Family Involvement in the Treatment of Hypertensive Patients using Dunn’s Health Grid: A Multiple Case Study

Abstract

Non-communicable diseases such as hypertension have overtaken infectious diseases as the leading causes of death in the world. However, it is considered to be a preventable disease. Family has a role in preventing and controlling this disease. The study aimed to analyze the involvement of family in the treatment of hypertensive patients in the community in Terban using qualitative research method with a multiple case study design. Using purposive sampling, four families were recruited to participate in this research, each of which represented four quadrants of Dunn's Health Grid. These characteristics include: (1) Case 1 is a family that has a patient with high-level of wellness in a favourable environment, (2) Case 2, has a patient with emergent high-level of wellness in an unfavourable environment, (3) Case 3, has a patient with protected poor health in a favourable environment, and (4) Case 4, has a patient with poor health in an unfavourable environment. To gather the data, this research used audio-recorded interviews, participant observation, field notes and documentation. The participants who were interviewed were 4 hypertensive patients,4 family members (1 each family), a public health nurse and a physician. Data were analyzed using thematic analysis and case descriptions which developed 3 main points; a) family as primary support, b) self-care maintenance, and c) barrier to treatment. This study concluded that family involvement in hypertensive treatment varied from case to case. The family members' involvement includes psychological and instrumental supports which affect the patients' independence in self-care treatment of hypertension. However, there are still some barriers to treatment, especially among families living in unfavourable environment. Therefore, the role of community health nursing becomes important to examine not only the health but also environmental conditions of hypertensive patients and to find out the weak points that need attention so that the role of family in managing hypertension patient can be maximized .