Living with high blood pressure

Abstract

This study was undertaken to explore the experience of people taking long-term antihypertensive medication. The study contributes to the understanding health professionals have of people with high blood pressure and the antihypertensive treatments they receive. Consideration was given to the full life context of people taking long-term antihypertensive medication and the health/medical culture in which people find themselves. A qualitative method of inquiry generated the descriptive data. Nineteen participants (four men and 15 women) were interviewed once, of which 16 were interviewed a second time. Data analysis involved extraction of concepts which in turn were clustered into themes. An organizing framework was constructed to integrate the six themes and 18 sub-themes. The framework represents the individual's experience as a sequence, starting broadly in the social context of her/his life, and narrowing down to the particulars of personal routine and patterns referring to living with hypertension and it's medication regimens. The final theme refers to the broader context of the health culture. A vast range of experiences were described by participants taking long-term antihypertensive medication. This accentuates the necessity for health professionals to address the uniqueness of the individual, and consider the context of a person's life when prescribing and monitoring medications for people with high blood pressure.

Evaluating meta-ethnography: systematic analysis and synthesis of qualitative research

“…PP's synthesis The four papers [134][135][136][137] focused on antihypertensive medications, with the aim of describing the experiences of patients taking these medications and providing reasons for not taking medicines as prescribed. For PP, the first published, by Morgan,134 was the 'index' paper against which the others were compared.…”

“…For PP, the first published, by Morgan,134 was the 'index' paper against which the others were compared. Morgan's 134 publication was a book chapter, and the others were articles published in journals: nursing (two 135,136 ) and clinical (one 137 ). PP then summarised and combined the findings from each of the papers around 13 issues that she felt emerged from the papers, some of which were inter-related.…”

“…At the end of the description of the papers and their findings, GDW provided a 'lines-ofargument' synthesis, indicating that the four studies [134][135][136][137] were essentially concerned with the same major issues about why people did or did not take the medications. He indicated that the studies did not refute each other, and that small differences between the studies related to the aims and samples in them.…”

“…• Lay evaluation, testing of drug to determine whether (1) necessary, [134][135][136][137] (2) effective 134,136,137 and (3) safe 136,137 • Information from media, health-care providers, others 135 • Worries regarding drug: current/future adverse effects, 134 mix with alcohol, 134 taking long term, 134 fear of dependency, 134 fear of addiction 134 • Fear of the illness or its symptoms 134,137 • Attitude towards doctors 137 • Doctor-patient relationship 137 • Availability of, and faith in, alternatives, e.g. herbal medicines 134,135 • Culture as a filter 134 • Occurrence of side effects 137 • Desire to reduce drug intake, 137 reduce risk of adverse effects, • Physical ability to take and ingest drugs 136 'Incidental non-adherence' -the incidental reasons why adherence might fail 136 • Interruption of routine 136 • Lack of reminders 136 • Forgetting 136 • Away from home 136 describe the papers in detail and the process he undertook, both to gain greater familiarity with this topic but also to check that he was doing this in the way that the group wanted.…”

Counseling Hypertensive Patients: An Observational Study of 21 Public Health Nurses

“…It is then important to discuss this matter with patients to help them think more carefully about the types of information they use to guide treatment decisions. Interviews with hypertensive patients revealed that adherence to treatment regimens ranged from blatant refusal to total commitment (van Wissen et al, 1998). Participants who were less adherent were those who had not identified any symptoms of hypertension.…”