Knowledge, attitudes, practices, and knowledge retention towards hypertension among caregivers of hypertensive patients in Neno, Malawi: A Rural setting

Abstract

Hypertension, a major public health concern, is a leading risk factor for cardiovascular diseases. Caregivers are essential for managing hypertension by supporting patients in medication adherence and blood pressure monitoring. This study examined caregivers' knowledge, attitude, and practices (KAP) and the determinants of KAP towards hypertension and caregivers’ knowledge retention after health education. The authors conducted a prospective cohort study in Neno, Malawi, a rural setting. 422 caregivers were enrolled from the Integrated Chronic Care Clinic (IC3). A structured questionnaire was used to collect baseline, post-health education, and week six data. Using SPSS V 22.0, we determined KAP scores, descriptive statistics. The authors compared changes from baseline in mean knowledge, attitude, and practices (KAP) scores, correlation between KAP and between KAP and social demographic characteristics using Wilcoxon signed-rank test, Pearson correlation, and independent t-test respectively. Among the 422 caregivers who participated in the study, 248 (58.8%) were from Lisungwi Community Hospital IC3 clinic and 174 people (41.2%) from Nino District Hospital IC3 clinic, 267 (63.2%) were females, and had a mean age of 44.94 years. At baseline, the scores of knowledge, attitude, and practices had respective means and standard deviations of 9.50 (38.0%) (SD=1.92), 16.76 (93.1%) (SD=1.31), and 25.24 (78.9%) (SD=3.10). Strong positive correlations were found between knowledge and practice (r=+0.252; p<0.001) and knowledge and attitude (r=+0.255; p<0.001). But there was no significant relationship between attitude and practice (r=+0.0.64; p=0.190). Age was strongly associated with attitude (r=+0.233; p<0.001) but not with knowledge (r=+0.034; p=0.490) or practice (r=+0.043; p=0.382) at baseline assessment. The baseline mean knowledge score was 9.50 (38.0%) and rose to 21.08 (84.3%); p= <0.001 immediate post-health education and a 2.1% decrease to 20.54 (82.2%); p= <0.001 at week six from the immediate post health education score. Attitude improved from 16.76 (93.1%) at baseline to 17.74 (98.6%) at the six-week mark. Similarly mean practice score rose from 25.24 (78.9%) at baseline to 27.42 (85.7%) at week six. There was a positive correlation between KAP while age had a negative correlation with knowledge (r=-0.146; p=0.003). There was a significant difference between different education levels on knowledge retention p=0.009 at week six assessment. Caregivers of individuals with hypertension exhibited poor knowledge and practices, accompanied by a positive attitude towards the disease at baseline. There was a positive and good knowledge retention among caregivers of hypertensive patients after health education at the week six mark. With improved knowledge and the ability to retain it resulting in improved attitude and practices, caregivers are a cornerstone for continued and improved hypertension care for the patients.