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自我报告持续坚持服用抗高血压药物的黑人女性所采用的自我护理管理策略。

Self-care management strategies used by Black women who self-report consistent adherence to antihypertensive medication.

作者信息

Abel Willie M, Joyner Jessica S, Cornelius Judith B, Greer Danice B

机构信息

School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, USA.

Internal Medicine, Novant Health First Charlotte Physicians, Matthews, NC, USA.

出版信息

Patient Prefer Adherence. 2017 Aug 16;11:1401-1412. doi: 10.2147/PPA.S138162. eCollection 2017.

Abstract

BACKGROUND

Black women in the USA have the highest prevalence rate of hypertension (HTN) contributing to a higher risk of organ damage and death. Research has focused primarily on poorly controlled HTN, negative belief systems, and nonadherence factors that hinder blood pressure control. No known research studies underscore predominantly Black women who report consistent adherence to their antihypertensive medication-taking. The purpose of this study was to describe self-care management strategies used by Black women who self-report consistent adherence to their antihypertensive medication and to determine the existence of further participation in lifestyle modifications, such as eating a healthy diet and increasing physical activity.

METHODS

Using a qualitative descriptive design, four focus groups with a total of 20 Black women aged 25-71 years were audio-taped. Transcripts were analyzed using qualitative content analysis. Participants were included in the study if they scored perfect adherence on the medication subscale of the Hill-Bone Compliance to High Blood Pressure Therapy Scale.

RESULTS

Medication adherence was predicated on three themes: HTN experience, involvement with treatment regimen, and a strong motivated mentality. Black women would benefit from treatment approaches that are sensitive to 1) diverse emotional responses, knowledge levels, and life experiences; 2) two-way communication and trusting, collaborative relationships with active involvement in the treatment regimen; 3) lifestyle modifications that focus on health benefits and individual preferences; and 4) spiritual/religious influences on adherence.

CONCLUSION

The use of self-care management strategies to enhance antihypertensive medication adherence is key to adequate blood pressure control and the reduction of cardiovascular events. This study provides preliminary insight for future research to develop interventions to aid those Black women who struggle with medication adherence and are disproportionately impacted by HTN.

摘要

背景

美国黑人女性的高血压患病率最高,这导致器官损害和死亡风险更高。研究主要集中在控制不佳的高血压、消极的信念体系以及阻碍血压控制的不依从因素上。尚无已知研究强调那些报告持续坚持服用抗高血压药物的黑人女性。本研究的目的是描述自我报告持续坚持服用抗高血压药物的黑人女性所采用的自我护理管理策略,并确定她们是否进一步参与生活方式的改变,如健康饮食和增加体育活动。

方法

采用定性描述性设计,对四个焦点小组共20名年龄在25 - 71岁的黑人女性进行了录音。使用定性内容分析法对转录本进行分析。如果参与者在希尔 - 博恩高血压治疗依从性量表的药物分量表上得分完全依从,则纳入本研究。

结果

药物依从性基于三个主题:高血压经历、参与治疗方案以及强烈的积极心态。黑人女性将从以下治疗方法中受益:对1)不同的情绪反应、知识水平和生活经历敏感的方法;2)双向沟通以及与积极参与治疗方案的信任、合作关系;3)关注健康益处和个人偏好的生活方式改变;4)精神/宗教对依从性的影响。

结论

使用自我护理管理策略来提高抗高血压药物依从性是充分控制血压和减少心血管事件的关键。本研究为未来研究提供了初步见解,以开发干预措施来帮助那些在药物依从性方面存在困难且受高血压影响 disproportionately 的黑人女性。

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