Contextual Effect of the Integrated Health Post (Posbindu) and Biopsychosocial Determinants of Tertiary Preventive Behavior in Patients with Hypertension

Abstract

Background: Tertiary prevention of hyper-tension is a preventive effort to make patients with hypertension do not have disabilities and further complications. It also improves the quality of life and makes life longer. The bio-psychosocial aspect affects individuals in learning , doing, and maintaining certain behaviors based on social cognitive theory. This study aimed to analyze the biopsychosocial determinants of tertiary preventive behavior among patients with hypertension. Subjects and Method: This study was an analytical observational study with a cross-sectional design. The study was conducted at 25 Integrated Health Posts (Posbindu) in Sragen, Central Java. A sample of 200 hypertensive patients was selected by stratified random sampling. The dependent variable was the tertiary preventive behavior of hypertension. The independent variables were observational learning, role model, imitation, vicarious learning, reinforcement , self-efficacy, self-regulation, outcome expectation, and attitude. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression. Results: Hypertension preventive behavior increased with observational learning (b= 2.85; 95% CI= 0.17 to 5.53; p= 0.037), role model (b= 2.73; 95% CI =0.73 to 4.73; p=0.007), imitation (b= 3.46 ; 95% CI= 0.73 to 6.19; p= 0.013),