Counseling: Improving Hypertension Handling Behavior in the Public

: Hypertension is a non-communicable disease which is a very serious health problem and the main cause of death throughout the world. This community service aims to increase knowledge of how to treat hypertension through education to the community. Service activities were carried out on Tuesday 21 March 2023 at Mitra Medika Bondowoso Hospital using lecture and discussion methods. with 25 participants to find out about hypertension in patients. The way to find out knowledge related to hypertension prevention and control behavior used in community service activities is to ask and answer questions directly to patients. Before being given education in the form of health education about asthma, participants were given a question and answer session and after delivering the material a question and answer session was held to find out the participants' knowledge about hypertension. The evaluation results showed that participants understood hypertension. Public knowledge about hypertension is increasing and people are motivated to get access to treatment and knowledge about how to recognize and prevent hypertension after health education is carried out. It is hoped that this community service activity can be carried out continuously to increase public knowledge regarding various other health problems.


Introduction
Hypertension is a non-communicable disease (NCD) which is a very serious health problem that is the main cause of death worldwide.Hypertension can be called the silent killer disease because there are no signs or symptoms that appear and cannot be seen from the outside, but if it is not controlled properly it is very risky to cause degenerative diseases and various complications that arise including stroke or rupture of the blood vessels of the brain, heart disease, and kidney failure which can cause sudden death (Amarchand et al., 2022).Hypertension is a condition where there is an increase in blood pressure both systolic and diastolic chronically (in a relatively long period of time), namely increasing more than 140/90 mmHg.(Mahyuvi & Nursalam, 2020).Data from the World Health Organization for 2018 shows that around 26.4% of the world's population has hypertension, with a ratio of 1,2,3Institute of Health Sciences STRADA, Indonesia, email: mahyuvi1922@gmail.com4,5Mitra Medika Bondowoso Hospital, Indonesia *Koresponden penulis Tata Mahyuvi 1 , Joko Prasetyo 2 , Yenny Puspitasari 3 , Munif Amar 4 , Dony Kristiya Marta 5 26.6% of men and 26.1% of women.The prevalence of hypertension will increase sharply, it is predicted that by 2025 as many as 29% of adults worldwide will suffer from hypertension.
Hypertension has resulted in the deaths of around eight million people every year, 1.5 million deaths in Southeast Asia where the population suffers from hypertension, which can cause an increase in the burden of health costs.One of the diseases in question is hypertension(RI Ministry of Health, 2021) The number of people with hypertension continues to increase every year, it is estimated that by 2025 there will be attainment of 1.5 billion people affected by hypertension and it is estimated that every year there will be 10.44 million people who die from hypertension and its complications (Tambunan et al., 2021).
Hypertension is a disease that causes ongoing problems leading to stroke, heart and kidney failure, all of which have an impact on causing death.To overcome hypertension requires good cooperation between the medical team, patients, as well as families and the environment (Pratiwi, 2020).Education of patients and families about the disease and complications will help improve treatment outcomes, and is expected to help improve the sufferer's quality of life.There are two risk factors for hypertension, namely factors that cannot be modified including genetic factors, age, gender and ethnicity and factors that can be modified include stress, obesity and nutrition.Stress that cannot be reduced or managed properly will pose a risk, one of which is attacking physical problems (Hidayat & Agnesia, 2021).There are several non-pharmacological techniquesthat are effective in controlling blood pressure in hypertensive patients are giving a mixture of tomato and cucumber juice, giving honey, finger holding and deep breathing relaxation therapy, natural sound music therapy and slow deep breathing.(Mahyuvi et al., 2023).This community service activity aims to improve hypertension management behavior in the community, which is carried out by providing education to the community.So if the behavior of hypertension sufferers improves, it is better for sufferers to take good precautions.

Method
This community service activity was held on Tuesday, March 21 2023 at Mitra Medika Bondowoso Hospital.This activity consists of 3 stages, namely the preparation, implementation and evaluation stages.

Preparation
The things that were done in the preparation stage were to do a problem analysis using primary and secondary data from Mitra Medika Bondowoso Hospital.Next, determine the location of the activity, prepare community service proposals, carry out various preparations including: facilities and infrastructure to be used including media, accommodation and consumption.As well as coordinating with the hospital.

Implementation
The implementation of this community service activity was carried out on Tuesday, March 21, 2023.Previously the team had coordinated with the Hospital Director and nursing manager regarding the location of this community service activity.The activity was carried out in front of the Internal Medicine Clinic at Mitra Medika Bondowoso Hospital.This activity consists of 2 sessions, namely, the first session is a review regarding hypertension to patients.Next, health education was given about hypertension using lecture and discussion methods.The community service team distributed books to patients before the material delivery session and continued with a discussion and question and answer session.The next activity is evaluating.

Evaluation
This community service activity is carried out according to the schedule specified in the proposal.Participants attended as many as 25 people who were outpatients at the internal medicine polyclinic at Mitra Medika Bondowoso Hospital.
The place where activities are carried out is in accordance with the plan, the facilities and infrastructure that have been prepared are used as appropriate.The use of language during health education was adjusted to the local language, namely Indonesian, so that it was easy for the participants to understand.Each team carries out its duties and responsibilities well.Evaluation of the results found that participants understood and understood aboutdefinition of hypertension, cause of hypertension, etiology or factors causing hypertension, hypertension classification, signs and symptoms of hypertension, complications arising from hypertension, management of hypertension, 10 foods to lower high blood pressure for hypertension sufferers, Non-pharmacological interventions to control hypertension in the community, technique or method of measuring blood pressure (Mahyuvi et al., 2023).

Result and Discussion
Realization of community service activities regarding hypertension in the form of education.The activities that have been running are as follows: 1. Disease-related education using the lecture method.The results of this community service were obtained Knowledge of behavior to prevent and control hypertension is very lacking.And after counseling and discussion by the community service team after being evaluated and asked questions by the community service team, many of the audience could answer questions about hypertension.
Knowledge is the most important domain for the formation of a person's behavior, therefore behavior that is based on knowledge and awareness will last longer than behavior that is not based on knowledge and awareness.(Herawati et al., 2021).Individual knowledge is the result of not knowing becomes knowing, occurs after individuals do sensing through the senses which are mostly obtained through the eyes and ears, information can be obtained through advertisements, mass media, counseling or education (Mahyuvi et al., 2022).Before a person adopts a new behavior, he must have awareness, from self-awareness, a person will be interested in doing something for himself, then that person will consider what is best for him, then that person will apply it to behavior, then the results can be applied in everyday life.(Notoatmodjo, 2014).Knowledge gained by hypertension sufferers aboutRecognizing and Preventing Hypertension in the Community (Hadidi, 2015).
When individuals have good knowledge about hypertension, ieknow and understand aboutdefinition of hypertension, cause of hypertension, etiology or factors causing hypertension, hypertension classification, signs and symptoms of hypertension, complications arising from hypertension, management of hypertension, 10 foods to lower high blood pressure for hypertension sufferers, Non-pharmacological Nonpharmacological interventions to control hypertension in the community, technique or method of measuring blood pressure, then the individual will behave correctly in how to prevent and control hypertension.

Conclusion
Public knowledge about hypertension is increasing and people are motivated to get access to treatment and knowledge on how to recognize and prevent hypertension after health education is carried out.It is hoped that this community service activity can be carried out continuously to increase public knowledge about various other health problems.
Figure 1.Education regarding hypertension