e-Journal of Nursing (e-Kp) volume 6 Number 1, May 2018

ROLE OF NURSE IN CONNECTION WITH educator

COMPLIANCE MANAGEMENT OF HYPERTENSION
IN HEALTH Tahuna EAST

Erick Johans Manoppo

Gresty M. Masi
Wico Silolonga

Nursing Science Program Faculty of Medicine

Sam Ratulangi University in Manado Email:
erickmanoppo85@gmail.com

abstact: Hypertension is one of the non-communicable diseases that can cause death. Management of hypertension
can be done by pharmacological and non-pharmacological therapy. Compliance underwent management of
hypertension is important to do such as not smoking, drinking alcohol, physical activity, food arrangements, disease
care as well as treatment to cure hypertension. Nurses have an educator role to assist clients in getting to know
health. The purpose of the study to know the association of nurse role as educator with the compliance of the
management of hypertension in Puskesmas East Tahuna. The research design is quantitative analytic method with
cross sectional design. samples is 103 responders. The Obtained Data were processed by Chi-square test with
degree of significance (α) = 0.05. The result

was found the majority of 46-70 years old as many as 89 respondents (86.4%), female sex as much 65 respondents
(63.1%). The role of the nurse as educator is Categorized as good as 77 respondents (74.8%) and less good counted
26 respondents (25.2%). Compliance of hypertension management was Categorized as dutiful as 97 respondents
(94.2%) and did not comply with six respondents (5.8%). Conclusion there is no association of the role of the nurse as
educator with compliance of hypertension management.

Keywords: Role as educator, compliance, hypertension management.

Abstract: Hypertension is one of the non-communicable diseases that can cause death. Management of
hypertension can be done by way of pharmacological and non-pharmacological therapy. Compliance
management of hypertension undergoing important to do such as not smoking, drinking alcohol, physical
activity, dietary, disease treatment and cure for hypertension. Nurses have a role as an educator to assist
clients in identifying health. Research purposes determine the relationship of the nurse's role as an educator
with the compliance management of hypertension in the Health Center East Tahuna. Research design is a
quantitative analytical method design cross sectional.

number of samples as many as 103 respondents. The data obtained were processed using the test
Chi-square with a significance level (α) = 0.05. result obtained the role of nurses as educators considered good by 77
respondents (74.8%) and unfavorable by 26 respondents (25.2%). Compliance management of hypertension
categorized as adherent as much as 97 respondents (94.2%) and non-adherent as much as six respondents (5.8%). Conclusion
there is no relationship nurse's role as an educator with the compliance management of hypertension.

Keywords: The role of nurses, educators, management of hypertension.

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e-Journal of Nursing (e-Kp) volume 6 Number 1, May 2018
PRELIMINARY
Hypertension is a disease
not contagious that can cause death. World
Health Organization
(WHO) to categorize
This illnesses as the silent disease
because people do not know he suffered from
hypertension before checking the pressure
blood. WHO Data
showed that there were 9.4 million people out of 1 billion
people in the world who die from complications of
hypertension. The prevalence of hypertension in
Southeast Asia as much as 36 percent of the adult
population (WHO, 2013). The result of Health Research
(Riskesdas) in 2013 the average prevalence of
hypertension in aged ≥18 years in Indonesia as much as
25.8 percent. North Sulawesi province included in the
eight provinces with cases of hypertension
the most. The prevalence rate of
hypertension incidence in North Sulawesi as much as
27.1 percent (Ministry
Health, 2013). By 2016 the number of people with
hypertension were recorded in health centers East
Tahuna many as 704 out of 4954 patients with
hypertension in Sangihe Islands Regency (Sangihe
Islands Health Service, 2017).
Someone had felt the impact of gravity
hypertension when occur
complications causing organ disorders such as
coronary heart function disorders
and stroke (Wibowo
& Wahyuningsih, 2011). A decrease in blood
pressure can reduce the risk of coronary heart
disease of about 20-25 percent and 35-40 percent
risk of stroke (Pujasari,
2015). Management of hypertension can basically
be done by way of pharmacological and
non-pharmacological therapy, in a previous study
found that factors
that take effect to
the management of hypertension is the level of education
Last, long-suffering
hypertension, level of knowledge about
hypertension, family support, role
health workers as well as the motivation for treatment
(Puspita, 2016). Implement a healthy lifestyle
has many proven could
lowers blood pressure and can
2
prevent occurrence disease
cardiovascular (Soenarta, 2015).
Obedience in living
the management of hypertension is very important
to do, such as not smoking, drinking alcohol,
physical activity, dietary, disease treatment and
cure for hypertension (Novian, 2013;
Dukomalamo,
2016). Results of research conducted by
Dukomalamo (2016) about the relationship of
knowledge about hypertension with complications
in elderly seeking treatment at health centers
Small Motoboi District of South Kotamobagu
showed that 12 of 30 respondents knowledgeable
good but still has the complications caused by
lack comply
therapy
hypertension is recommended.
Nurses as health care workers have a
role as an educator or educator.
As an educator,
nurse helps clients recognize health
and procedure care
nursing they need to do in order to restore or
maintain health (Kozier, 2010). The presence of
the correct information to improve knowledge of
hypertensive patients to carry a healthy lifestyle
(Sustrani in Kurniapuri & Supadmi, 2015).
Research conducted by Anggraeni (2013) about
the role of the nurse as an educator in a decrease
in blood pressure in the elderly with hypertension
in the health center in 2012 Basuki Rahmat
Palempang demonstrate knowledge and practice
nurses as educators is not optimal. The research
result Sutrisno (2013) the influence of education
nurse to
a decrease in blood pressure in the elderly with
hypertension in the working area
Public health center Purwodadi district
Grobogan shows nurse education effect on blood
pressure reduction in the elderly with
hypertension.
Preliminary studies conducted in East
Tahuna Health Center found that the number of
hypertension patients treated during the month of
September-November
e-Journal of Nursing (e-Kp) volume 6 Number 1, May 2018

2017 415 patients is the second most prevalent RESULTS and DISCUSSION Table 1. Berdasarakan
diseases frequency distribution characteristics of the respondents in
after ARI. administration the Health Center East Tahuna.
health education about hypertension is given by
nurses to patients with hypertension at the time of
Posyandu held each month as well as during the characteristics of
n (%)
medical examination at the health center. Based Respondents
20-45 years 14 13.6
on the background Age
46-70 years 89 86.4
on, Total 103 100
hypertensive patients increased tendency to Gender Male Female 38 36.9
encourage researchers to conduct research on 65 63.1
the relationship nurse's role as an educator with Total 103 100

the compliance management of hypertension in Source: primary data, 2018

the Health Center East Tahuna.
result research The majority
respondents aged 46-70 years ie
RESEARCH METHODS with the number of 89 respondents with a
This research is a quantitative analytical percentage of 86.4%. The results are consistent
method design cross sectional. The research was with research conducted by Runtukahu (2015)
conducted at the health center Sangihe Islands who studied the
Regency East Tahuna in December 2017 and analysis factors that
January related with obedience
dietary treatment in patients
Peneitian Population 2018. This is based on the average hypertension in the region of Eastern District
visit period month Langowan Wolaang health centers, that the
September-November 2017 in the clinic East majority of the characteristics of respondents in
Tahuna 138 visits. Sampling in this study using his research over 60 years with a total of 17
techniques consecutive sampling. respondents with a percentage scale

Measurement of the nurse's role as an 27.4%. In a similar study conducted

educator, researcher used a questionnaire consisting by Mangendai (2017)
of 20 items of questions and compliance management showed that the majority of respondents in the
consists of 18 items of questions that have been study were aged between 46-55 years with a
tested for validity and realibilitasnya by researchers number of 14 respondents with a percentage of
in 43.8%.
PHC Tahuna against 30 respondents, the validity The results of basic medical research shows
of the results declared invalid by a score of> 0.3 that the prevalence of hypertension is based on
and releabilitas test with values Cronbach alpha r count the diagnosis of health personnel showed an
to the nurse's role as an educator is 0.892 and increase with age (MoH, 2013). In over 40 years
compliance management of hypertension is 0.916. of age at risk of developing hypertension (Sugiarto
in Rosiana, 2014). Age is closely related to
hypertension. With age the changes in organ
function including tissues of the arteries, which
gradually loses its elasticity. Thing

this cause occurrence

an increase in peripheral vascular resistance that
can lead to the risk of hypertension (Haerunisa,
2014).

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e-Journal of Nursing (e-Kp) volume 6 Number 1, May 2018

The majority of respondents were female as
many as 65 respondents with a percentage of
63.1% and the remaining 38 respondents or
36.9% were male respondents. The results of this
study
in line with research conducted by Anisa
(2013) who studied the factors associated with
treatment compliance hypertension in the elderly
in health centers where Pattingalloang Makasar
majority characteristics
respondents were women, amounting to 84
respondents with a percentage
64.6%. In a similar study conducted by Puspita
(2016) who studied
about factors that
patient compliance associated with hypertension
in treatment shows that the majority
characteristics
respondents in a study of women totaling 55
respondents with a percentage of 65.5%.
result research health basic
showed that the prevalence of hypertension in
women increases after menopause (MoH, 2013).
This is due to the levels of the hormone estrogen
in women aged
more will
decreased which causes hypertension (Kumar et
al 2007 in Haerunisa, 2014).
carry out its role as an educator in hypertensive
patients. Results of research conducted by
Sutrisno (2013) who studied the effect of nurse
education to decrease blood pressure in the
elderly with hypertension in the working area
health centers
Purwodadi district
Grobogan shows that the education of nurses
affect the reduction of blood pressure in elderly
hypertensive patients with p = 0.000.
Education is a system of activities
aims produce
learning. Process this designed
such a way as to produce a specific learning
(kozier, 2010). The nurse educator role in the
helping patients to improve their health
through administration
knowledge related to nursing and medical
treatment is received so that the patient or family
can accept responsibility for the things that are
known (Doheny in Suryadi,
2013). Educational given nurses will increase the
client's knowledge of how to care and treatment of
the illness. Clients will know the best way to
disease management, so that awareness to
adhere to treatment and care will increase (Hadidi,
2015).

Table 2. Distribution of respondents based on the role of

nurses as educator in Table 3. Distribution of respondents based compliance
Puskesmas East Tahuna management of hypertension in the Health Center East
Tahuna
The role of
n (%)
nurses compliance
Good 77 74.8 management n (%)
Not good 26 25.2 hypertension

Total 103 100 Obedient 97 6 94.2

Source: primary data, 2018 Disobedience 5.8
Total 103 100
result analysis on the variables this Source: primary data, 2018
shows that the majority of respondents perceive the
role of the nurse as an educator at the health center is The result of statistical analysis it was found that
located on the East Tahuna both categories with the obedience management
number of 77 respondents hypertension in the Health Center East Tahuna
or 74.8%. result this show majority respondents
show that nurse already categorized as submissive to

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e-Journal of Nursing (e-Kp) volume 6 Number 1, May 2018

management of hypertension by 97 the number of Results of the analysis conducted by using

respondents with a percentage of total test chi-square the nurse's role as an educator
94.2%. In a previous study conducted by with the compliance management at the health
Koyongian et al (2015) who studied the role of the center in the East Tahuna get that role of nurses
family relationship with hypertensive patient and
treatment compliance in the village of Batu District obedience management
of South Likupang North Minahasa Regency, considered good and obedient to the percentage as
showed that patients who were in the village of much as 69% or 71 respondents. In the analysis
Stone adherent treatment. Another study results show the value of p = 0.166 (p> 0.05) which
conducted means accepting the null hypothesis that in this
by Ekarini (2011) study there was no relationship nurse's role as an
show most patient educator with the compliance management of
hypertension who underwent treatment at the hypertension in the Health Center East Tahuna.
health center Karanganyar Gondangrejo obedient
treatment.
Compliance according to the WHO is how The results are consistent with research
well the person's behavior in using medication, conducted by Damayanti (2012) which showed
following a diet or lifestyle change therapy that there was no association between therapeutic
appropriate governance communication nurse
(Sumantri, 2014). Ministry of Health with obedience patient
(2014) recommends implement therapy in Ward Class 3 RSU PKU
that p enatalaksanaan hypertension can be done Muhammadiyah Bantul with p = 0.641 (> 0.05). In
by using medications or by way of lifestyle this study differs from other studies conducted by
modification. Lifestyle modification can be done by Suryadi
limiting salt intake of no more than ¼-½ teaspoon (2013) which
(6 grams / day), lose weight, avoid caffeinated examines the relationship role educator
beverages, cigarettes, alcohol, exercise, get nurses in planing discharge with a compliance rate
enough rest (6-8 hours) and control stress. of hospitalized patients in hospitals to control lung
Jember, showing the role of nurses as educators
can make the patient to be obedient because the
patient know about his health condition with a
According to the researchers that with the needs of value of p = 0.001.
the client to recover from his illness so as to
encourage them to adhere to the management of
hypertension. The results of this study also still
the presence of the respondents who do not
Table 4. Relations nurse's role as educator comply with the recommendation of nurses as
with obedience much as 6 respondents with a percentage of 6%.
management of hypertension in the Health Center East In the study conducted by the Primary and
Tahuna Ariastuti (2014), which examines the factors that
compliance influence treatment adherence hypertension in the
management
The role of hypertension amount P elderly built health center Klungkung 1 to 97
nurses
submissive
Not Value respondents, that the study found to be the result
obey
n% n% n % of 62 respondents (63%) were categorized as
Good 71 69 6 6 77 75 level low adherence to the treatment of
Not good 0.166
26 25 0 0 26 25 hypertension, while the remaining 35 respondents
Total 97 94 6 6 103 100 or 36% have a high level of compliance.
Source: primary data, 2018

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e-Journal of Nursing (e-Kp) volume 6 Number 1, May 2018

Another study conducted by Annisa (2013) recovery of patients with hypertension on

who studied the factors related to the treatment of especially. more and more good nurse
hypertension in the Health Center Makassar provide health education to patients, the
Patingtalloang obtained that knowledge factor (p = compliance will be higher recommendation.
0.003), motivational factors (p = 0.000),

factor support officers CONCLUSION

health (p = 0.039) and family support factor (p =
0.000). Factors that have been mentioned earlier
is needed to fulfill the compliance management of
hypertension. In addition to factors already
pointed out earlier, in a similar study conducted by
Puspita (2016) found in his research, there are
some
factor additional
closely related to compliance in the management of
hypertension, among others, the respondents'
education level (p = 0.000) as well as
ever suffered from hypertension (p =
0.005).
Another factor that could affect compliance
among others lifestyle, embracing culture
in the treatment of certain diseases,
pembiyayaan therapy program, the complexity of
treatment or therapy programs are recommended as
well as their co-morbidities that may complicate
comply with treatment programs already established
or recommended (kozier, 2010). The results of this
study
also there are as many as 25
or 25% of respondents who adhere to what is
recommended by the nurse. It is possible factors
respondents support
for run
management hypertension walk
as it should be. such as cured uktuk motivation is
high, knowledge about hypertension that is good
or high family support
to cure the respondents to encourage
patients to be able to independently carry out the
management of hypertension.
According to the researchers concluded that
the role of the nurse as an educator is very
important to run with sebaikbaiknya
by enhancement level
health, maintaining and or recovery of patients in
general and
Based on the results of research conducted by
researchers at the Health Center East Tahuna
beriku can be summarized as:
1. The role of the nurse as an educator in
East Tahuna good perceived health centers.
2. Compliance management of hypertension
that categorized obedient.
3. The analysis showed the value of p> 0.05
(0.166) which means there is no relationship nurse's
role as an educator with the compliance management
of hypertension in the Health Center East Tahuna.
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