Franklin Mary M, Harden Janet K, Peters Rosalind M
Mary M. Franklin, PhD, RN, ACNP-BC Clinical Assistant Professor, College of Nursing, Wayne State University, Detroit, Michigan. Janet K. Harden, PhD, RN Clinical Associate Professor, College of Nursing, Wayne State University, Detroit, Michigan. Rosalind M. Peters, PhD, RN, FAAN Associate Professor, College of Nursing, Wayne State University, Detroit, Michigan.
J Cardiovasc Nurs. 2016 Mar-Apr;31(2):151-7. doi: 10.1097/JCN.0000000000000223.
In the United States, nearly 25% of all women older than 20 years have hypertension (HTN). Nearly 30% to 50% of persons with HTN experience symptoms attributed to high blood pressure (BP). Women with hypertensive symptoms may connect their symptoms to perceived BP changes and may be using their perceptions about BP changes to guide their HTN self-management. There is limited research about perceived BP changes or their use in self-management.
The purpose of this qualitative study is to describe the experiences of women with HTN self-managing their perceived BP changes.
van Manen's phenomenology methodology and method guided the inquiry. Women with HTN who believed they could tell when their BP changed based on their symptoms were recruited from community settings and were interviewed once with a semistructured guide. Interviews were digitally recorded and professionally transcribed. Textual data were analyzed using thematic analysis to identify major themes.
Seven black and 6 white women comprised the study sample. Participants were middle aged (mean [SD], 50.5 [9.62] years), were experienced in living with HTN (mean [SD],10.76 [9.50] years), had at least a high school education, and had a limited annual income (93% <$24 000). One central theme ("getting to normal") and 4 subthemes (i.e., "I can tell," "tending to it," "the wake-up call," and "doing it right") were discovered in the data. The themes depict a process of episodic symptom-driven and day-to-day actions that the participants used to get their BP to normal.
The study is significant as new knowledge was discovered about how women perceive their BP changes and use them to guide self-management. This study contributes to clinical practice through suggestions for improving patient assessments. Results serve as a foundation for further research of the self-management of BP changes and developing belief-based interventions with the potential to improve BP control.
在美国，20岁以上的女性中近25%患有高血压（HTN）。近30%至50%的高血压患者经历过归因于高血压（BP）的症状。有高血压症状的女性可能会将她们的症状与感知到的血压变化联系起来，并可能利用她们对血压变化的感知来指导自己的高血压自我管理。关于感知到的血压变化或其在自我管理中的应用的研究有限。
这项定性研究的目的是描述患有高血压的女性自我管理其感知到的血压变化的经历。
采用范曼的现象学方法指导研究。从社区环境中招募了那些认为自己能根据症状判断血压何时变化的高血压女性，并使用半结构化指南对她们进行一次访谈。访谈进行数字录音并专业转录。使用主题分析对文本数据进行分析以确定主要主题。
研究样本包括7名黑人女性和6名白人女性。参与者为中年（平均[标准差]，50.5[9.62]岁），有高血压生活经历（平均[标准差]，10.76[9.50]年），至少受过高中教育，且年收入有限（93%<$24000）。数据中发现了一个中心主题（“恢复正常”）和4个副主题（即“我能察觉”、“关注它”、“警钟”和“正确应对”）。这些主题描绘了参与者用于使血压恢复正常的由症状驱动的偶发过程和日常行动。
该研究具有重要意义，因为发现了关于女性如何感知血压变化并利用这些变化指导自我管理的新知识。本研究通过提出改进患者评估的建议为临床实践做出了贡献。研究结果为进一步研究血压变化的自我管理以及开发有可能改善血压控制的基于信念的干预措施奠定了基础。
