Social Support and Physical Activities on People with Hypertension

Aged 45 Years and Above

Riza Fikriana

1,2

* and Melya Intan

STIKes Kepanjen, Jalan.Tunorojoyo 16, (0341) 397644 Kepanjen, Malang, East Java, Indonesia

Doctoral Program of Public Health, University of Airlangga, Surabaya, Indonesia

Keywords: Social support, physical activities, hypertension.

Abstract: The blood pressure control through regular physical activities is necessary to prevent complications. Social

support is one of the factors that affect the physical activities of people with hypertension. This study aims

to identify the correlation between social support and physical activities of people with hypertension. This

study used correlational method with the cross-sectional approach. 110 people were chosen as participants

using simple random sampling technique. A questionnaire asking about support from family, health

workers, and peers, as well as International Physical Activity Questionnaire were used to collect the data.

The statistical test conducted was Gamma Correlation Test. Results showed that there was no relationship

between family support, health worker support, and peer support with physical activities among people with

hypertension aged 45 years and above indicated by the p-value for each variable: 0.655, 0.055, and 0.857.

Based on the three p-values, the support from health workers had a p-value close to 0.05. No correlation

between social support and physical activities of the people with hypertension signifies that social support

has not yet been able to be given adequately to the people with hypertension. Family, health workers, and

peers are expected to strengthen their role in controlling the blood pressure of the people with hypertension

through physical activities.

1 INTRODUCTION

The prevalence of hypertension increases every year

(Benjamin et al., 2017). Hypertension is a risk factor

for cardiovascular disease. A few complications

occur due to hypertension, such as cerebrovascular

accident and chronic kidney disease kronik (Latifi et

al., 2014). Studies have shown that 30% of patients

who died due to heart disease had a history of

hypertension (Tereshchenko et al., 2017). Thus,

blood pressure control is vital for people with

hypertension in order to prevent health

complications (Huang et al., 2017)

Steps to control blood pressure on people with

hypertension start by engaging regular physical

activities. Regular physical activities can reduce

systolic and diastolic blood pressure on people with

hypertension (Diaz and Shimbo, 2013). Social

support is one of the factors that influence

someone’s physical activity (Ishak et al., 2017).

Social support is able to decrease someone’s health

problems (Xie et al., 2018). Social support plays an

important role in health. It can determine an

individual’s mental and physical health. Moreover, it

also can increase efforts to prevent diseases, mental

health disorders, and psychological distress, as well

as decrease the number of deaths (Veiel, 1985)

2 METHODS

2.1 Research Design, Setting and

Sample

This study was observational analytical with the

cross-sectional approach. The study was conducted

in the areas surrounding Puskesmas Turen in Malang

Regency with the study population of all patients

with hypertension in Turen Sub-District. The

research sample was 110 patients with hypertension

aged 45 years and older selected using simple

random sampling technique.

Fikriana, R. and Intan, M.

Social Support and Physical Activities on People with Hypertension Aged 45 Years and Above.

DOI: 10.5220/0009119200050009

In Proceedings of the 2nd Health Science International Conference (HSIC 2019), pages 5-9

ISBN: 978-989-758-462-6

2.2 Data Collection

The research instrument was a questionnaire

designed to gather the information from the

respondents on demography, social support, and

physical activities. Demographic data included age,

sex, education, and jobs. In addition, data on the

respondents’ compliance to blood pressure

medication and blood pressure levels measured

using sphygmomanometer were collected. Another

questionnaire was designed to collect social support

data consisting of family support, health worker

support, and peer support.

The questionnaire on social support was arranged

based on the components of emotional and

appreciation supports, instrumental support, and

informational support. The questionnaire consisted

of questions with answer choices using the Likert

scale comprised of four answer choices which were

Strongly Disagree, Disagree, Agree, and Strongly

Agree. To measure the physical activities of the

people with hypertension, International Physical

Activity Questionnaire (IPAQ) was employed. The

total score was categorized into light, moderate, and

vigorous. Before data were collected, the

respondents were given an explanation of the aim,

the significance, and the procedure of the research.

The respondents signed the informed consent form

to show that they agreed to participate in the study.

2.3 Data Analysis

Data analysis was carried out using descriptive

analysis technique in the form of frequency

distribution to present data on demography, social

support, and physical activities. Besides, the

Spearman’s rank test was performed to analyze the

correlation between social support and physical

activities.

3 RESULTS AND DISCUSSION

3.1 Socio Demographic Data and

Health Status

Socio demographic data show that 63.6% of the

respondents were between 60 and 74 years old with

which the majority were women. 62% attended

elementary schools and 40% were unemployed. In

regard to health status measured by blood pressure,

65.5% were categorized into hypertension stage I

and 34.5% were categorized into hypertension stage

II. 35.5% regularly took anti-hypertension medicine,

while 64.5% did not.

3.2 Social Support and Physical

Activities

Data show that 40% of the respondents received

adequate family support, while 62.7% received

enough support from health workers. Enough

support from peers is also seen to be given to 56.4%

of the respondents (see Table 2).

Based on the components of emotional and

appreciation supports, instrumental support, and

informational support, family support had the

highest average score. Additionally, informational

support had the highest average score on each social

support, health worker support, and peer support

(see Table 3).

Table 1: Socio demographic data and health status (n=110).

Variable n (%) Variable n (%)

Age (years)

45 – 59

60 – 74

> 75

Education

Didn’t go to school

Elementary

Junior High

Senior High

Consumption of Anti-Hypertension

Medicine

Regularly

Not Regularly

Hypertension Categories

Hypertension Stage I

Hypertension Stage II

33 (30.0)

70 (63.6)

7 (6.4)

8 (7.0)

68 (62.0)

22 (20.0)

12 (11.0)

39 (35.5)

71 (64.5)

72 (65.5)

38 (34.5)

Sex

Male

Female

Marital Status

Unmarried

Married

Job

Private sector

Entrepreneur

Laborer

Unemployed

17 (15.5)

93 (84.5)

1 (0.9)

107 (99.1)

17 (15.5)

18 (16.5)

31 (28.0)

44 (40.0)

HSIC 2019 - The Health Science International Conference

3.3 Relationship between Social

Support and Physical Activities

Analysis results of statistical test show that the three

types of social support – family support, health

worker support, and peer support – had no link with

physical activities of the people with hypertension

with each p-value 0.655, 0.055, and 0.857. It can be

seen that the p-value of the health worker support

was close to the meaning of relationship between

social support and physical activities (see Table 4).

Blood pressure control on people with

hypertension can be done by taking advantage of

pharmacological and non-pharmacological therapy

approaches. Physical activity is one of the strategies

of a non-pharmacological therapy necessary for

people with hypertension to prevent an increase in

blood pressure and health complications (Han et al.,

2014). Results show that 25.5% of people with

hypertension performed light physical activities;

44.5% performed moderate physical activities; and

30% performed vigorous physical activities (see

Table 2).

Table 2: Frequency distribution of social support and physical activities of the people with hypertension (n=110).

Variable n (%) Variable n (%)

Family Support

Poor

Enough

Good

Health Worker Support

Poor

Enough

Good

29 (26.4)

44 (40.0)

37 (33.6)

24 (21.8)

69 (62.7)

17 (15.5)

Peer Support

Poor

Enough

Good

Physical Activities

Light

Moderate

Vigorous

37 (33.6)

62 (56.4)

11 (10.0)

28 (25.5)

49 (44.5)

33 (30.0)

Table 3: Average score of emotional support, appreciation support, instrumental support, and informational support of the

people with hypertension (n=110).

Social Support Average Score

of Emotional &

Appreciation Supports

Average Score

of Instrumental Support

Average Score

of Informational Support

Family Support 10.35 10.23 11.03

Health Worker Support 10.09 8.90 10.62

Peer Support 9.58 8.30 9.62

Table 4: Results of Analysis on the Gamma Correlation between Social Support and Physical Activities (n=110).

Physical Activities Correlation

Coefficient (r)

p-value

Light Moderate Vigorous

Family Support Poor 8 12 9 0.059 0.655

Enough 12 20 12

Good 8 17 12

Total 28 49 33

Health Worker Support Poor 8 11 5 0.253 0.055

Enough 19 28 22

Good 1 10 6

Total 28 49 33

Peer Support Poor 11 16 10 0.026 0.857

Enough 13 28 21

Good 4 5 2

Total 28 49 33

Social Support and Physical Activities on People with Hypertension Aged 45 Years and Above

Regular physical activities will cause peripheral

vascular resistance to weaken; thus, blood pressure

can be lowered thanks to the neuro hormonal and

structural responses as well as the decrease of the

sympathetic nerve activities and the increase of

arterial lumen diameter (Hamer, 2006). In addition,

doing physical activities regularly can prevent

people with hypertension from Left Ventricular

Hypertrophy (Hegde and Solomon, 2015).

Based on the health status of people with

hypertension, 65.5% were fallen into hypertension

stage I and the rest 34.5% were categorized into

hypertension stage II. Social environment is a

resource that mediates the relationship between

stress and health. Someone living in a pressuring

social environment will experience positive impacts

if he or she receives social support. However, poor

social support can contribute to someone’s mental

and physical health disorder (Schaefer, Coyne and

Lazarus, 1981). Support is vital for people with

hypertension. Good social support from the

environment can influence people with hypertension

in treatment management for them, including

physical activities.

The results of this study suggest that family

support had the highest average score compared to

health worker support and peer support. Social

support, especially from family, with the increase of

patients’ knowledge will positively affect their self-

care behavior (Ishak et al., 2017). (Wulandhani dkk,

2014) argued that family support can be expressed

by giving attention, empathy, encouragement,

advice, information, and etc. Family support is

associated with the development of mental balance

and psychological satisfaction. Family members

should be prepared to give assistance if needed.

Someone who receives family support will feel

emotionally calm to be able to feel the attention,

advice, and good impression given to them (Azizah,

2011).

Furthermore, Table 3 describes that among three

forms of social support, the highest average score

was fallen into informational support. Informational

support refers to a support by giving information or

advice that can help someone solve problems and

give feedback on how he or she does it. Feedback

can assist someone to maintain his or her social

identity and social integrity (Schaefer, Coyne and

Lazarus, 1981).

The results of gamma correlation analysis

indicate that no link is found between family

support, health worker support, peer support, and

physical activities among people with hypertension

(see Table 4). A few other factors are likely to

contribute to the physical activities of people with

hypertension. According to Precede-Proceed model

by Lawrence W. Green (1980), someone’s health

behavior is affected by three factors which are

predisposition factor, enabling factor, and

reinforcing factor. Predisposition factor includes

demographic factor, social structure, and health

beliefs. On the other hand, the enabling factor is the

facilities that support health care (Notoatmodjo,

2007). Social factor is supposed to be a reinforcing

factor. In this study, however, social support has no

association with physical activities.

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Social Support and Physical Activities on People with Hypertension Aged 45 Years and Above