124 ABSTRACTS: HIGH BLOOD PRESSURE CONTROL

E-183

PEDIATRIC HYPERTENSION: A STRATEGY FOR IMPROVED BLOOD PRESSURE CONTROL

Sue Porth, Division of Nephrology, Childrens Hospital of Los Angeles, Department of Pediatrics, USC School of Medicine, Los Angeles; Ellin Lieberman.

Results of detect ion, evaluation and monitoring of hypertensive diseases in individuals > 30 years of age are well known. In contrast, these issues have not

been addressed for children and adolescents with hypertension. A study of 256 hypertensive children from 5 southern California teaching hospitals revealed deficits that contributed to inadequate blood pressure interpretation, inadequate assessment and suboptimal blood pressure control.

The objective of the current activity is to utilize the accumulated data to develop quality control for a target population at the hypertension clinic at Childrens Hospital of Los Angeles. A specially trained nurse coordinates the identification of hypertensive patients , monitors care rendered by physicians

and allied health personnel by using a newly developed child/adolescent oriented checklist, provides patient education, develops out-reach strategies and focuses on dropouts and poorly controlled hypertensives.

implementation of current hypertension control activities is expected to improve the qua1 ity of 1 i fe for hypertensive children as wel I as increase the

degree of blood pressure control. Data collected during a specific time period in 197j’-lg78 will be compared with earlier experience to determine if these goals

have been achieved and to highlight medical problems unique to children and adolescents.

A-184 IRPROVING COMPLIANCE OF HYPERTENSIVE PATIENTS THROUGH NURSING ACTIONS.

Marjorie J. Powers (University of Illinois at the Medical Center, College of Nursing, Chicago,fllinois.)

The objectives were to develop techniques for the education and motivation of hypertensive patients and to evaluate the relative effectiveness of different approaches. Approaches were designed to include both educational and behavioral strategies. The level of fear arousal, the directiveness of the approach, the extent of patient participation, and the number of follow-up visits were mani- pulated. Dependent variables included blood pressure reduction, appointment keeping behavior, evaluation of knowledge, attitudes and compliance, along with nurse evaluation of goal attainment of specific goals. One hundred sixty diagnosed hypertensive8 made up the experimental group; sixteen patients were selected for a pure control; thirty-three patients who meet the criteria for the study but who could not participate constituted a chart review comparison group. Five different treatment sites were used in this study. These sites included two hospital clinics, two community health centers and one private physician's office. Data analysis of the dependent variables involve several distinct stages: 1) descriptive analysis of the distribution of each dependent variable; (2) before-after experimental analysis of changes in dependent variables; (3) comparison group analysis of experimental and control groups; (4) multi-variate hierarchical regression of the dependent variables on selected antecedent variables. Initial findings indicate that patients attending the hypertensive education program average blood pressure reduction which were both statistically and clinically significant.