Hypertensive Management in African American Patients
Hypertension continues to be a major issue among Americans. This illness can lead to serious conditions, even death. African Americans have the highest prevalence of high blood pressure in the world (Saeed, 2020). There have been many studies in research to gain insight on why this continues to be a racial disparity. It is known that management of high blood pressure includes diet, exercise, medication and minimal stressors. African Americans are the number one race to fail at complying with managing their high blood pressure (Wright, Still, Jones, et. 2018). Many research studies have been done and “Mutual Self-Management Goal Settings” showed to improve their hypertension (Zaber, Tsai, Cho, etc. 2018).
According to International Journal of hypertension African Americans have the lowest self-management and outcomes related to hypertension. Additional factors contribute to disparities in hypertension in the race (Zaber, Tsai, Cho, etc. 2018). Some major factors include limited social support, increased stress due to discrimination, and socioeconomic disadvantage. A lot of these play a factor in low sense of trust in the health care system. These genetic and social factors can also lead to electrolyte imbalances and weight changes leading to hypertension (Saeed, 2020). As a result, serious conditions and death have occurred in African Americans.
Hypertensive management has shown to be more effective as a patient centered approach in the African American community. Nursing care is essential in providing the education, tools, resources and support to promote self-management (Zaber, Tsai, Cho, etc. 2018). Due to the lack of trust in the health care system establishing trust and rapport is important. Involving the patient in creating a plan in managing their hypertension promotes independence and control of their own health.
Individualized patient-centered care to engage African Americans in self-management has shown improvement in hypertension (Zaber, Tsai, Cho, etc. 2018). The process involves the healthcare provider targeting specific problems reported by the patient. The nurse will implement nursing actions individualized to the specific patient. Then a plan is designed based on problems reported. Nurses will collaborate with the patient to create a plan and respect the client’s choices. They will also encourage their preferences for self-management. Stressors are also noted as having a significant impact on high blood pressure. Current health status is assessed including blood pressure and BMI. Personal goals will also be asked of the patient to improve his or her health (Zaber, Tsai, Cho, etc. 2018). Nursing implications includes educational interventions, monitoring health changes, and behavior modification. Collecting baseline data and creating goals is also important. Goals should also be realistic. For example, patient will see a decrease in BP of 10 mmHg within 2 months. Changes could also be made by increasing the number of visits based on the feedback. Changes can also be made to self-management such as diet and exercise.
Improvement is noticed for those that received patient centered care and when the nurse and patient are seen as equal partners. This evidence-based method put into practice has shown to have a significant positive effect on health outcomes of African Americans struggling with hypertension (Wright, Still, Jones, et. 2018). Nurses continue to play an essential role in helping patients make changes and gain trust within the healthcare system. In all, the concept of QSEN of patient-centered care has proven to be the best outcome in managing hypertension in African Americans (Wright, Still, Jones, et. 2018).
Saeed, MD, A. (2020). Racial Disparities in Hypertension Prevalence and Management: A Crisis Control? American College of Cardiology Retrieved February 9, 2021, from https://www.acc.org/latest-in-cardiology/articles/2020/04/06/08/53/racial-disparities-in-hypertension-prevalence-and-management
Wright, K. D., Still, C. H., Jones, L. M., & Moss, K. O. (2018). Designing a Cocreated Intervention with African American Older Adults for Hypertension Self-Management. International Journal of Hypertension, 2018, 1-7. doi:10.1155/2018/7591289
Zabler, B., Tsai, P., Fendrich, M., Cho, Y., Taani, M. H., & Schiffman, R. (2018). Effect of a nurse case management intervention for hypertension self-management in low-income African Americans. Contemporary Clinical Trials, 71, 199-204. doi:10.1016/j.cct.2018.06.011
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