城市非裔美国人高血压自我管理的促进因素和障碍：患者及家庭成员的观点
Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members.
作者信息
Flynn Sarah J, Ameling Jessica M, Hill-Briggs Felicia, Wolff Jennifer L, Bone Lee R, Levine David M, Roter Debra L, Lewis-Boyer Lapricia, Fisher Annette R, Purnell Leon, Ephraim Patti L, Barbers Jeffrey, Fitzpatrick Stephanie L, Albert Michael C, Cooper Lisa A, Fagan Peter J, Martin Destiny, Ramamurthi Hema C, Boulware L Ebony
机构信息
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
出版信息
Patient Prefer Adherence. 2013 Aug 6;7:741-9. doi: 10.2147/PPA.S46517. eCollection 2013.
INTRODUCTION
We aimed to inform the design of behavioral interventions by identifying patients' and their family members' perceived facilitators and barriers to hypertension self-management.
MATERIALS AND METHODS
We conducted focus groups of African American patients with hypertension and their family members to elicit their views about factors influencing patients' hypertension self-management. We recruited African American patients with hypertension (n = 18) and their family members (n = 12) from an urban, community-based clinical practice in Baltimore, Maryland. We conducted four separate 90-minute focus groups among patients with controlled (one group) and uncontrolled (one group) hypertension, as well as their family members (two groups). Trained moderators used open-ended questions to assess participants' perceptions regarding patient, family, clinic, and community-level factors influencing patients' effective hypertension self-management.
RESULTS
Patient participants identified several facilitators (including family members' support and positive relationships with doctors) and barriers (including competing health priorities, lack of knowledge about hypertension, and poor access to community resources) that influence their hypertension self-management. Family members also identified several facilitators (including their participation in patients' doctor's visits and discussions with patients' doctors outside of visits) and barriers (including their own limited health knowledge and patients' lack of motivation to sustain hypertension self-management behaviors) that affect their efforts to support patients' hypertension self-management.
CONCLUSION
African American patients with hypertension and their family members reported numerous patient, family, clinic, and community-level facilitators and barriers to patients' hypertension self-management. Patients' and their family members' views may help guide efforts to tailor behavioral interventions designed to improve hypertension self-management behaviors and hypertension control in minority populations.
引言
我们旨在通过识别患者及其家庭成员所感知到的高血压自我管理的促进因素和障碍，为行为干预设计提供信息。
材料与方法
我们对非裔美国高血压患者及其家庭成员进行了焦点小组访谈，以了解他们对影响患者高血压自我管理因素的看法。我们从马里兰州巴尔的摩市一家基于社区的城市临床诊所招募了非裔美国高血压患者（n = 18）及其家庭成员（n = 12）。我们在血压得到控制的患者（一组）、血压未得到控制的患者（一组）以及他们的家庭成员（两组）中分别进行了四个90分钟的焦点小组访谈。经过培训的主持人使用开放式问题来评估参与者对影响患者有效高血压自我管理的患者、家庭、诊所和社区层面因素的看法。
结果
患者参与者识别出了一些促进因素（包括家庭成员的支持以及与医生的积极关系）和障碍（包括相互竞争的健康优先事项、对高血压知识的缺乏以及社区资源获取困难），这些因素影响他们的高血压自我管理。家庭成员也识别出了一些促进因素（包括他们参与患者的就诊以及在就诊之外与患者的医生进行讨论）和障碍（包括他们自身有限的健康知识以及患者缺乏维持高血压自我管理行为的动力），这些因素影响他们支持患者高血压自我管理的努力。
结论
非裔美国高血压患者及其家庭成员报告了许多患者、家庭、诊所和社区层面的促进因素和障碍，这些因素影响患者的高血压自我管理。患者及其家庭成员的看法可能有助于指导为改善少数族裔人群的高血压自我管理行为和血压控制而量身定制行为干预措施的努力。
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