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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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College of Nursing, Wayne State University, Detroit, MI 48202, USA.



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.


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.


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.


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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