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J Am Acad Nurse Pract. 2011 Apr;23(4):200-8. doi: 10.1111/j.1745-7599.2011.00605.x. Epub 2011 Mar 28.

Self-care production experiences in elderly African Americans with hypertension and cognitive difficulty.

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1
College of Nursing, Wayne State University, Detroit, MI 48202, USA. k.klymko@wayne.edu

Abstract

PURPOSE:

The purpose of this qualitative descriptive study was to explore self-care production experiences in older African Americans who, despite some cognitive dysfunction, were able to produce hypertension-related self-care behaviors or blood pressure control successfully.

DATA SOURCES:

Participants were 10 urban, community-dwelling older African Americans, 60-89 years of age, living in a Midwest region of the United States. A semi-structured interview was conducted in participants homes' using Kvale's "conversational discourse" approach. Oral recordings were transcribed and analyzed for themes and codes.

CONCLUSIONS:

Elders' experiences with the production of self-care were characterized by three themes: preparation, monitoring, and evaluation. Self-care production was found to be cognitively challenging consistent with the finding that 60% of the participants had difficulty with a cognitive task requiring complex cognitive skills. This finding may explain why the production of self-care became a social phenomenon in which elders demonstrated resourcefulness in seeking assistance from surrounding support systems.

IMPLICATIONS FOR PRACTICE:

Nurse practitioners can support better health outcomes in older adults with hypertension by using valid and reliable measures for assessing complex cognitive skills, assessing individuals' progress in self-care production, and identifying individuals' use of social and professional supports to produce self-care.

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