Date of Award

7-15-2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Dr. Dawn Aycock

Second Advisor

Dr. Susan Kelley

Third Advisor

Dr. Trudy Gaillard

Abstract

Hypertension is the most significant risk factor for stroke, and African Americans (AA) experience disparities in uncontrolled hypertension and stroke. No studies have focused on stroke-related factors as predictors of hypertension self-management (HTN-SM) among AA. The purpose of this study was to examine stroke risk perceptions and knowledge, history of stroke symptoms, perceived stress and general health, and self-efficacy for managing HTN as predictors of HTN-SM in middle-aged to older AA; and to examine differences by age groups. This study used a cross-sectional, correlational design guided by the Health Belief Model. AA aged > 45 years were recruited via flyers distributed to various community sites in the southern United States and on social networking websites. Data were collected using questionnaires administered through Qualtrics or by telephone interviews. Participants (N = 142) had a mean age of 63.0 years (SD = 2.0); 74 (52%) middle-aged (45-64 years), and 68 (48%) older adults (> 65 years). On average, participants had HTN for 13.7 (SD = 11.1). Of those who could recall their most recent blood pressure (BP) reading (n = 99;70%), 33% were uncontrolled (i.e., > 140/90). The mean HTN self-care maintenance score used to assess HTN-SM was 58.1 (SD = 16.7); 72% had scores < 70 indicating inadequate HTN-SM. Overall, participants perceived a low-moderate stroke risk and had moderate knowledge, one-third reported a history of stroke symptoms, had vii low-moderate perceived stress, perceived their overall health as good/fair, and had inadequate self-efficacy. There were no significant differences in these variables by age group. The model explained 34.6% of the variance (R2 =.38, F (7, 134) = 11.64, p = .000) in HTN-SM. Self-efficacy (β = .42, p = .000), age (β=.21, p=.003), and perceived health (β = -.20, p = .01) were significant predictors. Higher HTN-SM was significantly associated with lower SBP (r = -.27, p = .006) and lower DBP (r = -.26, p = .011). Most participants self-reported BP in the control range; however, one-third were uncontrolled, and the majority of the sample had deficits in HTN-SM. Building individual self-efficacy for managing HTN, particularly among middle-aged AA, maybe more important than promoting stroke awareness to facilitate engagement in HTN-SM. Education, however, is still needed on knowing one’s BP reading and the personal risk of stroke in relation to uncontrolled HTN.

DOI

https://doi.org/10.57709/30236302

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