- NUR 600 Week 8 Assignment 2 Final Capstone Project Manuscript.
Abstract
Controlling patients with reliable ailments in the more settled gathering becomes shaky considering how making incorporates different gets and for the behaviour changes to strong regions for be, ought to stay aware of (Collado-Mateo et al., 2021). The MSN 600 Week 8 Assignment 2 Final Capstone Project Manuscript examines the significance of the Trans-Theoretical Model (TTM) in dealing with these issues by making behavioural interventions in old patients.
The TTM, taking into account times of progress, is a prominent model that aims to portray the critical times of progress patients could go through, beginning from pre-researching to finishing the support stage. This task explores the client’s consideration of using the TTM-based interventions to determine patients’ degree of treatment plan adherence, level of initiation, and thriving behaviour. Explore NUR 600 Week 6 Assignment Proposed Project Interventions for more information.
Importance of Behavior Change
Among the different openings, it is recommended that interventions zeroed in on patients’ season of progress have more perceptible possible outcomes working on the patients’ status in steadfast circumstances supported by higher patient fulfilment and lessened prospering expenses (Arsenault-Lapierre et al., 2021). There are loads of implications for the nursing practice here, and the reality is that the usage of TTM in ordinary nursing care will request that more coordinated patients be more attracted to their thinking in this manner, working on their satisfaction and reducing the expense outcomes of clinical advantages.
One of the substitute perspectives explored in this experience is how sensible frameworks are spread and the part dispatched to the escorts in executing behaviour change approaches among more coordinated individuals.
Background and Significance
More set up consistent ideas patients present the best worry in stream clinical thought frameworks from one side of the planet to the other. Diabetes, hypertension, and cardiovascular troubles become consistently normal in the making of individuals and require reliable mediation measures to resuscitate their flourishing status (Zhou et al., 2021). These disorders often allude to requiring crucial behavioural changes and are chased after old patients given issues like mental brokenness, portability shortcomings, or shortcomings.
These headways are a way-of-life change, the course of which is understood by the Trans-Theoretical Model (TTM) of behaviour change (Okubatsion Tekeste Okube and Kimani, 2024). Per the affirmation of progress, TTM is a valuable tool that organizes itself in pre-thought, thought, plan, development, and support designs that fit the patient.
Significance of Behavior Change
There is no question that there is monstrous worth in endeavour, the key behaviour change, as a matter of fact. Interventions that are fittingly designed can increment patient consistency with their therapy errands or frameworks and the overall organization of their disorders, thus working on their general flourishing. For more settled patients drawing in with one or more clinical issues, improving individualized interventions, which would fit the patient’s conditions, is head for persuading and widening the length of behaviour change (Corbett et al., 2020).
NUR 600 Week 8 Assignment 2 Final Capstone Project Manuscript
A couple of measures can forestall or confine the bet of making complexities and keep away from incessant hospitalizations to support achievement further.
The control of culture can’t be overemphasized there of mind, since culture picks the way and way wherein patients with these nonstop diseases handle and direct them. Parts like culture, information, and flourishing tutoring are essential, and they impact patients’ energy and capacity to improve and stick to the organized line of treatment (Baumeister et al., 2021).
Coordinating socially touchy measures inside the TTM framework by making the interventions material and socially sensitive is therefore possible. Socially and autonomously tailored TTM interventions could work on the abundance of intense disorder mediation in the more settled individuals and decline horrendous accomplishment assortments among seniors.
Literature Review
The different literature on consistent ailment the board in more coordinated patients has dependably featured the believability of behaviour change interventions in the improvement of thriving status as well as the specific satisfaction of the patients. Pneumonic disorders, diabetes, hypertension, and cardiovascular contaminations are a portion of the lively sicknesses that should be overseen rarely, and most importantly, what has the best impact shows imperative consistency with the proposed frameworks (Losi et al., 2021).
Considering the literature review, the authors saw that senior patients express solutions as applied by regular aiding dismissal to offer satisfactory results because of the different factors impacting behavioural change. The Trans-Theoretical Model (TTM) is another reasonable framework for this setting since it utilizes a phase-based behaviour change model that coordinates interventions to the subject’s time of progress (Muaddi et al., 2024).
Impact of TTM Implementation
TTM has been displayed to make helpful and clinically massive behaviour changes, particularly in solid sickness. For example, it has been found that TTM can develop patients’ cardinal behaviours by redesigning the seniors’ fix consistency, fat changes, and managing procedures. Since the model incorporates different succeeding behaviours and consistently changes them to the patient’s necessities, the theoretical framework is very valuable in nursing.
By executing TTM in unsurprising weight the heap up programs, it will be more straightforward to help the old patient move to the going with time of progress to redesign their flourishing status and decrease their portrayal of the purpose of clinical thought organizations (Wolfe et al., 2020). Nursing interventions considering TTM for coordinating advancing with difficulties in the more settled have been supported in the literature, and this gives upbraiding proof of the potential of TTM in working on quiet thought and drawing in patients to manage their flourishing.
Supporting Evidence
Existing literature gives solid, apparent evidence for embracing the Trans-Theoretical Model (TTM) due to the anticipated pollution of old patients. The assessment evidence shows that TTM’s stage-based framework is essential in driving behaviour change since it targets various interventions for patients’ further consoling of their self-organized accomplishment behaviour orchestrating (Miezah et al., 2024). Such reviews portray that, for example, in the pre-thought stage, where the patient has no impression of the need to change, edifying behaviour change frameworks that target getting that snappiness will assist in progressing to the assessment with bestowing. Where lifting talking and objective setting have been explored and used, they have been viewed as supportive for orchestrating and reinforcing better behaviours during the idea and plan stages.
In the outline stage, TTM-oriented interventions are based on finding genuinely behavioural cutoff focuses and satisfactory patient support, such as checking activities or diet plans (Salwen-Deremer et al., 2019). Last is the upkeep stage, where sponsor gatherings guarantee self-support and lose the assurance of the pioneers and essential factors in TTM are given. This evidence supports that it is pounding to apply TTM while giving interventions to change the predictable therapy ways of managing and directing development, the possible outcomes of progress, and outcomes in the organization of consistent disorders among the old (Samoggia & Riedel, 2020).
This paper points out that when unequivocal interventions are connected with the long periods of TTM, the particular difficulties that more coordinated patients have in muscular disorder the load up will be successfully watched for in a manner that reinforces better thriving status and individual satisfaction.
Purpose or Aims of the Study
The MSN 600 Week 8 Assignment 2 Final Capstone Project Manuscript aims to assess the reasonableness of using the Trans-Theoretical Model (TTM) to create sustainable behaviour changes among older adults undergoing treatment for chronic conditions. The study’s objectives are to uncover the appropriate assessments for incorporating the TTM’s stage-based interventions for older individuals and to explore the model’s potential to enhance health-related quality of life in the target population.
The study sees the Directorate for Social Opportunities, and taking into account As far as possible Standards, it endeavours to see socially related factors that could tie behaviour change among old clients (López et al., 2020). They formerly incorporated the energy to regard and do social loads that impact thriving related behaviours and decisions. Thus, the study aims to work with socially delicate methodologies in TTM to ensure that the interventions are essential and authentic, considering the social conviction frameworks of more coordinated patients, and to work on the plentifulness of the model in apparent disorder on the board.
Theoretical Model or Framework
The TTM is a profoundly grounded model that assesses and lifts behaviour change to cultivate recovery in patients with steady disorders further. TTM works on the explanation that behaviour change is an investment that fans out a long stretch through an improvement of stages; the stages incorporate pre-thought, assessment, organizing, action, and support (Abbas et al., 2022). All of them address a substitute season of the groundwork for change, and therefore, the exercises can be changed according to the issues posed by the brand name to the stages overall. Recommending overseeing oneself organization for tenacious disorders in the more ready, TTM would gain ground considering the way that the cycle presents a framework to work with the patient through a course of progress that, more often than not, is risky.
Preventing Relapse in Patients
In this study, the point was to remember the TTM’s seasons of progress for the more pre-arranged patient base first to survey their need to change their behaviours, pondering the organization of unsurprising conditions (da Rosa et al., 2021). For example, patients who may be in the pre-assessment stage and not see the need to change profited from educative materials zeroed in on name-changing on the potential additions of the change cycle.
NUR 600 Week 8 Assignment 2 Final Capstone Project Manuscript
The idea and plan subjects were given more unambiguous interventions, including inciting and setting reachable aims and targets. In the action and upkeep stage, patients were given reliable support. At the same time, the apostatize countering stage patients were offered approaches to overseeing, avoiding loss of certainty and staying aware of the new behaviours (DiClemente & Crisafulli, 2022). Therefore, by executing the ideal opportunities for progress, TTM supported slow and specific behaviour changes, which was the principal gathering of resolute debasements among old patients.
Methods/Design/Sampling
This study used a mixed methods approach for the exploration design of the study to assess the opportunity and utility of the Trans-Theoretical Model (TTM) in overseeing steady disorders in more pre-arranged patients. The quantitative part was operationalized using pretested organized examinations and appraisals of patient behaviours and achievement status in various seasons of TTM. The profound piece of the study pulled in with profundity gatherings and focus gatherings on understanding patients’ experiences, difficulties, and standpoints toward the course of behaviour change (Varsi et al., 2021). These parts engaged a cross-sectional assessment of the model that incorporated quantitative and profound information from individuals.
For sampling, old patients were picked considering unequivocal models: they ought to be 65 years old or more settled, have something like one dissected predictable difficulty which incorporates diabetes, hypertension, or coronary sickness, and ought to have the choice to consent to partake in the study. Patients were examined at fundamental through offices and neighbourhood centres, which give individuals from different social and social backgrounds.
Ethical Considerations in Research
An essential piece of the exploration was moral issues right from the outset of the assessment. Each participant was asked to sign a consent form to demonstrate that they could decipher the purpose of the study and the frameworks implied and that they had the decision to withdraw from the study whenever they wished (Millum and Bromwich, 2021). Affirmation was profoundly seen, and names were displaced with code numbers to ensure that individuals were not self-evident and that individual information was kept securely.
Collaborating with patients as sponsors and focusing on the importance of picking patients’ liability in solid cycles have also transformed into priorities in the formation of the study (Millum & Bromwich, 2021). An essential part of the reasoning was that patients were empowered to pick conclusions about their reasoning goals and select drugs that they mulled over fit. It straightforwardly worked with the fundamentals for self-organization in dependable disorders by ensuring that the interventions conveyed were client-centred and matched their season of progress, showing a theoretical and sensible commitment to the norms of autonomy in the patient.
Proposed Interventions
The interventions in the predictable study are a framework on TTM to give intervention that matches the specific stage that is being tended to. For patients in the pre-thought stage, the intercession is enlightening workshops to inform the clients about the bet of steady difficulties and the spots of lifestyle changes (Chao et al., 2022). In a coordinating gathering, individual and gathering coordinating are embraced to attract patients at the assessment level, check the benefits and damages of changing their behaviours, and oversee break certainty triggers.
During the orchestrating stage, the goals and cycles for behaviour change are settled upon and elaborated with the patient, and concrete and possible targets and exercises are. The advancement stage recollects further gatherings with the family for an endorsed repeat to mind progress, lift the overall viewpoint, and change the put-down frameworks.
Integrating TTM in Care
Lastly, the patients in the upkeep stage are enlivened and assisted with reviewing the central changes to avoid losing the certainty of old, unfortunate activities.
Organizational trailblazers are blamed for seeing that these interventions are incorporated into the thought advancement plan for the patients and ensuring that staff is told the most proficient technique to apply TTM.
Chiefs support, attestation, and advance teamwork by coordinating with dietitians, authentic therapists, and other prospering social workers, generally speaking of propelling debasement of the board. It moreover expects that if a particular method for managing the patient’s anxiety isn’t helpful or even minded, there would be other medications for the very general part, including mental support and lifestyle changes (Chan and Hazan, 2022). Along these lines, nursing pioneers advance a gathering demeanour and set forward unambiguous endeavours to inform accessories and make firm interventions to give the most intelligent idea of patient thought across the continuum of care.
Expected Results/Outcomes
A portion of the expected results of taking on TTM in directing enthusiastic disorders of old patients incorporates the going with. Most importantly, better therapy consistency with treatment regimens is scheduled as the TTM offers tailored interventions that incorporate each relentless time of behavioural change, thereby working on the probability of the patient’s consistency with the endorsed therapies and way of life changes.
NUR 600 Week 8 Assignment 2 Final Capstone Project Manuscript
Furthermore, there are going to be more colossal levels of the groundwork for behaviour change given that clients are no doubt going to be given tailored exhorting and support, which empower them to see the worth in the many advantages of changing as well as the impediments to changing and therefore, be more ready to change (Leal et al., 2020). Likewise, the hardship assumption will be viewed as a more favourable wrapping control of advancing sicknesses, a further developed way of life, and a lower frequency of infection weights.
These outcomes are on top of the target of the endeavour where improvement of indefatigable infection care, as well as self-organization by patients, is looked for. Using the times of progress and focusing on interventions at each stage, the endeavour aims to foster further sound behaviour change in significant areas of strength and plans (Leal et al., 2020). It is trusted that redesigning the patient’s condition, status, and adherence levels works on the constant ideas and creates an extraordinary organization of persistent diseases in accomplishing the endeavour’s purpose in including evidence-based interventions for the organization and support of consistent burdens.
Anticipated Conclusion
Considering the expected outcomes of this study, the Trans-Theoretical Model (TTM) is a highly noteworthy behaviour change model in coordinating old reliable torment patients. The portrayal of times of progress correspondingly suggests the capacity to give a degree of interventions oriented according to the patients’ degrees of status to change their thriving behaviour (Miake-Lye et al., 2020). This is an original strategy for overseeing individual patient ideas, which could increment patient consistency with adherence to professional therapy designs near better reliable disorders than the pioneers.
The ramifications for nursing practice are, according to the going, clinical experts express that using TTM in ceaseless affliction care transport, there is an expanded tailored care blueprint, as such addressing the patients in the proper ability to change their behaviour. It could work on continuing to flourish by moving the learning of behaviours that can be areas of strength for me for a truly significant time frame. Moreover, how TTM underscores patients’ times of progress derives from the fact that the interventions should be matched to the level of patients’ responsiveness (Miake-Lye et al., 2020). Therefore, the nursing practice could be more preventive and organized, working on care given to old patients who experience the malevolent effects of advancing burdens.
Possible Limitations
The limitations of this study are related to the model size, tendency, and the difficulty of summing up longitudinal behaviour change. Another shortcoming of small model size is the trouble in summing up the results to other masses of senior patients; in other words, the results may not be generalizable to the broader individuals of old patients (Hopwood et al., 2021). Moreover, issues, for example, explicit model choice might be a prerequisite, mainly if a model picked is a slanted portrayal of elderly folks individuals in a given setting; this detonates the probability of thinking of a slanted conclusion.Dubiousness of progress across the expected time is another shortcoming experienced while surveying behavioural change. Tolerating, we are to assess behaviour change itself precisely suggests that behaviour change is deferred. Reviewing it ought to be deliberate and objective. Evaluation instruments could offer wrong information, or patients could have assortments in reporting the outcomes (Hopwood et al., 2021). These could distort the results by either energetically or unfavourably portraying the adequacy of the TTM interventions. Consequently, the understandings made on the convinced results should be made with due respect with the impacts of these factors on the authenticity and getting through nature of the study.
Potential Implications to Practice
The execution of Trans-Theoretical Model (TTM) based interventions inside the setting of tenacious afflictions and the standard nursing practice in behavior change could further foster nursing practice (Elsaid et al., 2023). Since patients are organized into pre-thought, appraisal, orchestrating, development, and upkeep times of progress, an intercession that objectives those times of progress will assist experts with offering ideal ideas to the patients, relying on their degree of status to change.
Furthermore, developing patients’ responsibility and impelling their treatment consistency, interventions are expected to address the patients’ state to the degree that behaviour change theories. Specifically, strong talking could be necessary for the patients in the thought stage, while control choices and close monitoring could be helpful for those in the development stage. Incorporating TTM to broaden nursing practice can help the clinical gatekeepers deal with the confounded bits of continuing sickness of the bosses, work with behaviour alteration regarding patients, and be more orderly and solid.
Cultural Adaptation of Interventions
Future appraisals in the MSN 600 Week 8 Assignment 2 Final Capstone Project Manuscript should work towards redesigning the utilization of TTM for other gatherings of patients to guarantee suitability in different masses isn’t altogether settled. In this way, it is proposed to look at in the subsequent evaluations in what ways TTM-based interventions might be tailored for various cultures and piece masses and what the social congruity of a given mediation means for the reasonableness of behaviour change frameworks (Elsaid et al., 2023).
Moreover, further evaluation on how TTM can be improved with other behavioural frameworks or example-setting improvements like remembering PDA thriving applications for a persistent sickness balance setting could offer an elective methodology for therapy. Further exploration should explore expanded behavioural outcomes of the TTM-based interventions to pick the keeping-it-together consequences for flourishing behavioural changes and successful results.
By looking out for these areas, there is the opportunity for further movement of the practice of nursing while at the same time keeping incredible ideas given to patients with consistent infections and ensuring that the interventions presented are evidence-based and socially fitting.
References
Abbas, A., Ekowati, D., Suhariadi, F., Fenitra, R. M., & Fahlevi, M. (2022). Integrating cycle of Prochaska and Diclemente with ethically responsible behavior theory for social change management: Post-covid-19 social cognitive perspective for change. Handbook of Research on Global Networking Post COVID-19. https://www.igi-global.com/chapter/integrating-cycle-of-prochaska-and-diclemente-with-ethically-responsible-behavior-theory-for-social-change-management/309604
Arsenault-Lapierre, G., Henein, M., Gaid, D., Le Berre, M., Gore, G., & Vedel, I. (2021). Hospital-at-home interventions vs in-hospital stay for patients with chronic disease who present to the emergency department. JAMA Network Open, 4(6), e2111568. https://doi.org/10.1001/jamanetworkopen.2021.11568
Baumeister, A., Chakraverty, D., Aldin, A., Seven, Ü. S., Skoetz, N., Kalbe, E., & Woopen, C. (2021). “The system has to be health literate, too” – perspectives among healthcare professionals on health literacy in transcultural treatment settings. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06614-x
Chan, C. S., & Hazan, H. (2022). The Health Hexagon Model: Postulating a holistic lifestyle approach to mental health for times and places of uncertainty. SSM – Mental Health, 2, 100071. https://doi.org/10.1016/j.ssmmh.2022.100071
Chao, S.-M., Yen, M., Lin, H.-S., Sung, J.-M., Hung, S.-Y., & Natashia, D. (2022). Effects of helping relationships on health-promoting lifestyles among patients with chronic kidney disease: A randomized controlled trial. International Journal of Nursing Studies, 126, 104137. https://doi.org/10.1016/j.ijnurstu.2021.104137
Collado-Mateo, D., Lavín-Pérez, A. M., Peñacoba, C., Del Coso, J., Leyton-Román, M., Luque-Casado, A., Gasque, P., Fernández-del-Olmo, M. Á., & Amado-Alonso, D. (2021). Key factors associated with adherence to physical exercise in patients with chronic diseases and older adults: An umbrella review. International Journal of Environmental Research and Public Health, 18(4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922504/
Corbett, T. K., Cummings, A., Lee, K., Calman, L., Fenerty, V., Farrington, N., Lewis, L., Young, A., Boddington, H., Wiseman, T., Richardson, A., Foster, C., & Bridges, J. (2020). Planning and optimising CHAT&PLAN: A conversation-based intervention to promote person-centred care for older people living with multimorbidity. PLOS ONE, 15(10), e0240516. https://doi.org/10.1371/journal.pone.0240516
da Rosa, M. C., Rosa, C. B., Boff, R. de M., Oliveira, M. S., & Schwanke, C. H. A. (2021). Transtheoretical model for lifestyle changes in older persons: A systematic review protocol. Annals of the New York Academy of Sciences, 1508(1), 172–177. https://doi.org/10.1111/nyas.14714
DiClemente, C. C., & Crisafulli, M. A. (2022). Relapse on the road to recovery: Learning the lessons of failure on the way to successful behavior change. Journal of Health Service Psychology, 48(2), 59–68. https://doi.org/10.1007/s42843-022-00058-5
elsaid, hasnaa, Ebtisam Abd el-Aal, Mohamed, A., & Hedya Mohy. (2023). Application of trans-theoretical model on diet behavior modification among hypertensive employee in electrical company. Benha Journal of Applied Sciences, 0(0). https://doi.org/10.21608/bjas.2023.188709.1041
Hopwood, C. J., Bleidorn, W., & Wright, A. G. C. (2021). Connecting theory to methods in longitudinal research. Perspectives on Psychological Science, 17(3), 884–894. https://doi.org/10.1177/17456916211008407
Leal, J., Cunha, C., Santos, A., & Salgado, J. (2020). Helping clients victimized by intimate partners through stages of change: An emotion-focused approach. Journal of Contemporary Psychotherapy, 51(1), 41–48. https://doi.org/10.1007/s10879-020-09474-4
López, S. R., Ribas, A. C., Sheinbaum, T., Santos, M. M., Benalcázar, A., Garro, L., & Kopelowicz, A. (2020). Defining and assessing key behavioral indicators of the shifting cultural lenses model of cultural competence. Transcultural Psychiatry, 57(4), 594–609. https://doi.org/10.1177/1363461520909599
Losi, S., Berra, C. C. F., Fornengo, R., Pitocco, D., Biricolti, G., & Orsini Federici, M. (2021). The role of patient preferences in adherence to treatment in chronic disease: A narrative review. Drug Target Insights, 15, 13–20. https://doi.org/10.33393/dti.2021.2342
Miake-Lye, I. M., Delevan, D. M., Ganz, D. A., Mittman, B. S., & Finley, E. P. (2020). Unpacking organizational readiness for change: An updated systematic review and content analysis of assessments. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-4926-z
Miezah, D., Amoadu, M., Opoku, P. N., Junior, E. M., Zutah, J., Obeng, P., & Sarfo, J. O. (2024). Transtheoretical-based model of intervention for diabetes and prediabetes: A scoping review. Journal of Diabetes Research, 2024, e2935795. https://doi.org/10.1155/2024/2935795
Millum, J., & Bromwich, D. (2021). Informed consent: What must be disclosed and what must be understood? The American Journal of Bioethics, 21(5), 1–19. https://doi.org/10.1080/15265161.2020.1863511
Muaddi, M. A., Makeen, A. M., Gosadi, I. M., Jareebi, M. A., Alharbi, A. A., Bahri, A. A., Ryani, M. A., Mohamed Salih Mahfouz, Osama Albasheer, Ali, S. A., Arishi, A. A., Alsam, F. A., & Alqassim, A. Y. (2024). Satisfaction paradoxes in health behaviors: Contrasting patterns across weight, physical activity and dietary habits. Nutrients, 16(14), 2246–2246. https://doi.org/10.3390/nu16142246
Okubatsion Tekeste Okube, & Kimani, S. T. (2024). Effectiveness of trans-theoretical model-based health education intervention in the promotion of lifestyle changes among adults with metabolic syndrome: A randomized controlled trial. SAGE Open Nursing, 10. https://doi.org/10.1177/23779608241251658
Salwen-Deremer, J. K., Khan, A. S., Martin, S. S., Holloway, B. M., & Coughlin, J. W. (2019). Incorporating health behavior theory into mhealth: An examination of weight loss, dietary, and physical activity interventions. Journal of Technology in Behavioral Science, 5(1), 51–60. https://doi.org/10.1007/s41347-019-00118-6
Samoggia, A., & Riedel, B. (2020). Assessment of nutrition-focused mobile apps’ influence on consumers’ healthy food behaviour and nutrition knowledge. Food Research International, 128, 108766. https://doi.org/10.1016/j.foodres.2019.108766
Varsi, C., Ledel Solem, I. K., Eide, H., Børøsund, E., Kristjansdottir, O. B., Heldal, K., Waxenberg, L. B., Weiss, K. E., Schreurs, K. M. G., Morrison, E. J., Stubhaug, A., & Solberg Nes, L. (2021). Health care providers’ experiences of pain management and attitudes towards digitally supported self-management interventions for chronic pain: A qualitative study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06278-7
Wolfe, M. K., McDonald, N. C., & Holmes, G. M. (2020). Transportation barriers to health care in the United States: Findings from the national health interview survey, 1997–2017. American Journal of Public Health, 110(6), 815–822. https://doi.org/10.2105/ajph.2020.305579
Zhou, B., Perel, P., Mensah, G. A., & Ezzati, M. (2021). Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nature Reviews Cardiology, 18(18). https://doi.org/10.1038/s41569-021-00559-8