Dissertations, Theses, and Capstone Projects

Date of Degree

2-2017

Document Type

Dissertation

Degree Name

Ph.D.

Program

Nursing

Advisor

Donna Nickitas

Committee Members

Catherine Georges

Keville Fredrickson

William Gallo

Nancy Reynolds

Subject Categories

Other Nursing

Keywords

Hypertension, Illness Representation, African American, Male, Self-management.

Abstract

High blood pressure (HBP) is a common condition in the United States, affecting one in four American adults. Forty-one percent of African Americans have HBP compared to 27% of White Americans. African Americans develop high blood pressure at an earlier age and suffer more complications compared to other ethnic groups. Numerous studies have been conducted to find the causes and treatment for HBP in African Americans.

The purpose of this research is to explore self-management practices of African-American male veterans, who have positive HBP representation and controlled HBP. A mixed-methods approach guided the study to gain quantitative and qualitative explanatory knowledge of self-management practices. The Common-Sense Model (CSM), based on Leventhal’s self-regulation model, guided the research. The CSM hypothesizes that perceived health threats cause individuals to develop a commonsensical representation of the threat which guides their coping behavior. In this study, a mixed methods sequential explanatory design consisting of two distinct phases — quantitative followed by qualitative— was applied. All participants (N = 74) completed the Brief Illness Perception Questionnaire (Brief-IPQ) to determine their illness representations of HBP. Participants with positive illness representation and controlled HBP were invited to participate in the qualitative phase of the study which consisted of semi-structured interviews. The participants in the qualitative phase of the study (N = 8) were asked to report on the ways in which they modified their lifestyles to control their HBP.

Several themes emerged from qualitative analysis of the semi-structured interviews, including: motivation, independence, personal control, accessibility and adherence to HBP treatment. The findings from this study can be used to guide and motivate patients with HBP to achieve healthier outcomes. All participants expressed a commitment to controlling and sustaining their HBP. The study’s findings suggest participants with positive illness perceptions who are motivated and committed to controlling their HBP through self-management practices may have controlled and sustained HBP.

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