Effect of Nursing Counseling Based on Dorothy E. Johnson's Behavioral System Model on Knowledge and Self-Efficacy Among Hypertensive Outpatients: A Quasi-Experimental Study in East Java, Indonesia
DOI :
https://doi.org/10.62255/mjhp.v4i2.316Abstract
Background: Hypertension is a major cause of cardiovascular morbidity in low- and middle-income countries, while sustained blood pressure control requires adequate disease knowledge and self-management confidence.
Objective: To evaluate the effect of nursing counseling based on Dorothy E. Johnson’s Behavioral System Model on the knowledge and self-efficacy of hypertensive outpatients compared with standard hospital education.
Methods: A quasi-experimental pretest-posttest design with a nonequivalent control group was conducted at the Internal Medicine Polyclinic of Ngudi Waluyo Wlingi Regional Hospital, East Java, Indonesia, from December 2025 to January 2026, following the TREND statement. Sixty-two hypertensive outpatients were purposively allocated to an intervention group (n = 31), receiving structured Johnson-model counseling, or a control group (n = 31), receiving standard education. Knowledge and self-efficacy were assessed using the Hypertension Knowledge-Level Scale and Self-Care Efficacy subscale of the Hypertension Self-Care Profile. Between-group differences were analyzed using the Mann-Whitney U test.
Results: The intervention group achieved higher proportions of participants with high knowledge (93.5% vs. 80.6%) and high self-efficacy (90.3% vs. 83.9%), with significant between-group differences for both domains (p < 0.001).
Conclusion: Johnson-model nursing counseling demonstrated a statistically and clinically meaningful advantage over standard education in improving knowledge and self-efficacy, supporting its integration into routine outpatient nursing practice.
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