Hrev_master Healthcare in Low-resource Settings 2024; volume 12(s1):13434 Abstract Hypertension is a prevalent chronic condition that requires effective self-management strategies for optimal control and com- plications prevention. Self-management interventions have become a crucial component in the management of hypertension. Therefore, this review aimed to determine effective self-manage- ment strategies for hypertensive patients. Articles were searched from four databases, namely Science Direct, Ebsco (MEDLINE), Proquest, Pubmed and Sage Journals based on PRISMA guide- lines. The search included articles published in English between 2013 and 2022. A key term search strategy was adopted using “self-management interventions”, “nursing interventions”, “experimental study” and “hypertensive patients” to identify rele- vant studies. The results showed that self-management interven- tions have been proven to have positive effects on various aspects of hypertension self-management, including blood pressure mon- itoring, disease knowledge, medication adherence, and lifestyle modifications. These interventions can be delivered through tech- nology-based platforms. Moreover, there are different types of self-management interventions for hypertensive patients, includ- ing individual and group approaches, the use of technology, nurs- ing theory, and interventions based on the cultural aspects of patients. To conclude, as professionals, nurses should be able to determine which self-management strategies are suitable for the conditions and requirements of patients. Introduction Hypertension has become a significant contributor to the glob- al burden of disease and is recognized as a primary risk factor for cardiovascular disease.1,2 The majority (two-thirds) of the estimat- ed 1.28 billion adults aged 30-79 who suffer from hypertension reside in low- and middle-income countries.2 Furthermore, approximately 46% of adults with hypertension are oblivious to the condition.3 The condition has a substantial influence on health- related quality of life, mortality, hospitalization, and psychological well-being.4,5 It is essential for nurses to develop comprehensive management strategies with an understanding of the complica- tions.6 Self-management is crucial to hypertension control,7 has a substantial effect,8 and may contribute to multiple facets of patients’ condition.8 Moreover, effective approaches had a benefi- cial effect by lowering blood pressure,8,9 and enhancing quality of life.10 Self-management of hypertension included monitoring blood pressure, reducing cigarette and alcohol consumption, consuming a low-salt diet, maintaining a healthy weight through regular exer- cise, and medication adherence to prevent complications.11 The key to maintaining blood pressure within the normal range is com- pliance with effective and efficient self-management.12 However, hypertensive patients who implemented self-management required motivation and support from family members or relatives for follow-up, evaluation, and monitoring.13 This review aimed to determine the effective self-management strategies for hyperten- sive patients. Materials and Methods The study design was a scoping review, and articles were sourced from five databases, namely Ebsco (MEDLINE), Pubmed, Sage Journals, Proquest, and Science Direct based on PRISMA guidelines. The search included articles published between 2013 and 2022, and was carried out using keywords such as “self-management interventions”, “nursing interventions”, “hypertensive patients”, and “experimental study” with Boolean methods including “AND”, and “OR” to find relevant articles that match the purpose of writing a review. Furthermore, the search focused on reputable articles, namely original, full-text, and those published in English language. The qualifying requirements for this study do not include review articles, gray literature, papers, book chapters, personal opinions, or non-scientific publications. The inclusion and exclusion criteria were defined using the PICOS method (population, interventions, comparison, outcome and study design), with modifications made to fit the objective (Table 1). Figure 1 shows the selection results in a flowchart using the PRISMA guidelines. Following a search, 596 items were retrieved from Proquest, EBSCO (Medline), Science Direct, Sage Journals and PubMed. The retrieved articles were subjected to a duplicate selection process using the Endnote 20 program, while 17 articles with similarities were identified and eliminated from the selection process. After eliminating duplicates, 579 articles were chosen based on the inclusion and exclusion criteria. This procedure [Healthcare in Low-resource Settings 2024;12(s1):13434] [page 37] Significance for public health Hypertensive patients need self-management to help lower blood pressure, change lifestyle, and monitor the condition. Therefore, self-management interven- tions have been devised using individual and group approaches, technology, nursing theory-based approaches, and cultural aspects. Innovations might help hypertensive patients in avoiding complications and enhancing quality of life. Importance of self-management interventions in hypertension patients: a scoping review Alfrina Hany, Kuswantoro Rusca Putra, Ratih Arum Vatmasari, Anisa Nadya Nafis, Aura Tasya Amalia, Edy Khamdani Nursing Department, Faculty of Health Sciences, Universitas Brawijaya, Malang, East Java, Indonesia Non -co mmerc ial us e o nly obtained 441 items that did not meet the preset criteria. Following the procedure, it was determined that 138 articles met the qualify- ing requirements and could be selected. During the selection pro- cess based on eligibility criteria, 113 items were considered appro- priate for usage. Therefore, 25 articles were considered appropriate for inclusion in this scoping review (Figure 1, Supplementary Table 2). Results and Discussion Self-management plays a significant role in management of hypertension and has a profound impact on patients’ outcomes.14 The effects of the approaches included an increase in patients’ understanding and skills in coping with the disease by gradually adopting healthy lifestyle behaviors, improved satisfaction by reducing existing signs and symptoms, a decrease in hospital admission costs, and an improvement in quality of life.15–17 Interventions empower patients to take an active role in managing the condition, leading to better blood pressure control and overall health outcomes.18 Self-management interventions have the poten- tial to significantly improve the outcomes of hypertension manage- ment.19 In addition, family empowerment plays a significant role in promoting self-management among patients with chronic condi- tions.20 This includes assisting with dietary choices and medication adherence, as well as facilitating care discussions between patients and healthcare providers.19,21 It is important to include family members in the process to improve patients’ outcomes and compli- ance with behavioral recommendations.22 Interventions can be implemented in the form of education, training, self-help groups, classes, communities, follow-up, and application of technology.23–27 Education and training have a posi- tive effect on improving self-management skills of hypertensive patients.24,27–33 Furthermore, classroom, community, and follow-up intervention models significantly reduced the systolic blood pres- sure.34,35 The most effective methods are those that use technology as basis,25,36–38 including remote monitoring of patients condi- tion.25,36–38 Interventions for hypertensive patients may incorporate nursing theoretical approaches such as Roy’s adaptation, the health belief model, self-efficacy, and self-regulation model theo- ries.24,28,31,36,39,40 Nursing theory plays an essential role in guiding self-management interventions for hypertensive patients by pro- viding a framework for understanding the complex factors that influence the ability to effectively manage the conditions.39,41 Therefore, healthcare professionals could devise targeted interven- tions through nursing theory to meet the unique needs and chal- lenges of hypertensive patients.40 The application of nursing theory is essential for enhancing patients outcomes and encouraging effective self-care behavior.41 The use of cultural methods allows for the creation of personalized care plans that consider specific needs, preferences, and situations.42 Healthcare providers can tailor interventions to correspond with patients’ way of life and ensure appropriateness of the strategies.25 In addition, culturally informed interventions can address differences in beliefs towards medica- tion, logistical barriers to care, as well as other social and contex- tual factors that may impact patients.35 Conclusions Self-management in hypertensive patients can increase partici- pation and has led to a decrease in blood pressure, lifestyle changes, and avoidance of complications. Various interventions have been developed, such as individual and group approaches, the use of technology, nursing theory, and interventions based on the cultural aspects of patients. Families also play an important role in provid- ing self-management interventions. Hypertension management is not a “one size fits all”, hence nurses as professionals need to con- sider the suitable approaches for different conditions and needs. 4th International Nursing and Health Sciences Symposium Table 1. The inclusion and exclusion criteria. Criteria Inclusion criteria Exclusion criteria Population Hypertension patients Family, community, and other then hypertension patients (such as stroke, cardiovaskular diseases, chronic kidney diseases, cancer, etc) Interventions Self-management interventions No exclusion criteria Comparison Usual care or standard care No exclusion criteria Outcome Self-management interventions in No exclusion criteria hypertension patients are effective in improving self-management Study Design Experimental study Study articles that use mix-methods, cross-sectional (quasi-experimental and randomized study cohort, longitudinal, quantitative and review articles control trials) [page 38] [Healthcare in Low-resource Settings 2024;12(s1):13434] Figure 1. Flowchart of scoping review with selection process using PRIS-MA. Non -co mmerc ial us e o nly References 1. Roth GA, Abate D, Abate KH, et al. 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Conflict of interest: the authors declared that there were no potential con- flicts of interest Funding: none Ethics approval and consent to participate: not applicable. Clinical trials: not applicable Conference presentation: part of this article was presented at the 4th International Nursing and Health Sciences Symposium, from 27th-28th of October 2023, Universitas Brawijaya, Malang, East Java, Indonesia. Acknowledgment: the authors are grateful to Nursing Department, Faculty of Health Sciences, Universitas Brawijaya, Malang for the sup- port and encouragement. Received: 4 November 2023. Accepted: 8 June 2024. 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