Klymko Kay W, Artinian Nancy T, Price Jessica E, Abele Carrie, Washington Olivia G M
College of Nursing, Wayne State University, Detroit, MI 48202, USA.
J Am Acad Nurse Pract. 2011 Apr;23(4):200-8. doi: 10.1111/j.1745-7599.2011.00605.x. Epub 2011 Mar 28.
The purpose of this qualitative descriptive study was to explore self-care production experiences in older African Americans who, despite some cognitive dysfunction, were able to produce hypertension-related self-care behaviors or blood pressure control successfully.
Participants were 10 urban, community-dwelling older African Americans, 60-89 years of age, living in a Midwest region of the United States. A semi-structured interview was conducted in participants homes' using Kvale's "conversational discourse" approach. Oral recordings were transcribed and analyzed for themes and codes.
Elders' experiences with the production of self-care were characterized by three themes: preparation, monitoring, and evaluation. Self-care production was found to be cognitively challenging consistent with the finding that 60% of the participants had difficulty with a cognitive task requiring complex cognitive skills. This finding may explain why the production of self-care became a social phenomenon in which elders demonstrated resourcefulness in seeking assistance from surrounding support systems.
Nurse practitioners can support better health outcomes in older adults with hypertension by using valid and reliable measures for assessing complex cognitive skills, assessing individuals' progress in self-care production, and identifying individuals' use of social and professional supports to produce self-care.
这项定性描述性研究的目的是探索老年非裔美国人的自我护理行为产生经历，这些老年人尽管存在一些认知功能障碍，但仍能够成功地产生与高血压相关的自我护理行为或控制血压。
研究对象为10名居住在美国中西部地区城市社区的60至89岁老年非裔美国人。采用克瓦尔的“对话话语”方法，在参与者家中进行了半结构化访谈。对访谈录音进行转录，并分析其中的主题和编码。
老年人自我护理行为产生的经历具有三个主题特征：准备、监测和评估。研究发现，自我护理行为产生在认知上具有挑战性，这与60%的参与者在需要复杂认知技能的认知任务上存在困难这一发现一致。这一发现或许可以解释为何自我护理行为的产生成为了一种社会现象，即老年人在向周围支持系统寻求帮助时展现出了机智。
执业护士可以通过使用有效且可靠的方法来评估复杂认知技能、评估个体在自我护理行为产生方面的进展以及确定个体在产生自我护理行为时对社会和专业支持的利用情况，从而为患有高血压的老年人带来更好的健康结局。
