Developing personal sense of risk: a grounded theory in men with hypertension

BACKGROUND: For older men with hypertension living in rural areas, non-adherence to treatment is a common phenomenon. The experience on risk perception of individuals with their condition is recognized as playing a critical role in promoting treatment adherence. However, the experience on risk perception in a cohort of older men with hypertension seems unclear. AIM: To develop a theory concerning risk perception experience in a cohort of older men with hypertension from a rural area of Thailand. METHODS: A grounded theory approach was used. Semi-structured, face-to-face interviews with 29 hypertensive older men were conducted in Thailand using purposive and theoretical sampling methods. The grounded theory analytical method that included initial and focused coding, and constant comparison was used to analyse the data. FINDINGS: 'Developing a personal sense of risk' emerged as a core category, which incorporated the related four subprocesses: comparing healthcare provider information with stories of people with hypertension, comparing one's own situation with stories of people with hypertension, changing personal sense of risk and changing risk-related behaviour. Older men selected to focus on one particular outcome, using the selected outcome to monitor their risk. CONCLUSION: This investigation provides a theory for healthcare providers to understand older men's perceptions of personal risk for complications of hypertension. A personal sense of risk influences risk-related behaviour change. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The findings can be used in assessing a personal sense of risk and promoting treatment adherence in older men with hypertension. Effective storytelling intervention, a standard tool for assessment personal sense of risk in older men with hypertension, should be developed. Hypertension care policy needs to be developed for individualized approaches.