The Lived Experience of Rural Thai Older Adults with Poorly Controlled Hypertension
In the economically poor, northeast region of Thailand, many elderly adults with hypertension have difficulty achieving optimal blood pressure control. Factors such as deteriorating health, health beliefs and attitudes, low socioeconomic status, and low educational background may contribute to poor control of hypertension. Although nursing studies in Thailand have explored hypertension management among Thai patients in general, few studies have specifically examined the phenomenon of poorly controlled hypertension among rural older Thais with hypertension. Therefore, the aim of this study was to explore the lived experience of rural Thai older adults with poorly controlled hypertension. Purposive sampling was used to select 20 subjects who were aged 60 years and older and who received services at two health centers in Thailand. Data were gathered using semi-structured interviews. All interviews were analyzed following Giorgi's phenomenological methodology. The techniques of member checking, an inquiry audit, and an audit trail were employed to achieve trustworthiness of the findings. Most participants were female and ranged in ages from 60 to 74 years. The findings revealed four theme clusters: perception of hypertension, emotional representations, economic difficulties, and folkways for living with high blood pressure. The theme cluster representing the perception of hypertension included three common themes: healthy due to silent symptoms, living as usual, and focusing on medication use. In the theme cluster of emotional representations, the first common theme was fear and worry, and the second common theme was anger. The theme cluster representing economic difficulties had two common themes: low income and debt. The fourth theme cluster, folkways for living with high blood pressure, had two common themes. The first folkways common theme was physical activities in terms of farming, gardening, housework, and light walking. The second folkways common theme was cuisine and seasoning from the Isaan (northeast) region of Thailand. The findings of this study will help nurses to better understand the culture and daily living activities of rural elderly Thais with hypertension. Armed with this new understanding, nurses can modify their practice to fit older adults' lifestyles. Nurses can use the findings to develop specific interventions for older adults with hypertension.
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