure, and family history.

This pilot study is at the proposal stage with a time-line for completion by the end of 2011.

References:

Cohen, J., Saylor, D., Holzemer. W.L. & Gorenberg, B. (2000). Linking nursing care interventions with client outcomes: A community based application of an outcomes model. Journal of Nursing Care Quality, 15(1), 22-31.

Health People 2010 Progress Report: Health Disease and Stroke. (May 21, 2007). U.S. Department of Health and Human Services, Public Health Services. Downloaded 9/23/09 from www.healthypeople.gov/ data/2010prog/focus12/

Pender, N. J. (1996). Health promotion in nursing practice (3rd ed.). Stamford, CN: Appleton & Lange.

Pender, N.J., Murdaugh, C. L., & Parson, M. A. (2002). Health promotion in nursing practice (4th ed.). Upper Saddle River, NJ: Prentice Hall.

Mary Jo Bay, RN, PhD, Beth-El College of Nursing & Health Sciences, University of Colorado at Colorado Springs, CO and Andrea M. West, RN, PhD, International Parish Nurse Resource Center, St. Louis, MO.
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Author:Bay, Mary Jo
Publication:Parish Nurse Perspectives
Date:Sep 22, 2009
Words:805
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