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Getting to Normal

Women’s Experiences Self-Managing Their Perceived Blood Pressure Changes

Franklin, Mary M. PhD, RN, ACNP-BC; Harden, Janet K. PhD, RN; Peters, Rosalind M. PhD, RN, FAAN

Journal of Cardiovascular Nursing: March/April 2016 - Volume 31 - Issue 2 - p 151–157
doi: 10.1097/JCN.0000000000000223

Background: In the United States, nearly 25% of all women older than 20 years have hypertension (HTN). Nearly 30% to 50% of persons with HTN experience symptoms attributed to high blood pressure (BP). Women with hypertensive symptoms may connect their symptoms to perceived BP changes and may be using their perceptions about BP changes to guide their HTN self-management. There is limited research about perceived BP changes or their use in self-management.

Objective: The purpose of this qualitative study is to describe the experiences of women with HTN self-managing their perceived BP changes.

Methods: van Manen’s phenomenology methodology and method guided the inquiry. Women with HTN who believed they could tell when their BP changed based on their symptoms were recruited from community settings and were interviewed once with a semistructured guide. Interviews were digitally recorded and professionally transcribed. Textual data were analyzed using thematic analysis to identify major themes.

Results: Seven black and 6 white women comprised the study sample. Participants were middle aged (mean [SD], 50.5 [9.62] years), were experienced in living with HTN (mean [SD],10.76 [9.50] years), had at least a high school education, and had a limited annual income (93% <$24 000). One central theme (“getting to normal”) and 4 subthemes (ie, “I can tell,” “tending to it,” “the wake-up call,” and “doing it right”) were discovered in the data. The themes depict a process of episodic symptom-driven and day-to-day actions that the participants used to get their BP to normal.

Conclusions: The study is significant as new knowledge was discovered about how women perceive their BP changes and use them to guide self-management. This study contributes to clinical practice through suggestions for improving patient assessments. Results serve as a foundation for further research of the self-management of BP changes and developing belief-based interventions with the potential to improve BP control.

Mary M. Franklin, PhD, RN, ACNP-BC Clinical Assistant Professor, College of Nursing, Wayne State University, Detroit, Michigan.

Janet K. Harden, PhD, RN Clinical Associate Professor, College of Nursing, Wayne State University, Detroit, Michigan.

Rosalind M. Peters, PhD, RN, FAAN Associate Professor, College of Nursing, Wayne State University, Detroit, Michigan.

This research was supported in part by the Sigma Theta Tau International Honor Society of Nursing Lambda Chapter Research Award and a Dissertation Research Award from the Graduate School at Wayne State University.

The authors have no conflicts of interest to disclose.

Correspondence Mary M. Franklin, PhD, RN, ACNP-BC, 5777 Cass Ave, Rm 148, Detroit, MI 48202 (

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