The Role of Health Care Quality in Hypertension Self-Management: A Qualitative Study of the Experience of Patients in a Public Hospital, North-West Ethiopia.

IF 1.5 Q3 PERIPHERAL VASCULAR DISEASE
Integrated Blood Pressure Control Pub Date : 2021-04-27 eCollection Date: 2021-01-01 DOI:10.2147/IBPC.S303100
Mohammed Hussien, Ahmed Muhye, Fantu Abebe, Fentie Ambaw
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引用次数: 3

Abstract

Purpose: Hypertension is becoming a global epidemic in all population groups. For its effective management and control, patients should have enhanced self-management skills and get adequate support from care providers. Although the quality of health care is critical in enhancing self-management behaviors of patients with hypertension, the issue has not been fully explored in the Ethiopian context. Therefore, the purpose of this study was to explore the experience of hypertensive patients on the quality of health care and the self-management practice in a public hospital in North-west Ethiopia.

Patients and methods: This qualitative study involves a phenomenological approach. Participants were hypertension patients who are on treatment follow-up. They were recruited purposively with maximum variation approach. Eleven in-depth interviews and two key informant interviews were undertaken using a semi-structured interview guide with hypertensive patients and nurses respectively. Interviews were audio recorded, transcribed verbatim, translated into English, and then analyzed thematically by the investigators.

Results: The analysis identified two main themes and seven sub-themes. The first theme "experience in self-management practice" describes medication adherence, lifestyle modification, and self-monitoring of blood pressure. The second theme "experience in the quality of health care" discusses access to health services, patient-centered care, behavior of health care providers, and time and patient flow management.

Conclusion: The self-management practice of hypertensive patients is sub-optimal. Although several individual patient issues were identified, facility-level problems are mainly responsible for poor self-management practice. The main facility-level barriers, as reported by participants, include shortage of medicines, high cost of medicines, busyness of doctors due to high patient load, lack of appropriate education and counseling services, poor patient-provider interaction, and long waiting times. Intervention areas should focus on providing appropriate training for health care providers to enhance the patient-provider relationship. Improving the supply of hypertensive medications is also paramount for better medication adherence.

卫生保健质量在高血压自我管理中的作用:对埃塞俄比亚西北部一家公立医院患者经验的定性研究
目的:高血压正在成为所有人群中的全球性流行病。为使其得到有效的管理和控制,患者应提高自我管理技能,并得到护理人员的充分支持。虽然保健质量对加强高血压患者的自我管理行为至关重要,但在埃塞俄比亚的情况下,这一问题尚未得到充分探讨。因此,本研究旨在探讨埃塞俄比亚西北部某公立医院高血压患者对医疗保健质量和自我管理实践的体验。患者和方法:本定性研究采用现象学方法。参与者是接受治疗随访的高血压患者。他们是用最大变异法有目的地招募的。采用半结构化访谈指南对高血压患者和护士分别进行了11次深度访谈和2次关键信息提供者访谈。访谈录音,逐字抄录,翻译成英文,然后由调查人员按主题进行分析。结果:分析确定了两个主要主题和七个次要主题。第一个主题“自我管理实践的经验”描述了药物依从性、生活方式改变和自我监测血压。第二个主题“卫生保健质量的经验”讨论了获得卫生服务、以病人为中心的护理、卫生保健提供者的行为以及时间和病人流量管理。结论:高血压患者自我管理实践不理想。虽然确定了几个个别患者的问题,但设施层面的问题是导致自我管理不善的主要原因。与会者报告的主要设施层面障碍包括药品短缺、药品成本高、病人负荷大导致医生忙碌、缺乏适当的教育和咨询服务、患者与提供者互动不良以及等待时间长。干预领域应侧重于为卫生保健提供者提供适当的培训,以加强医患关系。改善高血压药物的供应对于提高服药依从性也至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Integrated Blood Pressure Control
Integrated Blood Pressure Control PERIPHERAL VASCULAR DISEASE-
CiteScore
4.60
自引率
0.00%
发文量
13
审稿时长
16 weeks
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