Self-managed hypertension: a phenomenological assessment of patients’ treatment behaviours in Ghana.

Introduction: The transition from facility-based care to patient-centred care for hypertension is a growing global trend. Self-management strategies are crucial in this shift, given that many chronic conditions lack cure and require effective long-term management. This study explores behaviours that influence the success of self-management of hypertension among the Ghanaian population.

Method: A phenomenological study design grounded in a constructivist approach was employed. Thirty-seven hypertensive patients on regular treatment were recruited based on theme saturation. An in-depth interview guide developed from literature and thoroughly pretested was used. All interviews were held face-to-face and the responses were recorded, transcribed and thematically analysed using Atlas.ti software

Results: The findings highlighted the use of several self-management strategies for hypertension control. The strategies were mainly behavioural, which included anti-hypertensive medication (AHM), DASH diet, physical exercise, smoking, alcohol use and self-monitoring blood pressure (BP) at home. However, consistency and proper use of the behaviours were lacking due to inadequate knowledge, carelessness, high cost of living and poverty. Frequently used behaviours were AHM, no smoking and no alcohol use. Also, the female participants had no history of smoking, and none of them was found to be an alcoholic, although some admitted to have consumed alcohol occasionally. The level of adherence to self-management behaviours for AHM intake, consumption of a DASH diet, engagement in physical exercise and ambulatory BP monitoring at home were poor.

Conclusions: To address the identified gaps in knowledge and non-adherence to adaptive behaviour, providing financial support, tailored health education programmes that focus on self-management behaviour for hypertension control are strongly recommended. Rolling out policies that make the healthy choice the easy choice in managing hypertension needs to be given a priority to promote a healthy behaviour.