Iranian Study on Social Determinants of Self‑management in Patients with Hypertension Referring to Tabriz Health Care Centers in 2017‑2018

Mohammad Zakaria Pezeshki, Fatemeh Keyghobadi Khajeh, Saeideh Ghaffarifar, Mahasti Alizadeh, Gholamreza Faridaalee


Aim: The present study aims to evaluate self‑management status in Iranian patients with hypertension and its relationship with social determinants. Setting and

Design: This study was carried out in 2017‑2018 in health care centers affiliated with Tabriz University of Medical Sciences in Iran.

Methods: A total of 240 patients with hypertension, who referred to health care centers of Tabriz, were invited to fill out the self‑management (researcher made) and social determinants of health questionnaires. Statistical Analysis: Spearman correlation was used to determine the relationship between self‑management score and its items with items of social determinants of health questionnaire. Also, Pearson correlation Student t‑test was used.

Results: In this research 197 patients were studied. Mean age of the participants was 56.6 ± 10.1 years. The mean ± SD (standard deviation) of self‑management score was 81.51 ± 13.16. The correlation coefficient of self ‑management
with financial ability of securing the education expenses, nutrition and fruits, and health care expenses were 0.228 (P = 0.001), 0.149 (P value <0.05), and 0.28 (P < 0.001) respectively. Also, the correlation coefficient of age with self‑management was - 0.206 (P value = 0.004). Item level analysis showed strong significant associations between social determinants and three items related to lifestyle and two items related to monitoring of blood pressure (BP) at home.

Conclusion: Overall self ‑management status of the patients was very good. Health centers that plan self ‑management support programs for patients should consider the social determinants of life style modification and monitoring of BP at home by hypertensive patients.

Keywords: Hypertension, self -care, self- management, social determinants of health

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