Barriers to Health Self-Management Among Older People with Hypertension and Diabetes in Institutions in China: A Phenomenological Study

The convergence of hypertension and diabetes in the elderly has become a pivotal health concern. The ability to self-manage the conditions such as taking medications and adhere to health lifestyle is extremely important. However, many older persons encounter barriers to health self-management which subsequently lead to various serious health related complications.   Understanding the barriers to health self-management is pivotal in preventing complications, developing appropriate educational materials and prioritizing interventions that empower individuals to care for themselves better. The objective of this qualitative study is to explore the barriers to self-management among older people with hypertension and diabetes in institutional settings from the perspectives of both patients and health professionals in China. This research aims to address the lack of attention to this vulnerable group and pinpoint areas needing improvement in health self-management education to promote better health outcomes. A qualitative phenomenological study employing semi-structured face-to-face interviews was conducted, involving eight older persons (OP) and ten health professionals (HP). Participants were recruited through purposive sampling to share their experiences regarding barriers to health-self-management.  The study was conducted in Xinyu City, Jiangxi Province, China. Data collection continued until data saturation was achieved. All interviews were audio-recorded, transcribed verbatim, and analyzed using NVivo software through thematic analysis. Thematic analysis revealed two main themes affecting health self-management among older person dealing with hypertension and diabetes in institutions: 1) individual-related factors and 2) limited social support. Major barriers to health self-management are low health literacy, cognitive challenges, limited mobility, resistance to change, limited resource access, inadequate health education, and economic constraints. This study provides insight to the barriers affecting health self-management among older person grappling with hypertension and diabetes in institutional settings. Tailored interventions considering these multifaceted barriers can positively impact the quality of life and health outcomes for older individuals dealing with hypertension and diabetes in institutional settings. As a qualitative study, potential selection bias might exist. The study was conducted in a city with a middle-level economy in central China, potentially limiting its representation in varying geographic and socioeconomic contexts. Besides, the study did not explore old persons’ socioeconomic status and educational backgrounds