Genius Journal - vol. 01 no. 02 (2020) 039-044
Original Article Prevalence and Correlation of Knowledge Level with Stress of Pa- tients with Hypertension Fidya Anisa Firdaus 1, Wina Widianti 2, Windi Oktavia3, Suhanda4
1 STIKes Muhammadiyah Ciamis, Jln. KH. Ahmad Dahlan No. 20 Ciamis 46216, Indonesia
ARTICLE INFORMATION A BSTRACT Received: November 22, 2020 Introduction: High blood pressure causes several complications Revised: December 21, 2020 such as heart failure, kidney failure, stroke, circulation problems Available online: December 23, 2020 and death. Hypertension can be triggered by stress due to activa- tion of the sympathetic nervous system which causes an intermit- tent increase in blood pressure. Patient's knowledge of hyperten- KEYWORDS sion is an important factor in controlling blood pressure and re- ducing stress levels. Hypertension, Knowledge, Stress. Objective: This study aims to determine the prevalence and cor- relation of the level of knowledge and stress in people with hyper- tension. CORRESPONDENCE Methods: This type of research is quantitative analytic with a cross sectional approach. The population in this study were hy- Phone: +6281312868566 pertension patients in the Public Health Centre of Cijeungjing E-mail: [email protected] working area who were more than 30 years old with a total 101. The research sample was taken as many as 50 respondents with purposive sampling technique. The research instrument used was a questionnaire to measure the level of knowledge of hyperten- sion and the perceived stress scale (PSS-10) as a measure of stress levels. Data were analyzed using SPSS version 20 with Chi Square statistical test. Results: The results showed that the majority of respondents had more knowledge than the average of 27 people (54%). While the majority of respondents' stress levels were in the medium catego- ry, namely as many as 33 people (66%). Conclusion: Based on the results of the analysis, it is concluded that there is no significant relationship between knowledge and stress levels of hypertensive patients as evidenced by the value α <ρ value (0.05> 0.067) and the value of chi square (X2) count INTRODUCTION blood pressure ≥90 mmHg) (Físico, Hipertensión, En, & Revisión, 2020). The Hypertension is a major risk factor for global higher the pressure, the greater the work of mortality and morbidity and is still a major the heart (Budi, Nurjannah, Nurhidayat, & cause of cardiovascular disease (Natsis, Rifai, 2017). Antza, Doundoulakis, Stabouli, & Kotsis, 2020). The World Health Organization Most people with hypertension are not aware (WHO) states that hypertension is a condi- of the dangers of hypertension caused by tion of the occurrence of high blood pressure the client's lack of knowledge about hyper- and persists in the blood vessels (systolic tension (Noorhidayah, 2020). Some of the blood pressure ≥140 mmHg and diastolic harmful effects of hypertension include heart 39 failure, kidney failure, stroke, circulatory dis- stress. This is related to one of the risk fac- orders that lead to death (Song, Ma, Wang, tors for hypertension, namely stress (Hsu & Chen, & Zhong, 2019). Even though some of Tain, 2020). The emergence of hypertension the causes and risk factors for hypertension due to stress can be caused by activation of such as high stress, obesity, smoking, con- the sympathetic nervous system which suming alcohol, caffeine and irregular exer- stimulates the hormones adrenaline, cortisol cise and poor sleep quality can be avoided and adenocorticotrophin stimulating hormone by everyone (Ngueta, 2019) (Gambardella, (ACTH). (Boyer-diaz et al., 2020). The secre- Morelli, Wang, & Santulli, 2020). Obesity is tion of these hormones can cause an inter- also a risk factor for hypertension and is mittent increase in blood pressure (Budi et considered to be an independent factor, al., 2017). which means it is not influenced by other risk factors (Tiara, 2020) (Setiawan, Based on WHO data in 2015, hypertension is Khaerunnisa, Ariyanto, & Firdaus, 2020). shown by around 1.13 billion people in the world, which means 1 in 3 people in the Blood circulation can be reduced due to the world are diagnosed with hypertension. It is nicotine in cigarettes which can shrink small estimated that 9.4 million people die from arteries and strengthen the work of the heart hypertension each year (Riskesdas, 2013). (Memah, Kandou, & Nelwan, 2019) Based on Riskesdas 2013 data, the preva- (Firmansyah, Jahidin, & Najamuddin, 2019). lence of hypertension in West Java, which The acidity of the blood can increase due to was obtained through measurements at ≥18 alcohol, when the acidity of the blood in- years of age, is in the 4th position with the creases, the blood will become thick and the most cases of hypertension (29.4%) after heart is forced to pump blood stronger, this is East Kalimantan (29.6%), South Kalimantan when blood pressure occurs (Memah et al., (30.8%) and Bangka Belitung in the first po- 2019) (Setiawan, Ediati, & Winarni, 2017). sition with Bangka 30.9% (Riskesdas 2013). Whereas in 2018, West Java experienced a Knowledge is the result of "knowing" and this high increase by ranking second as the prov- occurs after people sensing a certain object. ince with the highest cases of hypertension According to the theory of WHO (World in Indonesia, namely 39.6% after South Ka- Health Organization) cited by Notoatmodjo limantan with a prevalence of 44.1% (2007), one form of health object can be de- (Riskesdas, 2013). scribed by knowledge gained from one's own Lack of knowledge of hypertension sufferers experience (Anggreani & Nasution, 2019) based on cases, above, researchers are in- (Purba, 2019). Knowledge about risk factors, terested in examining the relationship be- causal factors and how to avoid it, it is very tween the level of knowledge and stress of important for people with hypertension to be hypertension sufferers in the work area of able to control it (Budi et al., 2017). Alexan- the Public Health Centre of Cijeungjing, Ci- der et al (2013) said that patient knowledge jeungjing District, Ciamis Regency. and awareness of hypertension are the main factors in controlling blood pressure METHOD (Wijayanti, 2020). Maintaining a healthy life- style, regular check-ups at health care cen- This type of research is quantitative analytic ters, and adherence to treatment programs with cross sectional approach. The inde- will increase along with a strong enough lev- pendent variable (independent) is the level of el of knowledge (Choroma et al., 2020). knowledge and the dependent variable (de- Several studies have shown that the level of pendent) is the level of stress in patients with knowledge can affect a person's attitude and hypertension. The population in this study character (Budi et al., 2017). were all patients with hypertension in the working area on the Public Health Centre of In his research, Andria (2013) said that Cijeungjing as many as 101 people. With a strong knowledge about hypertension is a purposive sampling technique as many as 50 great potential for sufferers to manage people. The inclusion criteria for this study 40 were people with hypertension, able to write 500.000 - 2.000.000 15 30 and read, not in the process of being hospi- 2.000.000 - 5.000.000 2 4 talized and willing to fill out an informed con- sent. Meanwhile, the exclusion criteria were The majority of respondents have female patients with chronic diseases other than gender, as many as 33 people (66%). The hypertension. This study uses primary data majority of respondents did not work, as or data obtained directly from the object of many as 31 people (62%). The majority of research by distributing questionnaires. In respondents' education was elementary conducting this research activity, researchers school graduates as many as 22 people were assisted by nurses in the work area on (44%). And the majority of respondents aged the Public Health Centre of Cijeungjing, Ci- between 20-60 as many as 31 people (62%). jeungjing District, Ciamis Regency. And the majority of respondents' income is Rp. 100,000-3.00,000 per month as many as The research instrument is a questionnaire 18 people (36%). that can be used as a measuring tool for the level of knowledge and stress levels of re- Univariate Analysis spondents. To measure the level of educa- tion using a questionnaire about the level of Description of Knowledge of Patients with knowledge of hypertension which had previ- Hypertension in the work area of the Pub- ously been tested for validity and reliability of lic Health Centre of Cijeungjing Ciamis 20 questions. Meanwhile, the questionnaire for the perceived stress scale (PSS-10) con- Table 2. Frequency distribution of respond- sists of 10 questions given to respondents as ents based on knowledge of hypertension a measure of stress levels. This research sufferers in the work area of the Public was conducted in the work area onf the Pub- Health Centre Cijeungjing Ciamis. lic Health Centre of Cijeungjing, Cijeungjing Knowledge F % Subdistrict, Ciamis Regency on November < Average 23 46 29, 2020. The data that has been obtained > Average 27 54 were then analyzed by statistical analysis Total 50 100 test Chi square with SPSS for Windows ver- sion 20. Based on the table above, the majority of respondents have more knowledge than the RESULTS average of 27 people (54%). Sociodemographic Data Description of Stress Level of Patients with Hypertension in the work area of the Table 1 Sociodemographic Public Health Centre of Cijeungjing Gender F % Ciamis Male 17 34 Female 33 66 Profession Table 3. Frequency distribution of respond- Work 19 38 ents based on the stress level of hyperten- Does Not Work 31 62 sion sufferers in the work area of the Public Education Health Centre of Cijeungjing Ciamis Elementary School 22 44 Junior High School 7 14 Level Stress F % Senior High School 15 30 Normal 6 12 D-III 1 2 Light 11 22 D-IV/S1 5 10 Moderate 33 66 Age Total 50 100 11-19 Years Old 7 14 20-60 Years Old 31 62 Based on the table above, the majority of 24 >60 Years Old 12 respondents have a moderate stress level, namely 33 people (66%). Income/month 100.000 - 300.000 18 36 300.000 - 500.000 15 30 41 Bivariate Analysis community with efforts to prevent hyperten- sion in Mandi Angin Timur Village, Karang Table 4. Knowledge Relationship with the Intan District, Banjar Regency. stress level of hypertension sufferers in the work area of Public Health Centre of Ci- According to Sugiharto's research (2007) jeungjing Ciamis. there is a relationship between stress and the incidence of hypertension, where people P X2 Stress Level Total who experience psychological stress must Value Count Knowledge experience hypertension. < Mean >Mean F % F % F % Another problem that arises is that often Normal 1 2 5 10 6 12 negative emotions such as anxiety and de- Light 3 6 8 16 11 22 0.067 5.709 pression arise slowly without realizing it and Moderate 19 38 14 28 33 66 the individual will realize after physical symp- Total 6 12 11 22 50 100 toms appear, such as hypertension (Budi et al., 2017). Based on the table above, respondents who had less than average knowledge had a In his research, Ramayulis (2010) states that moderate level of stress, namely 19 people, stress can cause an increase in blood pres- as well as respondents with more than aver- sure due to an increase in peripheral vascu- age knowledge had a moderate level of lar retention and cardiac output, thus stimu- stress, namely 14 people. lating sympathetic nerve activity, releasing adrenaline and causing the heart to beat From the results of data analysis, it was ob- faster (Mahmudah, Maryusman, Arini, & tained that the chi square value (X2) was Malkan, 2017). 5.412 and the value of ρ value was 0.067. 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