Health Education Exposure And Self-Management Practices Among Hypertensive And Diabetic Adults Attending Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Abstract:

Health education is an important component of chronic disease management, yet evidence on its relationship with self-management among patients with hypertension, diabetes mellitus, and hypertension–diabetes comorbidity remains limited in Nigerian tertiary-care settings. This study assessed the association between health education exposure and self-management practices among adults with hypertension, diabetes, and comorbid hypertension and diabetes attending Rivers State University Teaching Hospital (RSUTH), Port Harcourt. A hospital-based cross-sectional analytical study was conducted among 400 adults, comprising 150 with hypertension only, 90 with diabetes only, and 160 with comorbidity. Data were collected using a structured interviewer-administered questionnaire. Health education exposure was assessed according to the number of relevant disease-management topics received during the preceding six months, while self-management was classified as good or poor according to the study scoring criteria. Descriptive statistics, Pearson chi-square tests, linear-by-linear association tests, binary logistic regression, and propensity score matching were performed. Overall, 286 (71.5%) respondents reported health education exposure during the preceding six months. Good self-management was reported by 42 (28.0%) respondents with hypertension only, 25 (27.8%) with diabetes only, and 44 (27.5%) with comorbidity. Higher health education exposure was significantly associated with good self-management in all three disease groups. In adjusted analyses, high exposure remained associated with good self-management among respondents with hypertension only (AOR = 5.56, 95% CI: 1.72–17.98), diabetes only (AOR = 10.12, 95% CI: 1.98–51.72), and comorbidity (AOR = 6.68, 95% CI: 2.12–21.04). Propensity score matching also showed positive adjusted differences in the probability of good self-management between the higher-exposure and low-exposure groups. Because the study was cross-sectional, these estimates indicate association rather than definitive causation. Structured, comprehensive, and continuous health education should be strengthened within routine chronic disease care.