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

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.