i

Lifestyle Among Hypertensive Individuals

During the Pandemic in
Tagbilaran City, Bohol

By:

Barbarona, Vic Angelo R.

Basilad, Kaye L.

Bolongaita, Shanjay R.

Dumapias, Jill April N.

Lagumbay, Alexa T.

Pongase, Leah L.

Torculas, Ella Arsenia C.

COLLEGE OF NURSING
University of Bohol
City of Tagbilaran

June 01, 2021

Lifestyle Among Hypertensive Individuals

During the Pandemic in
Tagbilaran City, Bohol
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____________________________

A THESIS
Presented to
The Faculty of the College of Nursing
UNIVERSITY OF BOHOL

____________________________

In Partial Fulfillment
Of the Requirements for the Degree of
BACHELOR OF SCIENCE IN NURSING

__________________________

Barbarona, Vic Angelo R.

Basilad, Kaye L.

Bolongaita, Shanjay R.

Dumapias, Jill April N.

Lagumbay, Alexa T.

Pongase, Leah L.

Torculas, Ella Arsenia C.

June 01, 2021

TABLE OF CONTENTS
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Title Page ii
Table of Contents iv
I. THE PROBLEM AND ITS SCOPE
Introduction 1
Theoretical Background 4
Legal Basis 5
Research Flow of Study 7
Review of Related Literature 8
Review of Related Studies 14
THE PROBLEM
Statement of the Problem 16
Null Hypothesis 17
Significance of the Study 17
RESEARCH METHODOLOGY
Research Design 18
Respondent 18
Environment 19
Research Instrument 20
Data Gathering Procedure 22
Ethical Considerations 23
Statistical Treatment of Data 23
Definition of Terms 24
II. PRESENTATION, ANALYSIS, INTERPRETATION AND FINDINGS
Demographic Profile of the Respondents 26
Level of Lifestyle of the Respondents 29
Levels of Lifestyle Employed by the Respondents in terms of Diet 30
Levels of Lifestyle Employed by the Respondents in terms of Exercise 31
Levels of Lifestyle Employed by the Respondents in terms of Stress 32
Levels of Lifestyle Employed by the Respondents in terms of Cigarette Smoking 33
Levels of Lifestyle Employed by the Respondents in terms of Alcohol Intake 34
Summary of the Levels of Lifestyle Employed by the Respondents per category 35
Relationship Between the Demographic Profile and the Level of Lifestyle being employed by the 36

Respondents
III. SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS
Summary 39
The Findings 39
Conclusions 40
Recommendations 41
IV. APPENDICES
Transmittal Letters 42
Informed Consent 46
Questionnaire 48
Cronbach’s Alpha Result 51
Statistician Tabulation of Data 54
Integrity Result (Plagiarism and Grammarly Checked) 64
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Certificate to Gather Data 65

Curriculum Vitae 66
References 73
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CHAPTER I

THE PROBLEM AND ITS SCOPE

Introduction

The World Health Organization (2011) defined hypertension as increased or

raised blood pressure, a condition where the force of blood that pushes the walls of the

blood vessels (arteries) is often too high. The heart continually pumps oxygenated

blood. It is carried throughout the entire body through the blood vessels to allow cells or

muscles to utilize oxygen. As the heartbeats, it creates this pressure, and hypertension

requires the heart to increase its work.

           "The silent killer." Hypertension is primarily a concern that affects 1 in 4 men and

1 in 5 women - over a billion people - having this condition. With the current pandemic

situation, the enhanced community quarantine (ECQ) has involved every individual's

lifestyle and changed how people stay healthy when there is little motivation to be

physically active.

People with the condition are at threat and, therefore, at risk of raising the

possibility of heart, brain, and kidney health complications, such as heart attacks, heart

disease, stroke, or renal failure. Research has shown that one out of four men and one

out of four women are diagnosed with hypertension. However, it is more common

among the lower and middle world countries where more than half of the total cases are

due to health inequalities in those populations compared to first world countries.

Hypertension is the number one preventable risk factor of premature death around the

world.
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On the other hand, COVID-19, an infectious disease, a newly discovered virus,

originated from Wuhan, China, in December 2019. The COVID-19 pandemic is affecting

many countries globally, causing economic hardships and deaths. To decrease the

incidence of COVID-19 in the Philippines, lockdowns were officially and strictly

implemented in the country. President Rodrigo Duterte put in place an Enhanced

Community Quarantine on March 16, 2020. It meant a total lockdown that restricted the

population's movement except for necessities and health circumstances related to the

growing number of COVID positive cases.

          The way a hypertensive patient decides their lifestyle can prevent and reduce the

risk of high blood pressure. There is evidence that those living a healthy lifestyle can

help keep their hypertension in control and reduce the risk of a medical emergency

(Mayo Clinic, 2015).

          In 2018, the World Health Organization (WHO) published data on hypertension

deaths in the Philippines. Over the last three decades, the death rate in 1990 was 11%

but increased to 21% in 2017, and disabilities caused by hypertension increased from

4% to 11%. The data also showed that 2.38% of the Philippines' total deaths were

related to high blood pressure, and the age-adjusted death rate was 23 out of 100 of the

populations. 

          A heart attack, stroke, and other health issues may result from unmanaged

hypertension. Lifestyle modifications such as a salt-restricted diet, fresh fruits, and

vegetables, foods with low-fat, reduced alcohol drinking and maintaining regular

exercise, a healthy body weight, and smoking cessation are preventative strategies to

combat hypertension.
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        Based on the data, the death rate caused by hypertension continues to rise over

the last two decades in the Philippines increasingly. As future nurses, this is a

significant concern for the researchers as people's health is of the highest priority during

this pandemic. Due to COVID-19 and quarantine protocols, the researchers be afraid of

its effects on the population, especially those with high blood pressure. A person's

lifestyle choices can prevent and reduce health issues caused by hypertension.

However, with everyone required to stay within their household, there would be less

opportunity for physical activity. Also, staying inside for too long can lead to mental

disturbances (loneliness, depression), which could influence alcohol, smoking, or drug

use. It can lead to increased health effects caused by high blood pressure, so the

researchers believe that conducting this study is significant in understanding the

community's health.

            The pandemic has been a challenge to everyone, especially health issues that

affect individuals with pre-existing medical conditions such as hypertension. In these

trying times, it is essential to assess several things: Maintaining reasonable control of

the blood pressure and blood sugar, following a healthy diet and adhering to a

medication regimen and active lifestyle to manage their diseases, boosting the immune

system amid this health crisis. 

           Thus, the researchers would like to conduct a study to determine the lifestyle

practices employed by hypertensive individuals in Tagbilaran City, Bohol, and formulate

an informative, educational campaign. Specifically, the researchers would like to know

the profile of respondents in terms of age, sex, civil status, religion, educational

attainment, occupational status, weight, height, and part of any club related to
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hypertension; hypertensive individuals' lifestyle in terms of diet, exercise, stress,

cigarette smoking, alcohol intake, and to what recommendation can be given to the

hypertensive individuals in Tagbilaran City, Bohol. 

Theoretical Background

The theory of Dorothea Orem, known as the Self-Care Theory, is used in this

research study. This theory involves behaviors that can be carried out individually by a

person to encourage and preserve individuals' well-being. The person can conduct self-

care operations. When a person can establish actions that fulfill his or her needs, they

are appropriate for self-care. This ability is obtained by learning and affected by, among

other factors, age, life experiences, community, values, and education.

Therapeutic self-care standards are called the acts necessary to sustain life and

encourage health and well-being. However, if the need is greater than the person's

capacity, a deficiency in self-care occurs. It is the kind of situation in which nursing

practitioner function according to various systems: self-care is absent, a wholly

compensatory scheme. In this situation, nurses should make decisions and develop

strategies to fulfill the criteria for self-care. Partly compensatory method when both the

nurse and the person who needs them perform the actions; there is a rotation in self-

care results.

    Orem's proposed nursing process is a tool that aims to recognize the deficits of

self-care, and also the act of the nurse is to provide the required conditions for self-care.

The study's goal is to develop a nursing consultation using Orem's Self-Care Theory for
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hypertensive patients to direct the nursing process to recognize self-care deficits and

stimulate self-care in these patients.

     The Goal Attainment Theory, by Imogen king, is also used in this research

study. She clarifies connections shaped by three factors: every individual's very own

attributes, the relational links between the patient and the attendant, and the more

comprehensive social frameworks wherein they all work. Patients or clients with

hypertension need personal and social satisfaction.

    It also explains that the nurse and patient go hand-in-hand with knowledge

sharing, setting goals together, and taking steps to accomplish those objectives. Roles,

stress, space, and time are the variables that influence the attainment of objectives. On

the other hand, the nurse's purpose is to help patients preserve their well-being to work

in their roles. The nurse's role is to interpret knowledge, schedule, administer, and

assess clinical care in the nursing phase.

Legal Basis
The Sustainable Development Goal or otherwise known as the Global Goals, are part

of the United Nation’s General Assembly’s Resolution 70/1: “Transforming of World: the

2030 Agenda for Sustainable Development. One of the seventeen Sustainable

Development Goals (SDGs), which is “Goal 3: Good Health and Well-being”

Sustainable Development Goal 3 states that “Ensure healthy lives and promote

well-being for all at all ages.” This goal emphasizes that by 2030, a reduction by one-

third of premature mortality from non-communicable diseases will be achieved through

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prevention, treatment and promoting mental health and well-being tostrengthened the

capacity of all countries in health risk reduction and management.

Proclamation No. 1761, s. 2009; Declaring the month of May of each year as

“Hypertension Awareness Month”—here is to have urgent different strategies in the

prevention, treatment and control of hypertension be actively pursued to reduce

hypertension-related deaths and disability.

The Philippine Society of Hypertension under the Proclamation No. 1761 to

composed of multidisciplinary medical and allied professionals was organized in 1993 to

help address the prevention, treatment and control of hypertension in the Philippines.

Republic Act 10963: otherwise known as “Tax Reform for Acceleration and

Inclusion (Train) Law.” This law is to ensure that the government can provide for the

needs of those under its jurisdiction and care through the provision of better health,

education and social protection for the people.

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THEORY Legal Bases

● Sustainable Development
● Self-Care Theory by Goal 3
Dorothea Orem ● Proclamation No 1761, s.
● Goal Attainment 2009
Theory by Imogen
● Republic Act 10963 "Tax
King
Reform for Acceleration
and Inclusion (train) law"

INPUT
LIFESTYLE AMONG HYPERTENSIVE INDIVIDUALS
DURING THE PANDEMIC IN TAGBILARAN CITY,
BOHOL
● Diet
● Exercise
● Stress
● Cigarette Smoking
● Alcohol Intake

PROCESS
● Statistical Treatment
● Analysis and interpretation of findings
● Conclusions

OUTPUT
RECOMMENDATIONS
FIGURE 1

RESEARCH FLOW
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Review of Related Literature

This literature review presents a summary of relevant sources to gain a broad

view of hypertensive patients' lifestyle changes. Hypertension is the leading cause and

considered the most risk factor for cardiovascular disease that causes deaths

worldwide. The prevalence is still increasing for every individual in self-improvement in

developing self-awareness and self-control (Spiering, 2017).

According to the World Health Organization, having high blood pressure causes

7 million deaths per year, while 1.5 billion people suffer from complications.

Hypertension can be primary or secondary. Primary hypertension is a type of

hypertension that is not caused by disease; meanwhile, another disease causes

secondary hypertension (World Health Organization, 2017).

Almost one billion people worldwide are affected by an apparent risk factor for

cardiovascular disease. Rising mortality due to hypertension has been documented in

recent studies, revealing the significance of prophylactic blood pressure management

strategies. One of the most powerful ways to avoid and regulate hypertension is through

lifestyle improvements. Hypertension is correlated with lifestyle variables such as

dietary attitudes and physical activity (ARYA Atherosclerosis, 2012).

It exerts pressure as the heartbeats, which drives blood into the blood vessels.

The arteries, veins, and capillaries contain blood vessels. This pressure is then referred

to as "blood pressure." Two forces' effect is blood pressure: the first force, which is

"systolic pressure," arises as blood flows out of the heart and into the arteries. The
 9

second force is "diastolic pressure," produced between heartbeats while the heart rests

(American Heart Association, 2012).

High blood pressure typically does not cause any apparent signs. But when you

do, you will experience the following symptoms: dizziness, shortness of breath,

headaches, and nosebleeds. These display an increase in blood pressure. Some

complications that may occur when hypertension is untreated are heart disease, stroke,

and kidney failure. Chest pain, nausea, and anxiety can be caused by an unusual

occurrence, such as a hypertensive emergency. Symptoms can arise at any time

(Weber, 2019).

With a high number of deaths and infected people, COVID-19 is causing a global

pandemic. Governments also imposed bans on outdoor activities or even collective

quarantines on the population to control the spread of the COVID-19 virus. There are

some long-term effects of quarantine on cardiovascular disease, primarily linked to

unhealthy lifestyles and anxiety (Ballerini Puviani, 2020). Lifestyle influences strictly

caused cardiovascular diseases to burden (Mattioli, 2020).

A kaleidoscope of adverse metabolic consequences may increase the chance of

several diseases, namely diabetes, cancer, osteoporosis, and disorder that could also

be correlated with limited physical activity or as a consequence of strict quarantine

(LIPPI, 2020).

Although the world's attention is on the novel coronavirus during this period,

there is a danger that other diseases may be ignored. Control of stable chronic diseases

such as hypertension and diabetes may also be affected, in addition to acute conditions.

As part of social distancing steps, many hospitals worldwide have canceled all in-person
 10

elective medical care, including regular outpatient clinics, and pushed towards

telemedicine. Doing so also retains money to help solve issues in the supply chain and

other problems created by a surge in new coronavirus-infected patients. Even in these

circumstances, it is necessary for frequent monitoring of blood pressure and blood

glucose levels. This is especially important as diabetes, and hypertension patients may

be at higher risk of COVID-19 complications (Sunil k. Nadar, 2020).

The etiology of hypertension involves both genetic and behavioral influences and

is dynamic and complex. Many individuals suffer from increased anxiety, depression,

and chronic psychosocial stress induced by globalization, cultural changes, socio-

economic changes, and occupational stress (Khan, 2017). In patients with diabetes

mellitus, blood pressure (BP) is hard to regulate, and current trends are sub-optimal.

Community pharmacists and nurses are well placed on recognizing and monitoring

these patients, given the growing complexities of accessing primary care physicians

(Tsuyuki, 2008). Hypertension-related cardiovascular disease is projected to rise due to

the aging of the population shortly.

With a balanced diet and lifestyle, the regulation of high blood pressure is

possible. Physical exercise, avoiding tobacco use, and even limiting alcohol intake are

involved in lifestyle modification. For the prevention and treatment of hypertension, the

DASH diet is an essential dietary guideline. Other additional recommendations include a

low salt or sodium diet, controlling calorie intake, decreasing dietary fat, increasing food

intake through fruit and vegetable-rich diets like Potassium, Calcium, and Magnesium

(Bellows, 2013).
 11

Lowering blood pressure is effective in preventing stroke and other neurological

events, including heart failure. Over the past decade, therapeutic benefits have been

widely demonstrated among many subtotals and antihypertensive agents. Evidence for

treating patients aged 80 and over is irrational. Although the risk of stroke increases

with increasing blood pressure above about 115/75 mmHg, blood pressure and stroke

are associated with increasing age (Belhani, 2008).

Limiting the consumption of sodium will help lower blood pressure. In too many

foods, such as processed foods, sodium is present. Reading nutrition labels is essential.

By not eating more than 2,400 mg per day, limit your sodium intake. Refrain from

cooking with salt if possible. If you have kidney disease, before using any salt

replacements, ask a healthcare provider. Not all are salt-sensitive with hypertension.

You can test yourself for weeks by recommending a low-sodium diet (Dombrowski,

2019).

Hypertension care and management can require consulting your medical

practitioner if appropriate for prescribed medications. Prevention, otherwise healthy,

usually requires behavioral changes and healthy eating habits (National Nutrition

Council, 2017).

A global concern remains inadequate adherence to therapies. Adherence issues

are prevalent in people taking antihypertensive medicine. There has been a move

towards better hypertension regulation, and the number of patients with higher than

target blood pressure levels has remained stable. Medication adherence is a

multifaceted problem and consists of three components: initiation, execution, and

persistence (Vrijens, 2017).

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Elevated blood pressure has long been considered an unavoidable result of

aging in industrial economies, leading to hypertension (Pinto, 2007). Only by living a

balanced lifestyle, keeping blood pressure in a healthy range is possible. It involves

consuming a balanced diet, maintaining a healthy weight, having ample physical

exercise, not smoking, and limiting alcohol consumption (Centers for Disease

Prevention and Prevention,2014).

It is associated with high blood pressure to be inactive. Rising levels of physical

activity can also help reduce one's blood pressure. Indeed, exercise can cause one's

blood pressure to increase for some time. However, blood pressure will quickly return to

normal while at rest. The quickest it is complete, the more likely the fitter one will be

(Blood Pressure Association, 2008).

Lifestyle modification, such as exercise, is integrated with the prevention,

treatment, and high blood pressure regulation. Exercise services provide endurance

exercises that help prevent high blood pressure from developing and reducing blood

pressure in adults with normal BP and high BP (Pescatello, 2018).

Simply lowering blood pressure, exercise has plenty of advantages. Exercise will

improve your heart, lower your cholesterol, help control your weight, and avoid the risk

of diabetes, even if your blood pressure does not increase. It is also helpful for survivors

of stroke. According to the American Heart Association and the American College of

Sports Medicine, aerobic activity is critical for improving overall health and reducing the

risk of strokes (Woolston, 2019). Inactive individuals are at higher risk of experiencing

health conditions such as stroke and heart attack. On the other hand, daily physical
 13

exercise helps lower blood pressure levels, regulate weight, and relieve stress

(American Heart Association, 2016).

The reduction in each alcohol drink's daily intake decreases both systolic and

diastolic blood pressure by approximately one mmHg. For hypertensive people who

consume alcohol, an average limit of one drink a day for women and two drinks a day

for men is a fair objective to be met if drinking is not otherwise prohibited (Le Jacq

Communications, Inc., 2001). No safe level of alcohol consumption exists. It is

suggested that the two people, men and women, not drink more than 12 units per week,

of which one group is equal to 10 ml of pure alcohol. Having one drink a day can

already increase the risk of having hypertension. Drinking three or more alcoholic

beverages a day increases the risk of having hypertension by up to 70%. It doesn't

matter how much alcohol you drink, whether you drink lots of alcohol every day or drink

lots of liquor regularly at one time. The primary rule is that the greater your risk of

having high blood pressure, the more you drink in total. Blood pressure can then be

reduced and avoided by reducing alcohol consumption (Rettner, 2018).

The most effective lifestyle measure for preventing many cardiovascular

disorders, including hypertension, is smoking cessation. Smoking, via sympathetic

nerve stimulation, has a hypertensive effect (Virdis, 2010).

As the body responds to abnormally high blood pressure, it often results from

changes in blood vessels and function. ACE inhibitor drugs reversed any changes

caused by high blood pressure. The constriction of the blood vessels is an initial

reaction when high blood pressure occurs. The blood vessels' walls thicken, and tissue

damage gradually occurs, resulting in thickening the vessel walls (Shackelford, 2018).
 14

Lifestyle brings significant advantages for every person in bringing change.

Unmanaged hypertension may lead to health problems and cardiovascular diseases in

which, especially in this challenging period of the pandemic, hypertensive patients

should implement active and healthy lifestyles. Promoting health and disease

prevention in the promotion and control of hypertension among people must always be

a sight of lifestyle recommendations.

Review of Related Studies

There are numerous investigations directed by various explores about lifestyle

changes among hypertensive patients. One of these is the study conducted by

Lawrence J. Appel last July 14, 2003, entitled "Lifestyle Modification as a Means to

Prevent and Treat High Blood Pressure," which revealed that Blood Pressure is

affected by various dietary factors. The combined effects can be significant, although

each element usually has a modest effect. Even a modest decrease in Blood Pressure

can have a tremendous, beneficial impact on the incidence of hypertension and its

complications from a public health perspective. The current challenges for health care

practitioners, researchers, and public officials are establishing and adopting successful

clinical and public health strategies that achieve and sustain safe lifestyle changes.

A study by Anna V. Mattioli et Al. on May 20, 2020, entitled "Quarantine during

COVID'19 Outbreak; Change in diet and physical activity increase the risk of

cardiovascular disease," states that there are some long-term cardiovascular disease

consequences of quarantine, mostly related to unhealthy lifestyles and anxiety. A global

action that promotes a healthy diet and physical activity is mandatory after quarantine to
 15

inspire people to return to a good lifestyle routine. Cardiovascular disease patients need

to be prepared to cope with the anticipated rise in cardiovascular risk burden following

the pandemic. They must facilitate good eating and physical activity at home during the

quarantine. They need to re-evaluate the cardiovascular risk in patients after quarantine

and determine biometric and metabolic parameters. To recognize early the persistence

of anxiety and stress and the evolution of post-traumatic syndrome, a psychologist must

examine patients. To inspire people to return to a good lifestyle, global action that

encourages balanced eating and physical activity is mandatory. This intervention needs

to be more vital for people at a low socio-economic level who will suffer to a greater

degree from the unavoidable constraints and economic crisis following a vast and

prolonged quarantine.

Furthermore, A.D. Heymann et al. explores the study last November 9, 2011,

entitled "Factors Associated with Hypertensive Patients' compliance with the

recommended lifestyle behaviors," reveals that approximately half of patients with

hypertension reported doing daily exercise and adhering to a particular diet; 13% were

smokers. Around half documented seeking advice on avoidance of smoking and diet

and a third on physical activity. A quarter reported receiving explanations concerning

blood pressure self-measurement and signs of deterioration. Multivariate research

found that patients' opinions on hypertension treatment, their understanding of and

management of hypertension, and physician advice on a healthy lifestyle and self-care

have an independent effect on compliance with their prescribed actions. The low

counseling rates indicate that there might be a need to develop doctors' counseling

skills to be more particular and successful in providing their patients with this service. A
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model focused on educating both doctors and patients can improve the treatment of

patients with hypertension.

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THE PROBLEM

Statement of The Problem

This study aims to determine the lifestyle practices employed by a hypertensive

individual in Tagbilaran City, Bohol, and formulate an educational campaign.

Specifically, it sought to answer the following sub-questions:  

1. What is the profile of the respondents with regards to:

1.1 Age;

1.2 Sex;

1.3 Civil Status;

1.4 Religion;

1.5 Highest Educational Attainment;

1.6 Occupational Status;

1.7 Weight (kg);

1.8 Height (m); and

1.9 Membership of any Hypertensive Club?

2. What is the Level of Lifestyle employed by the respondents in terms of:

2.1 Diet;

2.2 Exercise;

2.3 Stress;

2.4 Cigarettes Smoking; and

2.5 Alcohol Intake?

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3. Is there a significant relationship between the respondents' profile and their level of

lifestyle?

4. What recommendations can be made based on the findings of the study?

Null Hypothesis
  There is no significant relationship between the respondents' profile and their

level of lifestyle.

Significance of The Study.

This study is beneficial to the group of people and hypertensive individuals.
Persons with Hypertension. Give them ideas about lifestyle modification and

awareness of the complications that may occur when their disease is left untreated.

Family/Significant Others. Provide new information about lifestyle modification

for patients with hypertension to prevent further complications.

Health Care Team.   This study will update health care workers on how to

effectively and appropriately deal with hypertensive patients and manage their lifestyle

modification and health condition.

University of Bohol-College of Nursing Students.  The study is remarkable

because it will provide new information, knowledge, and awareness about lifestyle

modification for hypertension patients.

City Government of Tagbilaran.  This study will provide information,

knowledge, and awareness to perform the specific task in health promotion and disease

prevention in Tagbilaran City, Bohol.

 19

School Administrators. This study will raise awareness and knowledge of how

the University of Bohol-College of Nursing Students renders and performs the specific

task in Community Health Nursing.

Future Researchers. The study will benefit and help future researchers as a

guide and source of reference.

RESEARCH METHODOLOGY

Research Design and Sampling Procedure

              The researchers utilized the descriptive quantitative approach with the aid of

survey techniques to determine the lifestyle practices employed by hypertensive

individuals. They can formulate an informative, educational campaign during the

pandemic in Tagbilaran City, Bohol.

Respondents
           The respondents of the study are the one hundred (100) hypertensive individuals

who were randomly selected from among the total of 310 hypertensive cases of

Barangay of Dao Tagbilaran City, Bohol. There are a total of three hundred ten

hypertensive cases were identified in Dao district. One hundred fifty (150) respondents

as proposed on the sample size were contacted through their FB messenger account,

cell phone numbers and email accounts asking for their participation to take part in the

study, however, only one hundred (100) respondents agreed to participate in the study.
 20

The one hundred (100) respondents who agreed to be part of the study was still within

the acceptable margin of error with a value of 8.08 as computed by the statistician.

Barangay Dao was among the top three who barangays of Tagbilaran City with the

highest number of hypertensive cases. The list of respondents were identified from the

records of Rural Health Center in Dao and City Health Office in Tagbilaran City.

Included in the study were hypertensive clients from the Dao district from 21-60 years

old individuals diagnosed with hypertension. Excluded are hypertensive individuals

residing in Dao, Tagbilaran City for less than six months, and those who are not

anymore residing in Dao Tagbilaran City since the pandemic started. Below is the

distribution of respondents, as depicted in Table 1.

Table 1
Distribution of Respondents

Total Number of Hypertensive Cases Sample Size

Male Female Male Female
125 185 50 50
TOTAL: 310 TOTAL: 100

Environment
         The study was conduct in Dao District, Tagbilaran City, Bohol. Barangay Dao is

situated in the northern part of the city, about 3 kilometers away. It has a land area of

394 hectares. It consists of six Puroks. Dao is one of the fifteen Barangay compromising

in the City of Tagbilaran, Province of Bohol. Its population, as determined by the 2015

Census, was 8,858. It represented 8.43% of the total population of Tagbilaran.

 21

Figure 2

Map of Dao Tagbilaran City, Bohol

Instrument
A researcher-made questionnaire was utilized to determine the lifestyle practices

employed by hypertensive individuals and formulate an educational campaign in

Tagbilaran City, Bohol. A pilot testing of the tool was conducted first to ten respondents

with a similar socio-demographic profile. A statistician measured the reliability or internal

consistency through the use of Cronbach’s alpha tests. The result was within

acceptable value as shown below:

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Lifestyle Among Cronbach's Number of

Hypertensive Individual Alpha Values Items
During Pandemic in
Tagbilaran City, Bohol

DIET .720 4
EXERCISE .826 2
STRESS .896 3
SMOKING .752 3
ALCOHOL INTAKE .708 3

The questionnaire is divided into two parts. Part I is used to elicit the

respondents' demographic profile such as name (optional), age, sex, civil status,

religion, educational attainment, occupational status, weight, height, and part of any

club related to hypertension. Part II utilized a Likert scale to assess hypertensive

individuals' lifestyles regarding diet, exercise, stress, cigarette smoking, and alcohol

intake. It used the corresponding weight equivalent of 4, 3, 2, and 1 to a different

description.

SCALE DESCRIPTIVE MEANING INTERPRETATION

VALUE
4 A Always Very Good Lifestyle
3 O Often Good Lifestyle
2 S Sometimes Fair Lifestyle
1 N Never Poor Lifestyle

The negatively stated items in the questionnaire were being coded reversely so

that a high score is transformed into the corresponding low score on the scale. These

includes the item 3 under Diet category "I eat processed foods such as canned goods,
 23

instant noodles, junk foods and etc."; and Item number 1 under smoking category- "I do

smoke.".

Data Gathering Procedure

The study underwent an ethics review from the University of Bohol Ethics Review

Board. After getting the certificate from the UB-ERB, permits were secure from the

University of Bohol Vice President of Academics, Dean of the UB College of Nursing,

and City Mayor through the City Health Office the study. When the permit to conduct the

study has been granted, a letter was also be sent to the Rural Health Unit of Dao district

Tagbilaran City asking permission to access the list of hypertensive clients in the

barangay. The respondents were identified through random sampling. The identified

respondents were contacted through their Facebook or e-mail accounts and asked for

their consent to be part of the study after presenting its purpose. When the respondents

give their consent to be part of the study, the researchers forwarded to their FB

messenger account the link of the google form containing the research questionnaire

and tool. The gathered data were coded, interpreted and analyzed statistically using

SPSS. The data were stored in the google drive of the researchers, where only the

researchers have access. Privacy and confidentiality of gathered data were strictly

observed throughout the conduct of the study, and the data were only be used for

research-purposes.
 24

Ethical Considerations
The researchers had undergone an ethics review from the ethics committee of

the University of Bohol, and the UBREC will review the protocol. The researchers asked

permission from the City Health Office (CHO) in Tagbilaran City to assess records of

Hypertensive Individual to let the researchers gain access to their records. The

researchers was able to get the informed consent of the respondents online after

presenting the purpose of the study. Voluntary participation was emphasized to the

respondents, and that they are free to refuse to answer some questions. Respondents

are also given the freedom to withdraw their participation from the study anytime.

Privacy and confidentiality are strictly observed throughout the respondent's survey's

conduct, and respondents are assured that the gathered data will be used for research

purposes only.

Statistical Treatment of Data

The gathered data underwent a normality test to determine the appropriate

statistical tests to be used. Results revealed that the distribution of the data was

skewed. Hence, nonparametric tests were employed in testing the hypotheses of the

research.
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Definition of Terms
Alcohol-Consumption 

Refers to the amount consumed amounts of alcoholic beverages consumed by

the respondents. 

Cigarette Smoking

Refers to a vices or behavior employed by an individual that contains harmful

substances that is not good for hypertensive individuals.

Community Quarantine 

Refers to the community's restrictions on activity in light of safety protocols that

would affect lifestyle and physical activity.

Diet

Refers to the type of food, the number of meals, and the intake of carbonated

drinks that respondents take in every day.

Exercise 

Refers to any physical activity that respondents perform to improves or preserves

the shape and general health and well-being is bodily activity that can reduce high blood

pressure development.          

Hypertension 

          Refers to a disorder within which the blood vessels have persistently elevated

pressure, commonly referred to as high or raised vital.

Lifestyle 
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Refers to the respondent's way of life factors that help prevent and treat

hypertension, with emphasis on diet, exercise, stress, cigarette smoking, and alcohol

intake. 

Stress

Refers to a feeling of emotional or physical tension caused by stressors

experienced by a hypertensive individual in the time of pandemic.