Evidence-based
Community
Health
Nursing
Practice
Mary
Jo
Clark
Hahn
School
of
Nursing
and
Health
Science
University
of
San
Diego
San
Diego,
California,
USA
Identification
and
control
of
hypertension
are
important
public
health
concerns.
In
the
United
States,
23%
of
residents
aged
20
to
74
years
have
diagnosed
hypertension.
Among
those
over
75
years
of
age,
77%
of
women
and
64%
of
men
are
affected,
and
many
others
have
elevated
blood
pressures
of
which
they
may
not
be
aware.
Even
when
hypertension
is
recognized,
control
may
be
difficult,
complicated
by
individual
responses
to
therapy
as
well
as
noncompliance
with
therapeutic
regimens.
Lack
of
regular
health
care
makes
diagnosis
and
control
difficult
in
some
populations.
Community
health
nursing
services
in
settings
where
clients
regularly
gather
promote
identification
and
control
of
hypertension.
This
study
focused
on
the
effects
of
hypertension
screening
and
monitoring
services
provided
by
community
health
nurses
to
participants
in
a
bread
distribution
program,
an
elder
nutrition
program,
an
English
language
class,
and
employees
of
several
social
and
health
service
agencies
housed
in
a
local
community
center.
In
18
months,
community
health
nurses
provided
blood
pressure-related
services
to
343
clients
in
2,407
encounters.
Blood
pressures
were
elevated
in
19%
of
encounters,
and
10%
of
clients
had
elevations
warranting
referral
for
medical
assistance.
At
the
end
of
the
study
period,
67%
of
all
clients
with
elevations
and
71%
of
those
referred
for
medical
assistance
had
achieved
normal
blood
pressures.
Fifteen
clients
(4%)
with
previously
undiagnosed
hypertension
were
identified
and
referred
for
medical
treatment.
Two
thirds
of
these
clients
achieved
normal
blood
pressures
by
the
end
of
the
study.
The
effectiveness
of
intervention
appeared
to
vary
among
groups
with
some
groups
more
likely
than
others
to
achieve
a
positive
outcome.
For
example,
clients
in
the
bread
distribution
group
were
more
likely
to
have
an
increased
number
of
visits
with
elevations
prior
to
achieving
a
normal
blood
pressure
than
other
groups.
Group
differences
in
outcome,
however,
were
not
statistically
significant.
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