Minahasa Culture, Family Support, Health Worker Support, Self-Efficacy, and Knowledge Associated with Self-Care Behavior among Hypertensive Patients: A Cross-Sectional Study

Authors

  • Dina Dewi Sartika Lestari Ismail Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, East Java, Indonesia
  • Christina Yunitha Pelealu Master of Nursing Program, Medical-Surgical Nursing Specialization, Faculty of Health Sciences, Brawijaya University, Malang, East Java, Indonesia
  • Lilik Supriati Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, East Java, Indonesia

DOI:

https://doi.org/10.55018/janh.v8i1.481

Keywords:

Self-Care Behaviour, Hypertensive Patients, Minahasa Culture

Abstract

Background: Hypertension is a leading cause of stroke and cardiovascular disease, and its high prevalence in Indonesia remains difficult to control. Evidence on how psychosocial and cultural factors, including Minahasa local culture, influence self-care is still limited. This study examined the effects of knowledge, self-efficacy, family support, health worker support, and Minahasa culture on self-care behavior among hypertensive patients in Southeast Minahasa Regency.

Methods: A quantitative correlational cross-sectional study was conducted among 165 hypertensive patients recruited by consecutive purposive sampling from the outpatient clinic of a general hospital in Southeast Minahasa. Data were collected using validated questionnaires, and associations between predictors and self-care behavior were analyzed using multiple linear regression (p < 0.05).

Results: Self-efficacy (β = 0.381; p < 0.001) and family support (β = 0.329; p < 0.001) had significant positive effects on self-care behavior. Knowledge (β = –0.009; p = 0.895), health worker support (β = –0.065; p = 0.643), and Minahasa culture (β = 0.127; p = 0.405) showed no significant direct effects. The model explained 34.7% of variance in self-care behavior (R² = 0.347).

Conclusion: Self-efficacy and family support are the main determinants of self-care behavior, whereas knowledge, health worker support, and Minahasa culture do not exert significant direct effects. These findings indicate that local cultural values alone do not automatically improve self-care and may act indirectly through family and psychosocial pathways. Hypertension programs should prioritize strengthening self-efficacy and mobilizing family support, and future longitudinal studies should test culturally grounded, family-centered interventions

Downloads

Download data is not yet available.

References

Afik, A., & Fikriana, R. (2021). Self-care Experience in Hypertensive Patients. Bali Medical Journal, 10(3), 1398–1402. https://doi.org/10.15562/bmj.v10i3.2982

Agnesia, Y., Sari, S. W., Nu’man, H., Ramadhani, D. W., & Nopianto. (2023). Buku Ajar Metode Penelitian Kesehatan. Penerbit NEM.

Amirin. (2011). Populasi Dan Sampel Penelitian 4: Ukuran Sampel Rumus Slovin. Erlangga.

Chaturvedi, A., Zhu, A., Gadela, N. V., Prabhakaran, D., & Jafar, T. H. (2024). Social Determinants of Health and Disparities in Hypertension and Cardiovascular Diseases. Hypertension, 81(3), 387–399. https://doi.org/10.1161/HYPERTENSIONAHA.123.21354

Darma Perbasya, S. T. (2022). Hubungan Hipertensi Terhadap Stroke. Jurnal Ilmu Kesehatan Indonesia (JIKSI), 2(2), 922–926. https://doi.org/10.57084/jiksi.v2i2.775

de Santana Silva, J. P., Cruz, H. R. A., Silva, G. A. G., Gualdi, L. P., & Lima, Í. N. D. F. (2024). Illness Perception and Self-Care in Hypertension Treatment: A Scoping Review of Current Literature. BMC Health Services Research, 24(1), 1529. https://doi.org/10.1186/s12913-024-12001-z

Ernawati, I., Fandinata, S. S., & Permatasari, S. N. (2020). Translation and Validation of the Indonesian Version of the Hypertension Knowledge-level Scale. Open Access Macedonian Journal of Medical Sciences, 8(E), 630–637. https://doi.org/10.3889/oamjms.2020.5152

Feigin, V. L., Stark, B. A., Johnson, C. O., Roth, G. A., Bisignano, C., Abady, G. G., Abbasifard, M., Abbasi-Kangevari, M., Abd-Allah, F., Abedi, V., Abualhasan, A., Abu-Rmeileh, N. M., Abushouk, A. I., Adebayo, O. M., Agarwal, G., Agasthi, P., Ahinkorah, B. O., Ahmad, S., Ahmadi, S., … Murray, C. J. L. (2021). Global, Regional, and National Burden of Stroke and Its Risk Factors, 1990–2019: A Systematic Analysis for The Global Burden of Disease Study 2019. The Lancet Neurology, 20(10), 795–820. https://doi.org/10.1016/S1474-4422(21)00252-0

Han, H.-R., Lee, H., Commodore-Mensah, Y., & Kim, M. (2014). Development and Validation of the Hypertension Self-care Profile. Journal of Cardiovascular Nursing, 29(3), E11–E20. https://doi.org/10.1097/JCN.0b013e3182a3fd46

Hani, S. B., Abu Sabra, M. A., Alhalabi, M. N., Alomari, A. E., & Abu Aqoulah, E. A. (2024). Exploring the Level of Self-Care Behavior, Motivation, and Self-Efficacy among Individuals With Hypertension: A Cross-Sectional Study. SAGE Open Nursing, 10, 1–8. https://doi.org/10.1177/23779608241257823

Huy, T. Q., Nguyet, N. T., Nguyet, N. M., & Truong, P. Van. (2024). Self-Care Behavior Mediates The Relationship Between Health Literacy and Blood Pressure in Older Adults with Hypertension. Bangladesh Journal of Medical Science, 23(2), 476–483. https://doi.org/10.3329/bjms.v23i2.72176

Jariyasakulwong, P., Wattanakitkrileart, D., Pongthavornkamol, K., Piaseu, N., & Roubsanthisuk, W. (2025). Factors Influencing Self-Care Practices and Blood Pressure Among Individuals with Uncontrolled Hypertension: A Cross-Sectional Study. Patient Preference and Adherence, 19, 1–17. https://doi.org/10.2147/PPA.S497555

Khotibul Umam, M., Win Martani, R., Mumpuni Yuniarsih, S., Studi Keperawatan, P., Ilmu Kesehatan, F., Pekalongan, U., & Studi Kesehatan Masyarakat, P. (2023). Perilaku Self-Care Pada Penderita Hipertensi di Indonesia: Sistematik Literatur Review. Jurnal Promotif Preventif, 6(6), 908–918. https://doi.org/https://doi.org/10.47650/jpp.v6i6.1051

Krisnawati, N. W. (2024). The Relationship Between Family Support and Self Care in Hypertension Clients. Health Access Journal, 1(1), 1–7. https://doi.org/10.31290/haj.v1i1.4347

Lazarus, & Folkman. (1984). Stress, Appraisal, and Coping. Spingrer.

Liberty, I. A. (2024). Metode Penelitian Kesehatan. Penerbit NEM.

Lindblom, S., Ivarsson, C., Wändell, P., Bergqvist, M., Norrman, A., Eriksson, J., Lund, L., Hagströmer, M., Hasselström, J., Sandlund, C., & Carlsson, A. C. (2024). Lifestyle Counseling in Patients with Hypertension in Primary Health Care and Its Association with Antihypertensive Pharmacotherapy. The Journal of Clinical Hypertension, 26(7), 816–824. https://doi.org/10.1111/jch.14852

Pahria, T., Nugroho, C., & Yani, D. I. (2022). Factors Influencing Self-Care Behaviors in Hypertension Patients with Complications. Vascular Health and Risk Management, 18, 463–471. https://doi.org/10.2147/VHRM.S366811

Pujiastuti, T., A. Aljaberi, M., Sansuwito, T., Abdullah, B. F., & Poddar, R. (2023). Effectiveness of Self Care Education on Knowledge and Behavior Among Android-based Hypertension Patients at Yogyakarta Health Center. Malaysian Journal of Medicine and Health Sciences, 19(s9), 1–5. https://doi.org/10.47836/mjmhs.19.s9.1

Putri, R. R. D. R. A., Romadhon, W. A., & Kolopaking, T. R. (2022). Self-Care Behavior and Associated Factors in the Elderly with Hypertension. Jurnal Ners Dan Kebidanan (Journal of Ners and Midwifery), 9(2), 248–254. https://doi.org/10.26699/jnk.v9i2.ART.p248-254

Sarfika, R., Sulistiawati, Afriyanti, E., & Saifudin, I. M. M. Y. (2023). Self-Care Behavior Among Adult Patients with Hypertension in Padang, West Sumatra, Indonesia: A Cross-Sectional Study. Belitung Nursing Journal, 9(6), 595–602. https://doi.org/10.33546/bnj.2915

Sharkiya, S. H. (2023). Quality Communication Can Improve Patient-Centred Health Outcomes Among Older Patients: A Rapid Review. BMC Health Services Research, 23(1), 886. https://doi.org/10.1186/s12913-023-09869-8

Shiri Mohammadabad, H., & Afshani, S. A. (2023). Women’s Participation in Self-Care and the Importance of Paying Attention to Cultural Capital: A Cross-Sectional Study among Women in Yazd (Iran). Community Health Equity Research & Policy, 43(4), 367–374. https://doi.org/10.1177/0272684X211033463

Simonsen, N., Koponen, A. M., & Suominen, S. (2018). Patients’ Assessment of Chronic Illness Care: A Validation Study Among Patients With Type 2 Diabetes in Finland. BMC Health Services Research, 18(1), 412. https://doi.org/10.1186/s12913-018-3206-7

Sistikawati, H. I., Fuadah, I. W., Salsabila, N. A., Azzahra, A. F., Aesyah, A., Insyira, I., Adhitama, P. F., Anggraini, R. K., & Nandini, N. (2021). Literature Review : Hubungan Pola Makan dengan Kejadian Hipertensi. Media Kesehatan Masyarakat Indonesia, 20(1), 57–62. https://doi.org/10.14710/mkmi.20.1.57-62

Slovin L.A. (1960). Sampling Methods of Research. The Journal of the American Statistical Association, 55(290), 708–713.

Susanti, S. N., Sukarmin, S., Jauhar, M., Tiara, N., & Lasmini, L. (2024). Efikasi Diri, Dukungan Sosial, dan Self-Care Management Klien Hipertensi. Jurnal Ilmiah Ners Indonesia, 5(2), 62–80. https://doi.org/10.22437/jini.v5i2.37546

Tan, F. C. J. H., Oka, P., Dambha-Miller, H., & Tan, N. C. (2021). The Association Between Self-Efficacy and Self-Care in Essential Hypertension: A Systematic Review. BMC Family Practice, 22(1), 44. https://doi.org/10.1186/s12875-021-01391-2

Tiwi, A. H., Dewi, P., & Cahyaningrum, E. D. (2022). Hubungan Dukungan Sosial dengan Tekanan Darah pada Penderita Hipertensi di Puskesmas Kembaran I Kabupaten Banyumas. Jurnal Keperawatan Raflesia, 4(2), 71–80. https://doi.org/10.33088/jkr.v4i2.814

von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The Strengthening The Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines For Reporting Observational Studies. The Lancet, 370(9596), 1453–1457. https://doi.org/10.1016/S0140-6736(07)61602-X

Wondmieneh, A., Gedefaw, G., Getie, A., & Demis, A. (2021). Self-Care Practice and Associated Factors among Hypertensive Patients in Ethiopia: A Systematic Review and Meta-Analysis. International Journal of Hypertension, 2021, 1–11. https://doi.org/10.1155/2021/5582547

World Health Organization. (2025). Hypertension. Newsroom. https://www.who.int/news-room/fact-sheets/detail/hypertension

Downloads

Additional Files

Published

2026-03-21

How to Cite

Ismail, D. D. S. L. ., Pelealu, C. Y. ., & Supriati, L. . (2026). Minahasa Culture, Family Support, Health Worker Support, Self-Efficacy, and Knowledge Associated with Self-Care Behavior among Hypertensive Patients: A Cross-Sectional Study. Journal of Applied Nursing and Health, 8(1), 45–68. https://doi.org/10.55018/janh.v8i1.481