The self management experience of subjects with hypertension – results from a qualitative study (Warsaw, Poland)

Abstract

Hypertension is a global health issue (1). The prevalence of hypertension in Poland is high and increases over time (2). Nearly 1/4 of Polish people are diagnosed with hypertension (3, p. 66), and 21% take blood pressure-lowering medications longterm. The number of hypertensive patients increases significantly with age, e.g. 31.1% of Polish people are diagnosed with hypertension within the age group 50-59, whereas the corresponding rate for people aged 60 to 69 years amounts to 46.5% (3). Hypertension treatment is lifelong and places many demands on the patient (4, 5). As part of selfmanagement, a hypertensive patient is obliged to take his/her medication regularly, follow a diet and specific dietary restrictions, quit smoking, exercise regularly, and collaborate with a health care provider (4, 6). Self-management requires from the patient such skills as problem-solving, decision making, resource utilization, the formation of a partnership with a health care provider, taking action, and self-tailoring (7). On average, only about half of patients with chronic hypertension takes medication as prescribed (8). In an international study, 57.6% of subjects from Poland self-reported as being non-adherent (9). Patients adhere to lifestyle modifications even less often (2, 10, 11). Currently, hypertension is controlled in only about 20.7% of patients (2, 12). The control of hypertension in Poland increases with age (13). The number of patients achieving therapeutic goals is steadily increasing, however, it is still unsatisfactory. Further action is needed to improve the diagnosis and effective treatment of hypertension in Poland (2). Due to the limited number of qualitative studies on hypertension in Poland, the aim of the study was to explore the experiences, beliefs and motivations regarding hypertension and its treatment using the grounded theory (14).