Comparison of quality-of-hypertension-care indicators for groups treated by physician versus groups treated by physician-nurse team.
OBJECTIVE
To determine whether the type of health care provider (i.e., physician versus physician-nurse team) affected the quality of hypertension care given to two groups of randomly selected adult women.


METHODS
Three indicators measured the quality of hypertension care: blood pressure control level, knowledge of hypertension, and discussion about blood pressure medications with the health care provider(s). Blood pressure readings were taken with a 24-hr ambulatory blood pressure monitor, and demographic data from survey results taken at orientation and researcher-collected data on posttreatment knowledge of hypertension and cognitive representations of hypertension were gathered. Chi-square and t tests were used to analyze the data.


CONCLUSIONS
The group whose care was managed by a physician-nurse team demonstrated lower means for 24-hr systolic blood pressure and diastolic blood pressure (systolic: M = 132, SD = 14.9; diastolic: M = 75, SD = 11.3) than the group whose care was managed only by one or more physicians (systolic: M = 136, SD = 13.4; diastolic: M = 79, SD = 11.24). Also, the group whose care was managed by a physician-nurse team revealed significantly higher scores for discussion of blood pressure medication than the group whose care was managed only by one or more physicians. There were no group differences for knowledge of hypertension.


CONCLUSIONS
Nurses qualified to assist with meeting the needs of hypertension clients in primary care settings can positively affect clients' knowledge about blood pressure medication and--perhaps as a result of this knowledge--how well the clients control their blood pressure.
University of Michigan School of Nursing, USA. mscisney@umich.edu
Margaret
M
Scisney-Matlock
Gail
G
Makos
Tracy
T
Saunders
Frances
F
Jackson
Susan
S
Steigerwalt
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008875:Middle Aged; D009722:Nurse Practitioners / Q000592:standards*; D010348:Patient Care Team; D010820:Physicians / Q000592:standards*; D019984:Quality Indicators, Health Care