title: Self-care production experiences in elderly African Americans with hypertension and cognitive difficulty.
abstract: OBJECTIVE
  The purpose of this qualitative descriptive study was to explore self-care production experiences in older African Americans who, despite some cognitive dysfunction, were able to produce hypertension-related self-care behaviors or blood pressure control successfully.
  
  
  METHODS
  Participants were 10 urban, community-dwelling older African Americans, 60-89 years of age, living in a Midwest region of the United States. A semi-structured interview was conducted in participants homes' using Kvale's "conversational discourse" approach. Oral recordings were transcribed and analyzed for themes and codes.
  
  
  CONCLUSIONS
  Elders' experiences with the production of self-care were characterized by three themes: preparation, monitoring, and evaluation. Self-care production was found to be cognitively challenging consistent with the finding that 60% of the participants had difficulty with a cognitive task requiring complex cognitive skills. This finding may explain why the production of self-care became a social phenomenon in which elders demonstrated resourcefulness in seeking assistance from surrounding support systems.
  
  
  CONCLUSIONS
  Nurse practitioners can support better health outcomes in older adults with hypertension by using valid and reliable measures for assessing complex cognitive skills, assessing individuals' progress in self-care production, and identifying individuals' use of social and professional supports to produce self-care.
authors.affiliation: College of Nursing, Wayne State University, Detroit, MI 48202, USA. k.klymko@wayne.edu
authors.forename: Kay W
authors.initials: KW
authors.lastname: Klymko
authors.forename: Nancy T
authors.initials: NT
authors.lastname: Artinian
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Price
authors.forename: Carrie
authors.initials: C
authors.lastname: Abele
authors.forename: Olivia G M
authors.initials: OG
authors.lastname: Washington
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders; D005260:Female; D006801:Humans; D006973:Hypertension / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D009722:Nurse Practitioners; D010349:Patient Compliance / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D012944:Social Support