Bridging the Gap: How Family Support and Health Literacy Shape Self-Care in Elderly Hypertension Management
DOI:
https://doi.org/10.5294/aqui.2026.26.2.3Keywords:
Hypertension, elderly, self-care, family support, health literacyAbstract
Introduction: Hypertension is a common chronic condition among older adults that negatively affects quality of life and requires effective self-care. Family support and health literacy are key factors influencing self-care behaviors, yet most studies have examined these factors separately and in high-income countries. This study explores their combined impact in a low- to middle-income setting. Objective: To examine the relationship between family support, health literacy, and self-care management among elderly individuals with hypertension. Materials and Methods: This quantitative, cross-sectional study involved 90 purposively selected participants aged ≥ 60 years with medically diagnosed hypertension from the Prolanis Community Health Center, Kedungmundu, Semarang, Indonesia. Inclusion criteria included the ability to communicate and willingness to participate. Data were collected using validated instruments: the House’s Family Support Questionnaire, the HLS-EU-Q16 for health literacy, and the HSMBQ for self-care. Data analysis used Spearman’s rho test with a significance level of 0.05. Results: A strong positive correlation was found between family support and self-care management (p = 0.000, r = 0.689). A weaker but statistically significant correlation was observed between health literacy and self-care (p = 0.045, r = 0.212). Conclusion: Family support plays a critical role in promoting self-care management among older adults with hypertension. While health literacy also contributes, its influence is comparatively weaker. These findings highlight the need for culturally appropriate interventions that strengthen family involvement and improve health literacy to enhance chronic disease management in aging populations.
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Ahmad A, Braden A, Khan S, Xiao J, Khan MM. Crosstalk between the DNA damage response and cellular senescence drives aging and age-related diseases. Semin Immunopathol 2024;46:10. https://doi.org/10.1007/s00281-024-01016-7
Prasetyo YB, Ramadan SW, Wardojo SSI, Dewi YS, Huriah T. Understanding enablers and barriers in Indonesia’s noncommunicable disease program: A qualitative study from nurses’ perspectives. Int J Noncommunicable Dis 2024;9:166-75. https://doi.org/10.4103/jncd.jncd_78_24
Kurnia AD, Melizza N, Ruhyanudin F, Masruroh NL, Prasetyo YB, Setyowati CI, et al. The Effect of Educational Program on Hypertension Management Toward Knowledge and Attitude Among Uncontrolled Hypertension Patients in Rural Area of Indonesia. Community Heal Equity Res Policy 2022;42:181-8. https://doi.org/10.1177/0272684X20972846
Neyazi A, Mohammadi AQ, Neyazi M, Timilsina S, Padhi BK, Griffiths MD. Hypertension, depression, and health-related quality of life among hospitalized patients in Afghanistan. J Hum Hypertens 2024;38:529-37. https://doi.org/10.1038/s41371-024-00914-5
WHO. Hypertension. World Heal Organ 2023. https://www.who.int/news-room/fact-sheets/detail/hypertension (accessed April 24, 2025).
Kementerian Kesehatan. Laporan nasional Riskesdas 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan, Departemen Kesehatan RI; 2019.
Shen Z, Ding S, Shi S, Zhong Z. Association between social support and medication literacy in older adults with hypertension. Front Public Heal 2022;10:987526. https://doi.org/10.3389/fpubh.2022.987526
Mengjiao L, Xujie Z, Ping J, Liwen H, Yuping N, Yangjing Z, et al. Self-management assessment tools for people with hypertension: a scoping review. BMC Nephrol 2025;26:219. https://doi.org/10.1186/s12882-025-04134-y
Rantepadang A, Hadibrata BES. Self-Efficacy Dan Self-Care Management Pada Penderita Hipertensi. Klabat J Nurs 2023;5:67. https://doi.org/10.37771/kjn.v5i1.913
Yang J, Zeng Y, Yang L, Khan N, Singh S, Walker RL, et al. Identifying personalized barriers for hypertension self-management from TASKS framework. BMC Res Notes 2024;17:224. https://doi.org/10.1186/s13104-024-06893-7
Kurnia AD, Hariyati S, Melizza N, Husna CH Al, Amatayakul A, Handoko A. Personal factors related to self-care management among people with hypertension at primary health care: A cross-sectional study. J Keperawatan Padjadjaran 2023;11:203-13. https://doi.org/10.24198/jkp.v11i3.2340
Morrissey EC, O’Grady L, Murphy PJ, Byrne M, Casey M, Doheny H, et al. Supporting GPs and people with hypertension to maximise medication use to control blood pressure: a pilot cluster RCT of the MIAMI intervention. BMC Prim Care 2024;25:394. https://doi.org/10.1186/s12875-024-02635-7
Sukcharoen P, Sakunpong N, Polruk J, Chumdaeng S. Impact of a transformative health literacy model for Thai older adults with hypertension. BMC Res Notes 2024;17:278. https://doi.org/10.1186/s13104-024-06782-z
Darabi F, Ziapour A, Janjani P, Motevaseli S, Rostami F. A cross-sectional study of the relationship between health literacy and health-promoting lifestyles in patients with hypertension in northwest Iran. BMC Prim Care 2025;26:117. https://doi.org/10.1186/s12875-025-02819-9
Ali SH, Nayak A, Qi X, Misra S, DiClemente RJ. How do Asian American young adults influence the health of family members? Structural equation modeling of age, acculturation, interactivity, and closeness. Discov Soc Sci Heal 2024;4:66. https://doi.org/10.1007/s44155-024-00128-7
Jariyasakulwong P, Wattanakitkrileart D, Pongthavornkamol K, Piaseu N, Roubsanthisuk W. Factors Influencing Self-Care Practices and Blood Pressure Among Individuals with Uncontrolled Hypertension: A Cross-Sectional Study. Patient Prefer Adherence 2025;Volume 19:1-17. https://doi.org/10.2147/PPA.S497555
Malini H, Efendi F, Kadar KS, Lenggogeni DP, Sari YP. Health literacy and associated factors among patients with chronic diseases in Indonesia. J Public Health (Bangkok) 2025;33:591-8. https://doi.org/10.1007/s10389-023-02035-8
Sibarani BE. Exploring the role of self-awareness, self-integrity, self-regulation, and ethics education in the student’s ethics compliance: evidence from Indonesia. Int J Ethics Educ 2024;9:283-305. https://doi.org/10.1007/s40889-024-00188-y
Song W, Deng J, Zhang F, Peng X, Jin X. Activating employee pro-environmental behavior in the workplace: the effects of environmental self-identity and behavioral integrity. Environ Dev Sustain 2023;26:1-27. https://doi.org/10.1007/s10668-023-03549-7
Heydari H, Sadeghi R, Jamshidi E, Rahimiforoushani A, Nikbakht HA, Mashhadsari MRA. Effectiveness of community-based intervention using PATCH on disease perception, empowerment, and self-care in hypertension: a community trial protocol. Trials 2025;26:91. https://doi.org/10.1186/s13063-025-08743-8
Erden Y, Yıldız GN, Çiftçi B, Avşar G, Özek S, Özbek E, et al. The effect of self-management program with tele-nursing based on the Roper-Logan-Tierney model on self-care of hypertensive patients: a randomized controlled trial. BMC Nurs 2025;24:313. https://doi.org/10.1186/s12912-025-02854-y
de Santana Silva JP, Cruz HRA, Silva GAG, Gualdi LP, Lima ÍNDF. Illness perception and self-care in hypertension treatment: a scoping review of current literature. BMC Health Serv Res 2024;24:1529. https://doi.org/10.1186/s12913-024-12001-z
Esen K, Kolcu M. The relationship between health literacy and self-care management in patients with hypertension attending primary healthcare centers. J Public Health (Bangkok) 2024;32:175-83. https://doi.org/10.1007/s10389-022-01801-4
He R, Wei F, Hu Z, Huang A, Wang Y. Self-management in young and middle-aged patients with hypertension: a systematic review and meta-synthesis of qualitative studies. Syst Rev 2024;13:254. https://doi.org/10.1186/s13643-024-02665-3
Cheung PLA. Resilience and Adaptation to Changing Family Support Among Older People in Urban China. Soc Indic Res 2023;170:465-83. https://doi.org/10.1007/s11205-023-03208-4
Tajvar M, Grundy E, Fletcher A, Allen E, Karami B. Role of family factors in provision and perception of social support for older people in Iran: a cross-sectional survey. BMC Prim Care 2023;24:279. https://doi.org/10.1186/s12875-023-02236-w
Nurannisa D, Febtrina R, ’Irfan MZ, Kharisna D. Family Support Increases the Hypertension Medication Adherence in the elderly at Public Health Center of Simpang Tiga Pekanbaru. Sci Midwifery 2022;10:4246-53. https://doi.org/10.35335/midwifery.v10i5.1010
Surani V, Lilik Pranata, Teresia Erina Sestiyowati, Dini Anggraini, Sindi Ernawati. Relationship between Family Support and Self-Care in Hypertension Patients. Formosa J Multidiscip Res 2022;1:1447-58. https://doi.org/10.55927/fjmr.v1i7.1784
Babygeetha A, Devineni D. Social support and adherence to self-care behavior among patients with coronary heart disease and heart failure: A systematic review. Eur J Psychol 2024;20:63-77. https://doi.org/10.5964/ejop.12131
Ojangba T, Boamah S, Miao Y, Guo X, Fen Y, Agboyibor C, et al. Comprehensive effects of lifestyle reform, adherence, and related factors on hypertension control: A review. J Clin Hypertens 2023;25:509-20. https://doi.org/10.1111/jch.14653
Anggeraeni A, Asiah N, Lontaan A, Akib A, Susilo C. The influence of motivation on the activeness of elderly people with hypertension in prolanis gymnastics activities. J Edukasi Ilm Kesehat 2024;2:1-6. https://doi.org/10.61099/junedik.v2i1.28
Sohrabi M, Karami M, Mirmoeini RS, Cheraghi Z. The Relationship between Health Literacy and Hypertension Control: A Cross-Sectional Study. J Tehran Univ Hear Cent 2023;17:243-8. https://doi.org/10.18502/jthc.v17i4.11614
Mahato RK, Myint Htun SS, Htike KM, Nawawonganun R, Sornlorm K. Development of health literacy tool for hypertension and determinants of limited health literacy in rural Myanmar: Implications for targeted public health interventions. Clin Epidemiol Glob Heal 2025;33:102018. https://doi.org/10.1016/j.cegh.2025.102018
SuriastiniI NW, Wijayanti IY, Oktarina D. Older People’s Capacity to Work in Indonesia. Asian Dev Rev 2024;41:69-94. https://doi.org/10.1142/S011611052440002X
Tandilangi TP, Rekawati E, Eriska W. Improving Functional Status of Older Adults Through Health Literacy Media: A Systematic Review. J Ber Ilmu Keperawatan 2024;17:218-26. https://doi.org/10.23917/bik.v17i2.5063
Beyna AT, Mengesha AK, Ayele HS, Dajane FM, Mule AH, Asrie AB, et al. Impact of health literacy and medication adherence on achieving blood pressure goals among hypertensive patients at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia. PLoS One 2026;21:e0341140. https://doi.org/10.1371/journal.pone.0341140
Lima EL de, Brasil VV, Moraes KL, Mendonça LM, Vila V da SC, Sampaio HA de C, et al. Health literacy evaluation in Latin America and the Caribbean: a scoping review. Heal Lit Commun Open 2025;3. https://doi.org/10.1080/28355245.2025.2545788
Tardelli NR, Fukushima FB, van der Steen JT, Rodríguez MIC, Mikelyte R, Forte DN, et al. Mapping advance care planning and advance directives in Latin America. BMC Palliat Care 2025;24:226. https://doi.org/10.1186/s12904-025-01849-5
Manirambona E, Khan NE, Ogungbe O, Irakoze S, Li J, Uwiringiyimana E, et al. Association between e-health literacy and perceived importance of future pandemic preparedness in sub-saharan Africa. Sci Rep 2024;14:30734. https://doi.org/10.1038/s41598-024-80121-x
Shibuya F, Usami M, Santillan MD, Warnaini C, Gregorio E, Satake N, et al. Comparative study on school-based mental health literacy in three Asian countries. Trop Med Health 2025;53:86. https://doi.org/10.1186/s41182-025-00697-6
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