A Qualitative Research on the Control Status and Needs of Hypertension Patients in Guangxi Region

A Qualitative Research on the Control Status and Needs of Hypertension Patients in Guangxi Region | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Qualitative Research on the Control Status and Needs of Hypertension Patients in Guangxi Region Yingqi ZHONG, Zhaopeng LIU, Xifeng DING, Jinghui ZHENG This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5433308/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective Understanding the current status and needs of hypertension patients in the Guangxi region to provide a reference for clinical diagnosis and treatment by medical staff. Methods Using purposeful sampling, 16 hypertension patients treated at a Class III Grade A integrated traditional Chinese and Western medicine hospital in Nanning City, Guangxi Zhuang Autonomous Region from March to July 2024 were selected as research subjects and semi-structured interviews were conducted. Data was analyzed using Colaizzi's 7-step analysis method in phenomenological research. Results The control status and needs of hypertension patients in the Guangxi region can be summarized into four themes：Psychological and social adaptation ( disease understanding and acceptance, treatment expectations and concerns, future planning and uncertainty ) ; medical needs and access ( hypertension-related knowledge of popular science, convenient medical needs, high-quality medical services needs, regular treatment needs, doctor-patient communication needs ) ; support system and resources ( family support, psycho-social support ) ; self-management and control ( lifestyle changes, treatment options, standardized monitoring and treatment ). Conclusion Society should pay attention to the control status and needs of hypertension patients, provide support to patients from multiple aspects and dimensions, reduce the incidence of adverse events, and improve the quality of life for patients. Guangxi Zhuang Autonomous Region，Hypertension，Current status of disease control，Needs，Qualitative Research INTRODUCTION Hypertension in China has a high incidence rate, is growing rapidly, and exhibits a clear trend of becoming younger , having a significant impact on the lives and health of patients.According to the "Guidelines for Cardiovascular Disease Risk Assessment and Management in China," the crude prevalence rate of hypertension among residents aged 18 and older in China from 2012 to 2015 was 27.9%, with a weighted prevalence rate of 23.2%. It is estimated that there are approximately 245 million adults with hypertension in China. The crude detection rate of elevated normal blood pressure was 39.1%, with a weighted rate of 41.3%, estimating that there are about 435 million individuals with elevated normal blood pressure in the country .A study published by the International Society of Hypertension shows that in 2019, the global blood pressure control rate was 23.5% for women and 18.4% for men. Although China's blood pressure control rate has improved compared to previous years, it is still below the global average (17.8% for men and 13.9% for women) .Therefore, it is particularly important to reduce the incidence of hypertension and improve the control rate of the disease. This study employs semi-structured interviews to gain an in-depth understanding of the current status and needs of hypertension patients in the Guangxi region, to explore their feelings and needs regarding the disease, and to provide insights for future hypertension prevention and treatment. METHODS Design During the preliminary stage of the study, a research team was established, led by medical staff with over 20 years of experience in the field of cardiovascular medicine, who were responsible for the overall guidance and quality control of the project. Graduate students who had received training in qualitative research methodologies were responsible for interviewing patients and analyzing the data. Adopting the COREQ standards for qualitative research reporting based on the research objectives.Based on a literature review − , the research team conducted a meta-synthesis to form an initial interview outline and then selected 2 patients for pre-interviews. Following the interview results, the outline was revised and refined after consulting with 5 medical staff with deputy senior titles or above in the field of cardiovascular medicine to form the final interview protocol. The content is as follows: 1 How did you find out you had hypertension? How have you been treated since your diagnosis?2 Do you feel your treatment was timely?Why ? Are you satisfied with the current treatment ?3 Do you have any concerns about this disease now ? For example, regarding its impact on your personal health or family?4 What do you think are the shortcomings of your current treatment? How would you like to see it improved or what kind of help would you like to receive?5 Do you approve of using traditional Chinese medicine to treat hypertension? 6 Can you share your views on online medical treatment ? Recruitment Using purposeful sampling, this study selected patients with hypertension treated at a tertiary integrated traditional Chinese and Western medicine hospital in Nanning, Guangxi Zhuang Autonomous Region, from March to July 2024. Inclusion criteria: ① Patients who meet the diagnostic criteria of the "Chinese Guidelines for the Prevention and Treatment of Hypertension (2018 Edition)" , with a previous diagnosis of "hypertension"; ② Natives of Guangxi and residents living in Guangxi for a long term; ③ No gender restrictions, aged 18 and above, without mental or neurological diseases; ④ Capable of reading and understanding, and willing to cooperate with this study. Exclusion criteria: Patients with concurrent tumors, severe cardiovascular and cerebrovascular complications, and severe liver or kidney dysfunction.Based on the principle of "data saturation" , analyze the interview content after each interview, and determine the sample size when the interview content becomes repetitive and no new themes emerge . Data collection Data was collected through semi-structured interviews. The interview location was chosen to be a quiet, bright, and spacious room. Before the interview, the purpose, significance, and methodology were explained to the patients, and informed consent was obtained. The interview began with "Could you please talk to me about your hypertension?" and concluded with "Is there anything else you would like to say?".Interviews should adhere to the principle of neutrality, focusing on the use of techniques such as reflection, probing, summarization, and response .Record in real-time and audio-record the entire session, with each interview lasting 20 to 30 minutes. After the interview, the interviewer transcribes the audio into text within 24 hours and organizes it into a detailed manuscript based on interview notes, which is then reviewed by another researcher. Data analysis The interview transcripts were imported into NVivo 11.0 software for data storage and analysis, which was conducted independently by two researchers. The analysis was performed using Colaizzi's seven-step method : ① Carefully read the raw data. ② Identify statements closely related to the theme of this study. ③ Code the data. ④ Assemble the coded perspectives. ⑤ Write detailed descriptions. ⑥ Distinguish similar viewpoints. ⑦ Return to the interviewees for verification. For any discrepancies, the group discusses and seeks help from qualitative research experts, ultimately forming the content of a qualitative study on the current status and needs of hypertension patients in the Guangxi region. RESULTS This study interviewed a total of 16 patients with hypertension, consisting of 10 males and 6 females. The average age is 55.9 years old, and the average duration of hypertension is 10.8 years.To protect the privacy of the respondents, they were replaced with numbers N1 to N16. Their general information can be found in Table 1 .A total of 4 themes and 13 sub-themes were distilled from the data(Table 2 ). Table 1 Description of study participants(n = 16) Number Gender Age(Years) Educational Attainment Occupation Duration of diagnosed hypertension (years) N1 Men 24 Bachelor's Degree Police Officer 1 N2 Men 60 Primary School Farmer 10 N3 Men 25 Bachelor's Degree Physician 1 N4 Women 54 Technical Secondary School Sole Proprietor 2 N5 Men 60 Junior College Retiree 15 N6 Men 78 Junior High School Retiree 20 N7 Men 77 Junior High School Farmer 25 N8 Women 57 High School Retiree 2 N9 Women 67 Junior High School Retiree 30 N10 Women 68 Junior High School Retiree 10 N11 Men 35 Master's Degree Physician 6 N12 Men 50 High School Farmer 3 N13 Men 27 Master's Degree Physician 0.5 N14 Men 82 High School Retiree 40 N15 Women 72 High School Retiree 5 N16 Women 59 Primary School Farmer 3 Table 2 Theme and Subtheme Extraction Results Theme Subtheme Disease Understanding and Acceptance Psychological and Social Adaptation Treatment Expectations and Concerns Future Planning and Uncertainty Public Education on Hypertension The Need for Convenient Medical Services Medical needs and access The Need for High-Quality Medical Services The Need for Regular Treatment The Need for Doctor-Patient Communication Support Systems and Resources Family Support Psychosocial Support Lifestyle Changes Self-Management and Control Choice of Treatment Methods Standardized Monitoring and Treatment Psychological and Social Adaptation Disease Understanding and Acceptance The interview results indicated that the majority of patients had inadequate understanding of the progression of hypertension, as well as how to cooperate with treatment and manage the condition."Before falling ill, I was unaware of hypertension, and even after becoming ill, I did not make an effort to understand it further. I didn't pay much attention to this condition; perhaps I was not fully conscious of its significance."(N1). However, since hypertension has become one of the most common cardiovascular diseases in China , most of the respondents are still relatively calm when diagnosed with hypertension."I don't have any particularly special thoughts on it. I feel that hypertension is quite common, so it's normal for me to have it."(N11). A small number of respondents had intense emotional reactions. Some were surprised: "I never thought I would have hypertension at such a young age!"(N1). while others felt anxious, "When I was first diagnosed, I was a bit nervous. I wondered why I would have this problem at such a young age, and if it's an issue with my health."(N13). Some expressed concern, "I might have thought about high blood pressure, but I never thought I would have it at this age. I'm too young, and what worries me more is the possibility of getting diabetes by the time I'm thirty."(N3). Additionally, following the diagnosis of hypertension, respondents typically engage in positive self-adjustments to accommodate their new identity as individuals living with hypertension."My father passed away due to hypertension, so I try not to dwell on it and maintain a positive mindset. I can't allow myself to be trapped in the vortex of this illness; I try to adjust myself towards more pleasant aspects of life."(N9). Treatment Expectations and Concerns Participants hold high expectations for the therapeutic outcomes of hypertension treatments and express a desire for the development of medications that would not require lifelong administration, aiming to enhance the treatment experience and overall quality of life."I hope we don 't need long-term, lifelong medication."(N11). At the same time, participants also indicated that they have concerns about the dependency and side effects of antihypertensive drugs, which have affected their medication compliance. "Most people believe that antihypertensive medications have certain side effects. Once you start taking the medication, it often needs to be taken regularly, or even long-term, and blood pressure cannot be controlled without it."(N13). in addition, Some respondents expressed skepticism about whether the use of antihypertensive drugs might lead to other diseases."I am uncertain if my stomach issues are related to the long-term use of antihypertensive medications, and I wonder if taking medication for an extended period will have an impact on my health."(N2). The treatment cycle for hypertension is lengthy, and many patients might perceive that the effects are not readily apparent and the benefits are inadequate throughout the course of treatment."I feel that since I've been taking antihypertensive drugs, my blood pressure control seems to be not very effective, which is a bit worrisome."(N9).Concurrently, the prolonged treatment process can easily lead to negative emotions among patients."People who have been ill for a long time will be very upset in their hearts, including the idea that I am upset and do not want to cure myself."(N2). Future Planning and Uncertainty Some participants mentioned that they face a conflict between work and disease treatment."My job is too demanding, I can't really take time off, so it's hard for me to find a chance to see a doctor."(N1). They mention that high blood pressure isn't just a threat to their physical health, but it also impacts their work performance and career advancement."I'm worried that when I get too tired, my blood pressure will rise. I feel like I can't work as hard as I used to, and when I'm uncomfortable, I just want to rest."(N11). They also voiced concerns about their future quality of life, fearing the potential burden of their illness on their children."Right now, I'm more worried that if I fall ill, my advanced age and limited mobility might prevent me from getting timely medical treatment, which could lead to serious consequences. It's not death that I fear, but the thought of burdening my children with the impact on their work."(N14). Therefore, participants hope to alleviate their concerns about future complications through regular treatment."I feel more at ease when I take my medication; not taking it scares me because I'm afraid my blood pressure might rise without my knowing, and I worry about what would happen if I had a stroke."(N10). Medical needs and access Public Education on Hypertension The interview findings revealed that participants have an urgent need for knowledge about hypertension."Regarding hypertension, I'm familiar with the name of the condition, but I don't know what causes it. So, there's a need for me to understand and learn more about this aspect."(N1). The Need for Convenient Medical Services Some participants mentioned that the process of seeing a doctor was overly complicated and troublesome."Due to the high volume of patients seeking medical attention, there are often long queues to see a doctor. Additionally, the process of checking out results is relatively slow, and getting test reports requires lining up again."(N5). With the advancement of science and technology, the evolution of online medical services has offered patients a more flexible approach to seeking healthcare , compensating for the shortcomings of offline medical treatments.In this interview, several participants also voiced their approval of internet-based medical care."The development of the Internet as a supplement to offline medical services is also a general trend. Currently, it is not convenient for most patients to visit and register at the outstanding hospital due to their compact schedules."(N3). Some participants also indicated a need for online medical treatment."Actually, I lean more towards online consultation because my work is too busy, and I don't have time to see a doctor. So, I think online consultation is very convenient."(N1). However, some respondents expressed concerns about potential risks associated with online medical treatment. They are skeptical about whether the doctors have the appropriate qualifications, the accuracy of the diagnoses, the possibility of misdiagnoses or missed diagnoses, and the potential for deception."I think there are still many shortcomings, because the online treatment can not see the overall situation of the patient, with experience, feeling, there may be missed diagnosis, misdiagnosis, the risk is relatively large."(N11). The Need for High-Quality Medical Services The interview results indicate that participants tend to prefer larger hospitals for medical treatment, seeking higher quality medical assurance and more professional diagnostic and therapeutic services."I come from the countryside, where we don't have access to high-quality medical care. To see a doctor, we have to go to the big hospitals. That's why it's not easy for me to come for a medical visit—it's just too far away."(N7). The Need for Regular Treatment At the same time, most participants prefer to be treated under the guidance of a consistent doctor who is familiar with their condition, in order to receive a personalized treatment plan and ongoing care."I now opt to see the same doctor each time, as he is familiar with my medical history. When I request a prescription, he can advise me on whether the medication is suitable for me based on his understanding of my health."(N12). The Need for Doctor-Patient Communication The interview results reveal that inadequate communication between doctors and patients leaves some patients with concerns, leading to their reluctance to express their discomfort. "Whenever I feel discomfort in my heart, I want to call a doctor to check it out, but by the time the doctor arrives, the issue seems to have resolved itself. I hate to trouble others and have them come all the way for nothing."(N9). Although the communication between doctors and patients is not smooth, patients can understand the hard work of the medical staff and have expressed their understanding."Doctors are incredibly busy with many patients to see and numerous issues to handle, so I don't want to trouble them unnecessarily. However, if there is something important about my condition, they should explain it to me in detail so that I can manage it myself,.And we should also understand the difficulties of doctors."(N7). Nevertheless, patients still hope that doctors can enhance communication and alleviate their concerns."Because if the doctor doesn't explain things clearly to us, these questions will always linger in our minds."(N15). Support Systems and Resources Family Support The interview results indicate that increased communication with close ones can deepen patients' understanding of their disease and bolster their confidence in managing the condition."I communicate with my friends and my family. After our conversations, I realized that high blood pressure is quite common, and I don't find this condition to be particularly severe. I now have very good control over it. When difficulties arise, I think of ways to address them, and if they can't be resolved, I can at least mitigate their impact."(N4). Furthermore, when family members are dealing with hypertension, they can collectively maintain a healthy lifestyle through mutual monitoring and support."For instance, my spouse and I control our diet together every day, take walks together, and supervise each other to take medication... Through these joint efforts, we don't feel uncomfortable; instead, we feel more relaxed, and our blood pressure control has become relatively stable."(N5). However, some participants mentioned that the excessive care from those around them can also create pressure."My children are very concerned about me, often asking if I've measured my blood pressure, telling me not to get too tired and to rest. They're overly worried, saying I can't do this or that every day, which makes me feel a bit unhappy. I already have enough on my mind without my family nagging at me."(N6). Psychosocial Support The interview results demonstrate that patients require conversation to receive emotional understanding and support when dealing with their illness."Having someone to communicate with makes my heart feel more comfortable."(N2). Additionally, some elderly participants with hypertension indicated that they have a single source of income, a substantial burden of treatment costs, and perceive social support as insufficient."I'm concerned that illness will affect the quality of life, and currently, there isn't an adequate support system for the elderly. For those of us who depend solely on pensions, healthcare costs are still a bit too heavy to bear."(N14). Self-Management and Control Lifestyle Changes Most participants reported that they would alter their lifestyles after being diagnosed with hypertension."I try to sleep as early as possible now, maintain a light diet, and exercise every evening. With these lifestyle modifications, I find that my blood pressure remains within an acceptable range."(N4). Choice of Treatment Methods The interview also revealed that during the disease treatment process, patients choose different treatment methods based on their own conditions and preferences. Some participants indicated that they would prioritize the use of Western medicine."I believe that Western medicine is more convenient to carry and store, and by simply taking one pill in the morning, my blood pressure can be lowered."(N4). Other participants felt that treatment with Chinese medicine can better accommodate their physical constitution."I believe that Western medicine only offers a short-term solution for controlling blood pressure, and I am concerned about becoming dependent on these drugs. Since I am still young and am starting to take Western medicine now, I worry about what will happen when I am older. Therefore, I hope that by undergoing treatment with traditional Chinese medicine, which gradually adjusts the body, I might achieve better results. I think Chinese medicine could be a better option for me."(N1). Standardized Monitoring and Treatment Although patients are aware of the importance of regular monitoring of blood pressure and taking drugs on time, they still face a variety of obstacles."I have been taking my medication, but I don't monitor my blood pressure very regularly because sometimes there are just too many things going on at home, and I get so busy that I don't have time to measure it."(N9). DISCUSSION In this study, participants generally had insufficient knowledge of hypertension, which contributed to heightened psychological stress and negative emotions such as tension and worry during the initial diagnosis.These findings are in line with those of Chen Yuling and colleagues . Concurrently, this study discovered that some hypertensive patients manage to achieve blood pressure control by enhancing their lifestyle post-diagnosis. Such behavior may correlate with heightened health consciousness, increased sense of family responsibility, and the discomfort brought on by the disease. Psychological factors are increasingly recognized as playing a significant role in the etiology and management of hypertension 1 . Therefore, it is imperative to enhance the quality of health education, assist patients in establishing a scientific understanding of their condition, improve their quality of life, and thereby optimize disease outcomes. Considering the varying levels of patient cognition, healthcare workers should employ clear and concise language to elucidate the etiology, consequences of hypertension, and the significance of pharmacological management. They should also address misconceptions regarding the side effects of antihypertensive medications and alleviate any irrational fears associated with the disease.The study by Zhu Haixiang and colleagues also identified that patients with newly diagnosed hypertension are more likely to seek treatment. This stage is a critical period for conducting hypertension education for patients and ensuring their standardized treatment, which can alleviate patient concerns, bolster treatment confidence, and improve compliance. This study found that the demand for hypertension treatment among patients is on the rise. However, the communication time between doctors and patients is limited, and adverse reactions during home medication are often difficult to detect and address promptly. The advancement of internet medical treatment has enhanced the flexibility of healthcare delivery, as this service is not constrained by time and location. Physicians can provide health education online, and patients can promptly receive professional diagnosis and advice from doctors via the internet. Nevertheless, there are potential risks associated with online healthcare, including but not limited to the practice of over-qualification, inaccurate diagnostic and treatment information, non-compliant self-treatment, inadequate management of patient information, and delays in diagnostic and treatment responses .These issues have the potential to compromise the safety and efficacy of medical care. Consequently, it is imperative for patients to augment their self-protection awareness and safeguard the security of their personal information when engaging with online medical services. This study also revealed that a significant number of patients tend to opt for large hospitals when seeking treatment,This is consistent with the findings of Tong Tong Xiyang and colleagues .China's health resources are distributed in an "inverted pyramid" pattern, with an excessive concentration of high-quality resources ,Patients' preference for large hospitals highlights the common issues faced by primary health institutions, such as a lack of professional expertise and skill levels, along with the aging of medical equipment and obsolescence of hardware facilities .Therefore, in addition to enhancing hardware facilities, primary medical and health institutions are in urgent need of advancing the implementation of talent mobility strategies and encouraging medical staff to undergo professional training at higher-level medical institutions. Concurrently, higher-level hospitals should regularly dispatch experts to grassroots institutions to offer technical support and assistance. This approach aims to bolster the diagnostic and therapeutic capabilities of grassroots medical and health institutions,which ease the predicament of patients seeking medical treatment. This study revealed that the specialized nature and intricacy of medical knowledge create communication barriers between physicians and patients, fostering a sense of distrust among patients towards doctors, a finding that aligns with the research conducted by Wang Hao and others 9 .Patients typically view doctors as authoritative figures and share their experiences of pain with them. Physicians, however, often concentrate on medical details, which can result in a relatively limited response to patients' emotional needs . This may cause patients to perceive a lack of empathy from doctors, thereby impacting the doctor-patient relationship negatively.Therefore, during the clinical diagnosis and treatment process, healthcare providers should be attentive to the emotional experiences of patients and strive to enhance the quality of doctor-patient communication. By embracing a "shared decision-making" model between doctors and patients, patients are encouraged to actively engage in the decision-making process regarding their clinical diagnosis and treatment. This approach can improve patient satisfaction and alleviate tensions within the doctor-patient relationship. This study also discovered that family and social support can mitigate the negative emotions experienced by patients with hypertension, deepen their understanding of the disease, and boost their adherence to treatment regimens, echoing the findings of studies like those conducted by MULLEN M .Additionally, this study revealed that the presence of co-morbidity within families significantly influences patient disease management, a finding that aligns with the research of Dai Minghui and colleagues .However, the majority of patients with hypertension encounter a deficiency in family and social support throughout their treatment. The absence of familial support is primarily evident in the lack of awareness about the patient's condition among family members, a lack of empathy towards the patient's emotional ups and downs, and insufficient care for the patient. Hypertensive patients often shoulder a considerable economic burden due to the prolonged nature of the disease treatment, with this burden being particularly pronounced among elderly patients.In this study, several elderly participants indicated that their family's monthly income is quite low, making it challenging to afford the medical expenses associated with long-term treatment. They perceive the support provided by society as inadequate. Consequently, it is essential to stimulate the enthusiasm of patients' family members,recognize the pivotal role of the family within the social support framework, and encourage their involvement in the health management of patients. In parallel, society should construct a comprehensive support network and refine medical policies to alleviate the financial strain on patients. This study also discovered that despite the necessity for regular medication among patients, numerous obstacles persist, particularly for elderly patients. This finding is consistent with the outcomes reported by Lin Liyu and colleagues .The medication adherence among elderly hypertensive patients is typically low,which may be related to the physiological function degradation, psychological and physiological state changes caused by aging .Concurrently, elderly patients are often burdened with the responsibility of caring for their grandchildren and managing household duties. Amidst their busy daily routines, they are more prone to overlook their medication regimen. Hence, it is imperative for family members and healthcare providers to assist patients in establishing sensible daily living schedules, integrating blood pressure monitoring and medication adherence into their regular activities.Additionally, this study revealed that the selection of treatment methods for patients with hypertension is influenced by a multitude of factors, including personal perceptions of treatment, cultural background, and individual variability. Some patients prefer Traditional Chinese Medicine due to its distinct therapeutic philosophy, holistic treatment approach, synergistic adjustment with lifestyle modifications, and emphasis on long-term outcomes. CONCLUSION The control status and demands of patients with hypertension constitute a multifaceted issue, encompassing numerous factors. Consequently, a multifaceted approach involving policy, medical, familial, and societal support is necessary to enhance the disease's incidence and control rates, as well as to elevate the quality of life for patients. Nonetheless, this study primarily concentrates on the current state and needs of patients, which presents certain limitations. Future research could broaden the sample scope and extend the duration and breadth of the study to achieve a more holistic understanding of patients' long-term control status and needs. Declarations Ethics approval and consent to participate Before recruitment, this study obtained approval from the Institutional Review Board of the authors’ hospital (Approval No. YJS2023-111). Consent for publication All participants were informed and provided verbal consent. Availability of data and materials Not applicable Competing interests The authors declare that they have no competing interests Funding This study was supported by the Guangxi Major Science and Technology Project: Research on the Service Model and Industrial Development of Professionally Guided Health Autonomous Management (Grant No. GuiKe AA22096028). Author contributions Zhong proposed the primary research objectives and was in charge of the research's conception, design, execution, and the drafting of the manuscript; Liu and Ding were responsible for data collection and organization; Zheng was tasked with the quality control and review of the manuscript, as well as the overall supervision and management of the paper.All authors read and approved the final manuscript. Acknowledgements We sincerely thank all individuals who participated in this qualitative study . References China Hypertension Prevention and Treatment Guide Revision Committee, Hypertension Alliance (China), China International Exchange and Promotion Association for Medical and Healthcare Hypertension Branch, Chinese Geriatrics Society Hypertension Branch, China Gerontological Health Association Hypertension Branch, Chinese Stroke Association, & China CDC Chronic Non-communicable Disease Prevention and Control Center. (2024). 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The mediating role of family care in the relationship between health literacy and self-care ability among elderly hypertensive residents. Jiangsu Health System Management , 34(1), 138-142. Lin, L. Y., Xu, L. C., Zhong, Y. F., et al. (2021). The correlation analysis between frailty and medication adherence in community-dwelling elderly patients with hypertension. Geriatrics Research , 2(4), 35-39. Delavar, F., Pashaeypoor, S., & Negarandeh, R. (2020). The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. Patient Education and Counseling , 103(2), 336-342. https://doi.org/10.1016/j.pec.2019.08.028 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5433308","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":377680357,"identity":"3dd9d0a3-cc1f-4c03-985a-087481d1d397","order_by":0,"name":"Yingqi ZHONG","email":"","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Yingqi","middleName":"","lastName":"ZHONG","suffix":""},{"id":377680358,"identity":"ba9cc4f4-b406-4098-912f-b3f665b5a8e9","order_by":1,"name":"Zhaopeng LIU","email":"","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Zhaopeng","middleName":"","lastName":"LIU","suffix":""},{"id":377680359,"identity":"5630b07d-a64e-4fdf-a794-de10b3dab9dc","order_by":2,"name":"Xifeng DING","email":"","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Xifeng","middleName":"","lastName":"DING","suffix":""},{"id":377680360,"identity":"c5277bc7-e98d-482d-9f0d-bff90374bd00","order_by":3,"name":"Jinghui ZHENG","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/0lEQVRIiWNgGAWjYDACCRDBIwFmHPjYAOIxNh4gWsvBmQ0girGBCC1QBjNvA4SPV4v87OZjD7/IWOTJR/cYHrbdYVOn234YaEuNTTQuLYxzjqUby/BIFBveOWNwOPdMmoTZmUSglmNpuQ04tDBL5JhJS/BIJG6ckQPU0nZYwuwAUAtjw2GcWtgk8r8htFiCtJx/iF8Lj0QOm+QHoJb5EkAtjCAtNwjYIiGRZiYN1Ji4QSKt4GBvW5rkthtAWxLw+EV+RvIzyZ89dYnzZyRv/vCzzYbf7Hz6wwcfamxwagEHAW8PA4PBAWShBDzKQYDxxw+gdfgMHQWjYBSMgpENAHcnYS3tqwJgAAAAAElFTkSuQmCC","orcid":"","institution":"Ruikang Affiliated Hospital of Guangxi Medical University","correspondingAuthor":true,"prefix":"","firstName":"Jinghui","middleName":"","lastName":"ZHENG","suffix":""}],"badges":[],"createdAt":"2024-11-11 15:38:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5433308/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5433308/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102506026,"identity":"e6cedffa-947f-459c-a79c-3ebd0f751c84","added_by":"auto","created_at":"2026-02-12 11:27:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":460429,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5433308/v1/fb34f2af-7874-4870-be93-17ea15161f0b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Qualitative Research on the Control Status and Needs of Hypertension Patients in Guangxi Region","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eHypertension in China has a high incidence rate, is growing rapidly, and exhibits a clear trend of becoming younger\u003ca class=\"FNLink\" href=\"#Fn1\" id=\"#FNLinkFn1\"\u003e\u003c/a\u003e, having a significant impact on the lives and health of patients.According to the \"Guidelines for Cardiovascular Disease Risk Assessment and Management in China,\" the crude prevalence rate of hypertension among residents aged 18 and older in China from 2012 to 2015 was 27.9%, with a weighted prevalence rate of 23.2%. It is estimated that there are approximately 245\u0026nbsp;million adults with hypertension in China. The crude detection rate of elevated normal blood pressure was 39.1%, with a weighted rate of 41.3%, estimating that there are about 435\u0026nbsp;million individuals with elevated normal blood pressure in the country\u003ca class=\"FNLink\" href=\"#Fn2\" id=\"#FNLinkFn2\"\u003e\u003c/a\u003e.A study published by the International Society of Hypertension shows that in 2019, the global blood pressure control rate was 23.5% for women and 18.4% for men. Although China's blood pressure control rate has improved compared to previous years, it is still below the global average (17.8% for men and 13.9% for women)\u003ca class=\"FNLink\" href=\"#Fn3\" id=\"#FNLinkFn3\"\u003e\u003c/a\u003e.Therefore, it is particularly important to reduce the incidence of hypertension and improve the control rate of the disease. This study employs semi-structured interviews to gain an in-depth understanding of the current status and needs of hypertension patients in the Guangxi region, to explore their feelings and needs regarding the disease, and to provide insights for future hypertension prevention and treatment.\u003c/p\u003e "},{"header":"METHODS","content":"\u003cp\u003eDesign\u003c/p\u003e\u003cp\u003eDuring the preliminary stage of the study, a research team was established, led by medical staff with over 20 years of experience in the field of cardiovascular medicine, who were responsible for the overall guidance and quality control of the project. Graduate students who had received training in qualitative research methodologies were responsible for interviewing patients and analyzing the data.\u003c/p\u003e\u003cp\u003eAdopting the COREQ standards\u003ca class=\"FNLink\" href=\"#Fn4\" id=\"#FNLinkFn4\"\u003e\u003c/a\u003e for qualitative research reporting based on the research objectives.Based on a literature review\u003ca class=\"FNLink\" href=\"#Fn5\" id=\"#FNLinkFn5\"\u003e\u003c/a\u003e\u003csup\u003e−\u003c/sup\u003e\u003ca class=\"FNLink\" href=\"#Fn6\" id=\"#FNLinkFn6\"\u003e\u003c/a\u003e, the research team conducted a meta-synthesis to form an initial interview outline and then selected 2 patients for pre-interviews. Following the interview results, the outline was revised and refined after consulting with 5 medical staff with deputy senior titles or above in the field of cardiovascular medicine to form the final interview protocol. The content is as follows: 1 How did you find out you had hypertension? How have you been treated since your diagnosis?2 Do you feel your treatment was timely?Why ? Are you satisfied with the current treatment ?3 Do you have any concerns about this disease now ? For example, regarding its impact on your personal health or family?4 What do you think are the shortcomings of your current treatment? How would you like to see it improved or what kind of help would you like to receive?5 Do you approve of using traditional Chinese medicine to treat hypertension? 6 Can you share your views on online medical treatment ?\u003c/p\u003e\u003cp\u003eRecruitment\u003c/p\u003e\u003cp\u003eUsing purposeful sampling, this study selected patients with hypertension treated at a tertiary integrated traditional Chinese and Western medicine hospital in Nanning, Guangxi Zhuang Autonomous Region, from March to July 2024.\u003c/p\u003e\u003cp\u003eInclusion criteria: ① Patients who meet the diagnostic criteria of the \"Chinese Guidelines for the Prevention and Treatment of Hypertension (2018 Edition)\"\u003ca class=\"FNLink\" href=\"#Fn7\" id=\"#FNLinkFn7\"\u003e\u003c/a\u003e, with a previous diagnosis of \"hypertension\"; ② Natives of Guangxi and residents living in Guangxi for a long term; ③ No gender restrictions, aged 18 and above, without mental or neurological diseases; ④ Capable of reading and understanding, and willing to cooperate with this study. Exclusion criteria: Patients with concurrent tumors, severe cardiovascular and cerebrovascular complications, and severe liver or kidney dysfunction.Based on the principle of \"data saturation\"\u003ca class=\"FNLink\" href=\"#Fn8\" id=\"#FNLinkFn8\"\u003e\u003c/a\u003e, analyze the interview content after each interview, and determine the sample size when the interview content becomes repetitive and no new themes emerge\u003ca class=\"FNLink\" href=\"#Fn9\" id=\"#FNLinkFn9\"\u003e\u003c/a\u003e.\u003c/p\u003e\u003cp\u003eData collection\u003c/p\u003e\u003cp\u003eData was collected through semi-structured interviews. The interview location was chosen to be a quiet, bright, and spacious room. Before the interview, the purpose, significance, and methodology were explained to the patients, and informed consent was obtained. The interview began with \"Could you please talk to me about your hypertension?\" and concluded with \"Is there anything else you would like to say?\".Interviews should adhere to the principle of neutrality, focusing on the use of techniques such as reflection, probing, summarization, and response\u003ca class=\"FNLink\" href=\"#Fn10\" id=\"#FNLinkFn10\"\u003e\u003c/a\u003e.Record in real-time and audio-record the entire session, with each interview lasting 20 to 30 minutes. After the interview, the interviewer transcribes the audio into text within 24 hours and organizes it into a detailed manuscript based on interview notes, which is then reviewed by another researcher.\u003c/p\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eThe interview transcripts were imported into NVivo 11.0 software for data storage and analysis, which was conducted independently by two researchers. The analysis was performed using Colaizzi's seven-step method\u003ca class=\"FNLink\" href=\"#Fn11\" id=\"#FNLinkFn11\"\u003e\u003c/a\u003e: ① Carefully read the raw data. ② Identify statements closely related to the theme of this study. ③ Code the data. ④ Assemble the coded perspectives. ⑤ Write detailed descriptions. ⑥ Distinguish similar viewpoints. ⑦ Return to the interviewees for verification. For any discrepancies, the group discusses and seeks help from qualitative research experts, ultimately forming the content of a qualitative study on the current status and needs of hypertension patients in the Guangxi region.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThis study interviewed a total of 16 patients with hypertension, consisting of 10 males and 6 females. The average age is 55.9 years old, and the average duration of hypertension is 10.8 years.To protect the privacy of the respondents, they were replaced with numbers N1 to N16. Their general information can be found in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.A total of 4 themes and 13 sub-themes were distilled from the data(Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescription of study participants(n\u0026thinsp;=\u0026thinsp;16)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAge(Years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEducational Attainment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDuration of diagnosed hypertension (years)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBachelor's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePolice Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBachelor's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePhysician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTechnical Secondary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSole Proprietor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJunior College\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRetiree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJunior High School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRetiree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJunior High School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRetiree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJunior High School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRetiree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJunior High School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRetiree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMaster's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePhysician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMaster's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePhysician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRetiree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRetiree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTheme and Subtheme Extraction Results\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTheme\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSubtheme\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisease Understanding and Acceptance\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychological and Social Adaptation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTreatment Expectations and Concerns\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFuture Planning and Uncertainty\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePublic Education on Hypertension\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe Need for Convenient Medical Services\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical needs and access\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe Need for High-Quality Medical Services\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe Need for Regular Treatment\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe Need for Doctor-Patient Communication\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSupport Systems and Resources\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily Support\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychosocial Support\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLifestyle Changes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-Management and Control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChoice of Treatment Methods\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStandardized Monitoring and Treatment\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePsychological and Social Adaptation\u003c/p\u003e \u003cp\u003eDisease Understanding and Acceptance\u003c/p\u003e \u003cp\u003eThe interview results indicated that the majority of patients had inadequate understanding of the progression of hypertension, as well as how to cooperate with treatment and manage the condition.\"Before falling ill, I was unaware of hypertension, and even after becoming ill, I did not make an effort to understand it further. I didn't pay much attention to this condition; perhaps I was not fully conscious of its significance.\"(N1).\u003c/p\u003e \u003cp\u003eHowever, since hypertension has become one of the most common cardiovascular diseases in China\u003ca class=\"FNLink\" href=\"#Fn12\" id=\"#FNLinkFn12\"\u003e\u003c/a\u003e, most of the respondents are still relatively calm when diagnosed with hypertension.\"I don't have any particularly special thoughts on it. I feel that hypertension is quite common, so it's normal for me to have it.\"(N11).\u003c/p\u003e \u003cp\u003eA small number of respondents had intense emotional reactions. Some were surprised: \"I never thought I would have hypertension at such a young age!\"(N1).\u003c/p\u003e \u003cp\u003ewhile others felt anxious, \"When I was first diagnosed, I was a bit nervous. I wondered why I would have this problem at such a young age, and if it's an issue with my health.\"(N13).\u003c/p\u003e \u003cp\u003eSome expressed concern, \"I might have thought about high blood pressure, but I never thought I would have it at this age. I'm too young, and what worries me more is the possibility of getting diabetes by the time I'm thirty.\"(N3).\u003c/p\u003e \u003cp\u003eAdditionally, following the diagnosis of hypertension, respondents typically engage in positive self-adjustments to accommodate their new identity as individuals living with hypertension.\"My father passed away due to hypertension, so I try not to dwell on it and maintain a positive mindset. I can't allow myself to be trapped in the vortex of this illness; I try to adjust myself towards more pleasant aspects of life.\"(N9).\u003c/p\u003e \u003cp\u003eTreatment Expectations and Concerns\u003c/p\u003e \u003cp\u003eParticipants hold high expectations for the therapeutic outcomes of hypertension treatments and express a desire for the development of medications that would not require lifelong administration, aiming to enhance the treatment experience and overall quality of life.\"I hope we don 't need long-term, lifelong medication.\"(N11).\u003c/p\u003e \u003cp\u003eAt the same time, participants also indicated that they have concerns about the dependency and side effects of antihypertensive drugs, which have affected their medication compliance.\u003c/p\u003e \u003cp\u003e\"Most people believe that antihypertensive medications have certain side effects. Once you start taking the medication, it often needs to be taken regularly, or even long-term, and blood pressure cannot be controlled without it.\"(N13).\u003c/p\u003e \u003cp\u003ein addition, Some respondents expressed skepticism about whether the use of antihypertensive drugs might lead to other diseases.\"I am uncertain if my stomach issues are related to the long-term use of antihypertensive medications, and I wonder if taking medication for an extended period will have an impact on my health.\"(N2).\u003c/p\u003e \u003cp\u003eThe treatment cycle for hypertension is lengthy, and many patients might perceive that the effects are not readily apparent and the benefits are inadequate throughout the course of treatment.\"I feel that since I've been taking antihypertensive drugs, my blood pressure control seems to be not very effective, which is a bit worrisome.\"(N9).Concurrently, the prolonged treatment process can easily lead to negative emotions among patients.\"People who have been ill for a long time will be very upset in their hearts, including the idea that I am upset and do not want to cure myself.\"(N2).\u003c/p\u003e \u003cp\u003eFuture Planning and Uncertainty\u003c/p\u003e \u003cp\u003eSome participants mentioned that they face a conflict between work and disease treatment.\"My job is too demanding, I can't really take time off, so it's hard for me to find a chance to see a doctor.\"(N1).\u003c/p\u003e \u003cp\u003eThey mention that high blood pressure isn't just a threat to their physical health, but it also impacts their work performance and career advancement.\"I'm worried that when I get too tired, my blood pressure will rise. I feel like I can't work as hard as I used to, and when I'm uncomfortable, I just want to rest.\"(N11).\u003c/p\u003e \u003cp\u003eThey also voiced concerns about their future quality of life, fearing the potential burden of their illness on their children.\"Right now, I'm more worried that if I fall ill, my advanced age and limited mobility might prevent me from getting timely medical treatment, which could lead to serious consequences. It's not death that I fear, but the thought of burdening my children with the impact on their work.\"(N14).\u003c/p\u003e \u003cp\u003eTherefore, participants hope to alleviate their concerns about future complications through regular treatment.\"I feel more at ease when I take my medication; not taking it scares me because I'm afraid my blood pressure might rise without my knowing, and I worry about what would happen if I had a stroke.\"(N10).\u003c/p\u003e \u003cp\u003eMedical needs and access\u003c/p\u003e \u003cp\u003ePublic Education on Hypertension\u003c/p\u003e \u003cp\u003e The interview findings revealed that participants have an urgent need for knowledge about hypertension.\"Regarding hypertension, I'm familiar with the name of the condition, but I don't know what causes it. So, there's a need for me to understand and learn more about this aspect.\"(N1).\u003c/p\u003e \u003cp\u003eThe Need for Convenient Medical Services\u003c/p\u003e \u003cp\u003eSome participants mentioned that the process of seeing a doctor was overly complicated and troublesome.\"Due to the high volume of patients seeking medical attention, there are often long queues to see a doctor. Additionally, the process of checking out results is relatively slow, and getting test reports requires lining up again.\"(N5).\u003c/p\u003e \u003cp\u003eWith the advancement of science and technology, the evolution of online medical services has offered patients a more flexible approach to seeking healthcare\u003ca class=\"FNLink\" href=\"#Fn13\" id=\"#FNLinkFn13\"\u003e\u003c/a\u003e, compensating for the shortcomings of offline medical treatments.In this interview, several participants also voiced their approval of internet-based medical care.\"The development of the Internet as a supplement to offline medical services is also a general trend. Currently, it is not convenient for most patients to visit and register at the outstanding hospital due to their compact schedules.\"(N3).\u003c/p\u003e \u003cp\u003e Some participants also indicated a need for online medical treatment.\"Actually, I lean more towards online consultation because my work is too busy, and I don't have time to see a doctor. So, I think online consultation is very convenient.\"(N1).\u003c/p\u003e \u003cp\u003eHowever, some respondents expressed concerns about potential risks associated with online medical treatment. They are skeptical about whether the doctors have the appropriate qualifications, the accuracy of the diagnoses, the possibility of misdiagnoses or missed diagnoses, and the potential for deception.\"I think there are still many shortcomings, because the online treatment can not see the overall situation of the patient, with experience, feeling, there may be missed diagnosis, misdiagnosis, the risk is relatively large.\"(N11).\u003c/p\u003e \u003cp\u003eThe Need for High-Quality Medical Services\u003c/p\u003e \u003cp\u003eThe interview results indicate that participants tend to prefer larger hospitals for medical treatment, seeking higher quality medical assurance and more professional diagnostic and therapeutic services.\"I come from the countryside, where we don't have access to high-quality medical care. To see a doctor, we have to go to the big hospitals. That's why it's not easy for me to come for a medical visit\u0026mdash;it's just too far away.\"(N7).\u003c/p\u003e \u003cp\u003eThe Need for Regular Treatment\u003c/p\u003e \u003cp\u003eAt the same time, most participants prefer to be treated under the guidance of a consistent doctor who is familiar with their condition, in order to receive a personalized treatment plan and ongoing care.\"I now opt to see the same doctor each time, as he is familiar with my medical history. When I request a prescription, he can advise me on whether the medication is suitable for me based on his understanding of my health.\"(N12).\u003c/p\u003e \u003cp\u003eThe Need for Doctor-Patient Communication\u003c/p\u003e \u003cp\u003eThe interview results reveal that inadequate communication between doctors and patients leaves some patients with concerns, leading to their reluctance to express their discomfort.\u003c/p\u003e \u003cp\u003e\"Whenever I feel discomfort in my heart, I want to call a doctor to check it out, but by the time the doctor arrives, the issue seems to have resolved itself. I hate to trouble others and have them come all the way for nothing.\"(N9).\u003c/p\u003e \u003cp\u003eAlthough the communication between doctors and patients is not smooth, patients can understand the hard work of the medical staff and have expressed their understanding.\"Doctors are incredibly busy with many patients to see and numerous issues to handle, so I don't want to trouble them unnecessarily. However, if there is something important about my condition, they should explain it to me in detail so that I can manage it myself,.And we should also understand the difficulties of doctors.\"(N7).\u003c/p\u003e \u003cp\u003eNevertheless, patients still hope that doctors can enhance communication and alleviate their concerns.\"Because if the doctor doesn't explain things clearly to us, these questions will always linger in our minds.\"(N15).\u003c/p\u003e \u003cp\u003eSupport Systems and Resources\u003c/p\u003e \u003cp\u003eFamily Support\u003c/p\u003e \u003cp\u003eThe interview results indicate that increased communication with close ones can deepen patients' understanding of their disease and bolster their confidence in managing the condition.\"I communicate with my friends and my family. After our conversations, I realized that high blood pressure is quite common, and I don't find this condition to be particularly severe. I now have very good control over it. When difficulties arise, I think of ways to address them, and if they can't be resolved, I can at least mitigate their impact.\"(N4).\u003c/p\u003e \u003cp\u003eFurthermore, when family members are dealing with hypertension, they can collectively maintain a healthy lifestyle through mutual monitoring and support.\"For instance, my spouse and I control our diet together every day, take walks together, and supervise each other to take medication... Through these joint efforts, we don't feel uncomfortable; instead, we feel more relaxed, and our blood pressure control has become relatively stable.\"(N5).\u003c/p\u003e \u003cp\u003eHowever, some participants mentioned that the excessive care from those around them can also create pressure.\"My children are very concerned about me, often asking if I've measured my blood pressure, telling me not to get too tired and to rest. They're overly worried, saying I can't do this or that every day, which makes me feel a bit unhappy. I already have enough on my mind without my family nagging at me.\"(N6).\u003c/p\u003e \u003cp\u003ePsychosocial Support\u003c/p\u003e \u003cp\u003eThe interview results demonstrate that patients require conversation to receive emotional understanding and support when dealing with their illness.\"Having someone to communicate with makes my heart feel more comfortable.\"(N2).\u003c/p\u003e \u003cp\u003eAdditionally, some elderly participants with hypertension indicated that they have a single source of income, a substantial burden of treatment costs, and perceive social support as insufficient.\"I'm concerned that illness will affect the quality of life, and currently, there isn't an adequate support system for the elderly. For those of us who depend solely on pensions, healthcare costs are still a bit too heavy to bear.\"(N14).\u003c/p\u003e \u003cp\u003eSelf-Management and Control\u003c/p\u003e \u003cp\u003eLifestyle Changes\u003c/p\u003e \u003cp\u003eMost participants reported that they would alter their lifestyles after being diagnosed with hypertension.\"I try to sleep as early as possible now, maintain a light diet, and exercise every evening. With these lifestyle modifications, I find that my blood pressure remains within an acceptable range.\"(N4).\u003c/p\u003e \u003cp\u003eChoice of Treatment Methods\u003c/p\u003e \u003cp\u003eThe interview also revealed that during the disease treatment process, patients choose different treatment methods based on their own conditions and preferences. Some participants indicated that they would prioritize the use of Western medicine.\"I believe that Western medicine is more convenient to carry and store, and by simply taking one pill in the morning, my blood pressure can be lowered.\"(N4).\u003c/p\u003e \u003cp\u003eOther participants felt that treatment with Chinese medicine can better accommodate their physical constitution.\"I believe that Western medicine only offers a short-term solution for controlling blood pressure, and I am concerned about becoming dependent on these drugs. Since I am still young and am starting to take Western medicine now, I worry about what will happen when I am older. Therefore, I hope that by undergoing treatment with traditional Chinese medicine, which gradually adjusts the body, I might achieve better results. I think Chinese medicine could be a better option for me.\"(N1).\u003c/p\u003e \u003cp\u003eStandardized Monitoring and Treatment\u003c/p\u003e \u003cp\u003eAlthough patients are aware of the importance of regular monitoring of blood pressure and taking drugs on time, they still face a variety of obstacles.\"I have been taking my medication, but I don't monitor my blood pressure very regularly because sometimes there are just too many things going on at home, and I get so busy that I don't have time to measure it.\"(N9).\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn this study, participants generally had insufficient knowledge of hypertension, which contributed to heightened psychological stress and negative emotions such as tension and worry during the initial diagnosis.These findings are in line with those of Chen Yuling and colleagues\u003ca class=\"FNLink\" href=\"#Fn14\" id=\"#FNLinkFn14\"\u003e\u003c/a\u003e. Concurrently, this study discovered that some hypertensive patients manage to achieve blood pressure control by enhancing their lifestyle post-diagnosis. Such behavior may correlate with heightened health consciousness, increased sense of family responsibility, and the discomfort brought on by the disease. Psychological factors are increasingly recognized as playing a significant role in the etiology and management of hypertension\u003csup\u003e1\u003c/sup\u003e. Therefore, it is imperative to enhance the quality of health education, assist patients in establishing a scientific understanding of their condition, improve their quality of life, and thereby optimize disease outcomes. Considering the varying levels of patient cognition, healthcare workers should employ clear and concise language to elucidate the etiology, consequences of hypertension, and the significance of pharmacological management. They should also address misconceptions regarding the side effects of antihypertensive medications and alleviate any irrational fears associated with the disease.The study by Zhu Haixiang and colleagues\u003ca class=\"FNLink\" href=\"#Fn15\" id=\"#FNLinkFn15\"\u003e\u003c/a\u003e also identified that patients with newly diagnosed hypertension are more likely to seek treatment. This stage is a critical period for conducting hypertension education for patients and ensuring their standardized treatment, which can alleviate patient concerns, bolster treatment confidence, and improve compliance.\u003c/p\u003e \u003cp\u003eThis study found that the demand for hypertension treatment among patients is on the rise. However, the communication time between doctors and patients is limited, and adverse reactions during home medication are often difficult to detect and address promptly. The advancement of internet medical treatment has enhanced the flexibility of healthcare delivery, as this service is not constrained by time and location. Physicians can provide health education online, and patients can promptly receive professional diagnosis and advice from doctors via the internet. Nevertheless, there are potential risks associated with online healthcare, including but not limited to the practice of over-qualification, inaccurate diagnostic and treatment information, non-compliant self-treatment, inadequate management of patient information, and delays in diagnostic and treatment responses\u003ca class=\"FNLink\" href=\"#Fn16\" id=\"#FNLinkFn16\"\u003e\u003c/a\u003e.These issues have the potential to compromise the safety and efficacy of medical care. Consequently, it is imperative for patients to augment their self-protection awareness and safeguard the security of their personal information when engaging with online medical services.\u003c/p\u003e \u003cp\u003eThis study also revealed that a significant number of patients tend to opt for large hospitals when seeking treatment,This is consistent with the findings of Tong Tong Xiyang and colleagues\u003ca class=\"FNLink\" href=\"#Fn17\" id=\"#FNLinkFn17\"\u003e\u003c/a\u003e.China's health resources are distributed in an \"inverted pyramid\" pattern, with an excessive concentration of high-quality resources\u003ca class=\"FNLink\" href=\"#Fn18\" id=\"#FNLinkFn18\"\u003e\u003c/a\u003e,Patients' preference for large hospitals highlights the common issues faced by primary health institutions, such as a lack of professional expertise and skill levels, along with the aging of medical equipment and obsolescence of hardware facilities\u003ca class=\"FNLink\" href=\"#Fn19\" id=\"#FNLinkFn19\"\u003e\u003c/a\u003e.Therefore, in addition to enhancing hardware facilities, primary medical and health institutions are in urgent need of advancing the implementation of talent mobility strategies and encouraging medical staff to undergo professional training at higher-level medical institutions. Concurrently, higher-level hospitals should regularly dispatch experts to grassroots institutions to offer technical support and assistance. This approach aims to bolster the diagnostic and therapeutic capabilities of grassroots medical and health institutions,which ease the predicament of patients seeking medical treatment.\u003c/p\u003e \u003cp\u003eThis study revealed that the specialized nature and intricacy of medical knowledge create communication barriers between physicians and patients, fostering a sense of distrust among patients towards doctors, a finding that aligns with the research conducted by Wang Hao and others\u003csup\u003e9\u003c/sup\u003e.Patients typically view doctors as authoritative figures and share their experiences of pain with them. Physicians, however, often concentrate on medical details, which can result in a relatively limited response to patients' emotional needs\u003ca class=\"FNLink\" href=\"#Fn20\" id=\"#FNLinkFn20\"\u003e\u003c/a\u003e. This may cause patients to perceive a lack of empathy from doctors, thereby impacting the doctor-patient relationship negatively.Therefore, during the clinical diagnosis and treatment process, healthcare providers should be attentive to the emotional experiences of patients and strive to enhance the quality of doctor-patient communication. By embracing a \"shared decision-making\" model\u003ca class=\"FNLink\" href=\"#Fn21\" id=\"#FNLinkFn21\"\u003e\u003c/a\u003e between doctors and patients, patients are encouraged to actively engage in the decision-making process regarding their clinical diagnosis and treatment. This approach can improve patient satisfaction and alleviate tensions within the doctor-patient relationship.\u003c/p\u003e \u003cp\u003eThis study also discovered that family and social support can mitigate the negative emotions experienced by patients with hypertension, deepen their understanding of the disease, and boost their adherence to treatment regimens, echoing the findings of studies like those conducted by MULLEN M\u003ca class=\"FNLink\" href=\"#Fn22\" id=\"#FNLinkFn22\"\u003e\u003c/a\u003e.Additionally, this study revealed that the presence of co-morbidity within families significantly influences patient disease management, a finding that aligns with the research of Dai Minghui and colleagues\u003ca class=\"FNLink\" href=\"#Fn23\" id=\"#FNLinkFn23\"\u003e\u003c/a\u003e.However, the majority of patients with hypertension encounter a deficiency in family and social support throughout their treatment. The absence of familial support is primarily evident in the lack of awareness about the patient's condition among family members, a lack of empathy towards the patient's emotional ups and downs, and insufficient care for the patient. Hypertensive patients often shoulder a considerable economic burden due to the prolonged nature of the disease treatment, with this burden being particularly pronounced among elderly patients.In this study, several elderly participants indicated that their family's monthly income is quite low, making it challenging to afford the medical expenses associated with long-term treatment. They perceive the support provided by society as inadequate. Consequently, it is essential to stimulate the enthusiasm of patients' family members,recognize the pivotal role of the family within the social support framework, and encourage their involvement in the health management of patients. In parallel, society should construct a comprehensive support network and refine medical policies to alleviate the financial strain on patients.\u003c/p\u003e \u003cp\u003eThis study also discovered that despite the necessity for regular medication among patients, numerous obstacles persist, particularly for elderly patients. This finding is consistent with the outcomes reported by Lin Liyu and colleagues\u003ca class=\"FNLink\" href=\"#Fn24\" id=\"#FNLinkFn24\"\u003e\u003c/a\u003e.The medication adherence among elderly hypertensive patients is typically low,which may be related to the physiological function degradation, psychological and physiological state changes caused by aging\u003ca class=\"FNLink\" href=\"#Fn25\" id=\"#FNLinkFn25\"\u003e\u003c/a\u003e.Concurrently, elderly patients are often burdened with the responsibility of caring for their grandchildren and managing household duties. Amidst their busy daily routines, they are more prone to overlook their medication regimen. Hence, it is imperative for family members and healthcare providers to assist patients in establishing sensible daily living schedules, integrating blood pressure monitoring and medication adherence into their regular activities.Additionally, this study revealed that the selection of treatment methods for patients with hypertension is influenced by a multitude of factors, including personal perceptions of treatment, cultural background, and individual variability. Some patients prefer Traditional Chinese Medicine due to its distinct therapeutic philosophy, holistic treatment approach, synergistic adjustment with lifestyle modifications, and emphasis on long-term outcomes.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe control status and demands of patients with hypertension constitute a multifaceted issue, encompassing numerous factors. Consequently, a multifaceted approach involving policy, medical, familial, and societal support is necessary to enhance the disease's incidence and control rates, as well as to elevate the quality of life for patients. Nonetheless, this study primarily concentrates on the current state and needs of patients, which presents certain limitations. Future research could broaden the sample scope and extend the duration and breadth of the study to achieve a more holistic understanding of patients' long-term control status and needs.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eBefore recruitment, this study obtained approval from the Institutional Review Board of the authors’\u0026nbsp;hospital (Approval No. YJS2023-111).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eAll participants were informed and provided verbal consent.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Guangxi Major Science and Technology Project: Research on the Service Model and Industrial Development of Professionally Guided Health Autonomous Management (Grant No. GuiKe AA22096028).\u003c/p\u003e\n\u003cp\u003eAuthor contributions\u003c/p\u003e\n\u003cp\u003eZhong proposed the primary research objectives and was in charge of the research's conception, design, execution, and the drafting of the manuscript; Liu and Ding were responsible for data collection and organization; Zheng was tasked with the quality control and review of the manuscript, as well as the overall supervision and management of the paper.All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eWe sincerely thank all individuals who participated in this qualitative study .\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eChina Hypertension Prevention and Treatment Guide Revision Committee, Hypertension Alliance (China), China International Exchange and Promotion Association for Medical and Healthcare Hypertension Branch, Chinese Geriatrics Society Hypertension Branch, China Gerontological Health Association Hypertension Branch, Chinese Stroke Association, \u0026amp; China CDC Chronic Non-communicable Disease Prevention and Control Center. (2024). Chinese Guidelines for the Prevention and Treatment of Hypertension (2024 Revised Edition). \u003cem\u003eChinese Journal of Hypertension\u003c/em\u003e, 32(7), 603-700. https://doi.org/10.16439/j.issn.1673-7245.2024.07.002\u003c/li\u003e\n\u003cli\u003eChina Cardiovascular Disease Risk Assessment and Management Guidelines. (2019). \u003cem\u003eChinese Circulation Journal\u003c/em\u003e, 34(01), 4-28.\u003c/li\u003e\n\u003cli\u003eSchutte, A., Jafar, T., Poulter, N., et al. (2023). Addressing global disparities in blood pressure control: Perspectives of the International Society of Hypertension. \u003cem\u003eCardiovascular Research\u003c/em\u003e, 119(2), 381-409. https://doi.org/10.1093/cvr/cvac130\u003c/li\u003e\n\u003cli\u003eDossett, L., Kaji, A., \u0026amp; Cochran, A. (2021). SRQR and COREQ Reporting Guidelines for Qualitative Studies. \u003cem\u003eJAMA Surgery\u003c/em\u003e, 156(9), 875-876. https://doi.org/10.1001/jamasurg.2021.0525\u003c/li\u003e\n\u003cli\u003eYuan, R. Y., Wang, H. Y., Li, Y., et al. (2024). Qualitative study on the facilitators and barriers to medication adherence in elderly hypertensive patients from ethnic minorities. \u003cem\u003eChinese Evidence-Based Nursing\u003c/em\u003e, 10(04), 693-696.\u003c/li\u003e\n\u003cli\u003eLong, X., Jing, M. X., Wang, Y. X., et al. (2023). Qualitative study on medication non-adherence in elderly hypertensive patients under community management. \u003cem\u003eClinical Research and Practice\u003c/em\u003e , 8(33), 18-22. https://doi.org/10.19347/j.cnki.2096-1413.202333005\u003c/li\u003e\n\u003cli\u003eMiller, A., Song, N., Sivan, M., et al. (2024). 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A qualitative study on the attribution of non-adherence to medication in middle-aged and young hypertensive patients. \u003cem\u003eModern Nurse\u003c/em\u003e, 29(4), 83-85. https://doi.org/10.19793/j.cnki.1006-6411.2022.12.021\u003c/li\u003e\n\u003cli\u003eWriting Group of 2018 Chinese Guidelines for the Management of Hypertension, Chinese Hypertension League, Chinese Society of Cardiology, Chinese Medical Doctor Association Hypertension Committee, Hypertension Branch of China International Exchange and Promotive Association for Medical and Health Care, Hypertension Branch of Chinese Geriatric Medical Association. (2019). Chinese Guidelines for the Prevention and Treatment of Hypertension (2018 Revised Edition).\u003cem\u003e Chinese Journal of Cardiovascular Medicine\u003c/em\u003e, 24(1), 24-56.\u003c/li\u003e\n\u003cli\u003eLiu, Y. Q. (Ed.). (2023). \u003cem\u003eResearch Methods in Nursing\u003c/em\u003e. Wuhan University Press.\u003c/li\u003e\n\u003cli\u003eYang, L., Qi, L., \u0026amp; Zhang, B. (2022). Data saturation and its determination in qualitative research. \u003cem\u003eAdvances in Psychological Science\u003c/em\u003e, 30(3), 511-521.\u003c/li\u003e\n\u003cli\u003eBai, Y. (2023). \u003cem\u003eQualitative Interviewing: Listening and Understanding in Educational Research\u003c/em\u003e [M]. Shanghai: East China Normal University Press.\u003c/li\u003e\n\u003cli\u003eLiu, M. (2019). Application of Colaizzi\u0026apos;s seven steps in the analysis of phenomenological research data.\u003cem\u003e Journal of Nursing Science\u003c/em\u003e, 34(11), 90-92.\u003c/li\u003e\n\u003cli\u003eLi, W., \u0026amp; Feng, Y. (2018). Advances in clinical research on prehypertension. \u003cem\u003eChinese Journal of Hypertension\u003c/em\u003e, 26(6), 516-520. https://doi.org/10.16439/j.cnki.1673-7245.2018.06.008\u003c/li\u003e\n\u003cli\u003eGu, L. F., Pan, H. Q., Yang, T., et al. (2024). Development strategies for internet medical services from the perspective of patient satisfaction. \u003cem\u003eModern Hospital\u003c/em\u003e, 24(03), 431-433.\u003c/li\u003e\n\u003cli\u003eChen, Y. L., Zhu, X. H., Wang, D. D., et al. (2023). A meta-synthesis of qualitative research on the true psychological experience of pregnant women with hypertensive disorders. \u003cem\u003eJournal of Medical Information\u003c/em\u003e, 36(12), 43-48.\u003c/li\u003e\n\u003cli\u003eZhu, H. X., Ye, Z. H., Jin, J. H., et al. (2020). A survey study on knowledge and attitude of cardiac rehabilitation in patients with acute myocardial infarction. \u003cem\u003eChinese Journal of Nursing\u003c/em\u003e, 55(1), 78-83.\u003c/li\u003e\n\u003cli\u003eZhao, M., \u0026amp; Liu, J. H. (2024). Research on the prevention of new legal risks involved in China\u0026apos;s internet medical services. \u003cem\u003eMedicine and Society\u003c/em\u003e, 37(07), 115-122. https://doi.org/10.13723/j.yxysh.2024.07.017.\u003c/li\u003e\n\u003cli\u003eTong, X. Y., Li, H. Y., Su, J., Zhang, J. X., Zhao, S. C., \u0026amp; Sun, X. J. (2024). Comparison of patient trust patterns between tertiary hospitals and primary healthcare institutions: A mixed research based on interviews and survey experiments. \u003cem\u003eChinese Journal of Health Policy\u003c/em\u003e, 17(4), 38-44.\u003c/li\u003e\n\u003cli\u003eDu, X., Patel, A., Anderson, C., et al. (2019). Epidemiology of cardiovascular disease in China and opportunities for improvement: JACC International. \u003cem\u003eJournal of the American College of Cardiology\u003c/em\u003e, 73(24), 3135-3147. https://doi.org/10.1016/j.jacc.2019.04.036\u003c/li\u003e\n\u003cli\u003eYip, W., Fu, H., Chen, A., et al. (2019). 10 years of health-care reform in China: progress and gaps in Universal Health Coverage. \u003cem\u003eLancet\u003c/em\u003e, 394(10204), 1192-1204. https://doi.org/10.1016/S0140-6736(19)32136-1\u003c/li\u003e\n\u003cli\u003eWang, J. X., \u0026amp; Zhang, C. X. (2024). The impact of cultural factors on patient-doctor communication: An analysis based on the life narratives of medical staff. \u003cem\u003eJournal of Guangxi Minzu University(Philosophy and Social Science Edition)\u003c/em\u003e, 46(3), 1-8.\u003c/li\u003e\n\u003cli\u003eMo, J., \u0026amp; Liu, J. (2024). Multiple modes of doctor-patient shared decision-making from the ethical perspective. \u003cem\u003eChinese Medical Ethics\u003c/em\u003e, 37(3), 261-265.\u003c/li\u003e\n\u003cli\u003eMullen, M., Cucchiara, B., Mess\u0026eacute;, S., et al. (2023). Randomized trial of a social support intervention to improve home blood pressure monitoring in patients with cerebrovascular disease. \u003cem\u003eThe Neurologist\u003c/em\u003e, 28(6), 402-408. https://doi.org/10.1097/NRL.0000000000000507\u003c/li\u003e\n\u003cli\u003eDai, M. H., Xue, M. X., Liu, M., et al. (2024). The mediating role of family care in the relationship between health literacy and self-care ability among elderly hypertensive residents. \u003cem\u003eJiangsu Health System Management\u003c/em\u003e, 34(1), 138-142.\u003c/li\u003e\n\u003cli\u003eLin, L. Y., Xu, L. C., Zhong, Y. F., et al. (2021). The correlation analysis between frailty and medication adherence in community-dwelling elderly patients with hypertension.\u003cem\u003eGeriatrics Research\u003c/em\u003e, 2(4), 35-39.\u003c/li\u003e\n\u003cli\u003eDelavar, F., Pashaeypoor, S., \u0026amp; Negarandeh, R. (2020). The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. \u003cem\u003ePatient Education and Counseling\u003c/em\u003e, 103(2), 336-342. https://doi.org/10.1016/j.pec.2019.08.028\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Guangxi Zhuang Autonomous Region，Hypertension，Current status of disease control，Needs，Qualitative Research","lastPublishedDoi":"10.21203/rs.3.rs-5433308/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5433308/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnderstanding the current status and needs of hypertension patients in the Guangxi region to provide a reference for clinical diagnosis and treatment by medical staff.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUsing purposeful sampling, 16 hypertension patients treated at a Class III Grade A integrated traditional Chinese and Western medicine hospital in Nanning City, Guangxi Zhuang Autonomous Region from March to July 2024 were selected as research subjects and semi-structured interviews were conducted. Data was analyzed using Colaizzi's 7-step analysis method in phenomenological research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe control status and needs of hypertension patients in the Guangxi region can be summarized into four themes：Psychological and social adaptation ( disease understanding and acceptance, treatment expectations and concerns, future planning and uncertainty ) ; medical needs and access ( hypertension-related knowledge of popular science, convenient medical needs, high-quality medical services needs, regular treatment needs, doctor-patient communication needs ) ; support system and resources ( family support, psycho-social support ) ; self-management and control ( lifestyle changes, treatment options, standardized monitoring and treatment ).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion \u003c/strong\u003eSociety should pay attention to the control status and needs of hypertension patients, provide support to patients from multiple aspects and dimensions, reduce the incidence of adverse events, and improve the quality of life for patients.\u003c/p\u003e","manuscriptTitle":"A Qualitative Research on the Control Status and Needs of Hypertension Patients in Guangxi Region","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-03 04:57:38","doi":"10.21203/rs.3.rs-5433308/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c853ce9a-52f4-4af7-8303-9c00bfab96bd","owner":[],"postedDate":"December 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-12T11:25:12+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-03 04:57:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5433308","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5433308","identity":"rs-5433308","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}