Small-group hypertension health education programme: a process and outcome evaluation

Aim. This paper reports a study to explore the expectations, attainments and opinions of the participants, the objectives and experiences of nurse facilitators, and the changes in nurse–client relationship after a small‐group hypertension health education programme. Background. Effective control of blood pressure among hypertensive patients is essential in the reduction of cerebrovascular‐related morbidity and mortality. A ‘small‐group hypertension education programme’ has been implemented in all general outpatient clinics in Hong Kong since 2000. In order to identify what aspects of the programme were beneficial and how it benefited clients, a process evaluation study was conducted. Methods. Following implementation of a small‐group hypertension health education programme, two focus groups were run to collect data from eight nurse facilitators, and individual semi‐structured interviews were conducted with 16 programme participants. The data were collected in 2001. Findings. The findings indicate that both clients and nurses gained a great deal from and enjoyed the process of this health education programme, and their relationships were improved after the programme. About half of the clients reported having adopted health‐enhancing behaviour. The study also revealed discrepancies between the nurses and clients in their perceptions of the objectives of the programme. This indicates that there is a need to clarify the objectives with clients to minimize disappointments from unrealistic expectations. Conclusion. There is a need for the nurse facilitators to clarify the goal of the programme as an education group rather than as a support group. Also, needs assessment is suggested before group member recruitment in order to make the group more homogeneous.