Living healthier: a grounded theory of older adults with prehypertension

Background: To prevent hypertension and long-term risk of cardiovascular events, older adults with prehypertension have to adhere to preventive behaviors. Little is known about the experience of adherence to preventive behavior among older adults with prehypertension. Method: A constructivist grounded theory approach was used to develop a model explaining the process of adherence to preventive behavior among older adults with prehypertension living in Thailand. Participants were recruited using purposive and theoretical samplings from two primary health care units in Western Thailand. Semi-structured interviews were conducted with 26 participants. All interview data collection was recorded, transcribed, and analyzed simultaneously. Initial and focused coding, as well as constant comparison, were used to analyze the data. Results: ‘Living healthier’ appeared as a core category describing the process of adherence. Three categories were identified in the process of adherence: (1) recognizing the danger, (2) fitting self-care strategies, and (3) managing for the long -term. Creating connectedness to live longer seemed to intercede adherence behavior. Conclusion: Adherence emerges from experiential learning when participants realized preventive behavior as the life source of living longer. These findings may help in the design of nursing interventions to increase trust in preventive behavior adherence and enhance awareness of prehypertension and its possible consequences. Family intervention in promoting adherence to preventive behavior among older adults with prehypertension should be developed as a desire to live longer with family is forceful. Keywords: Adherence, Older adult, Prehypertension, Preventive behavior, Thailand