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Facilitators and barriers to optimal home blood pressure management in patients with hypertensive disorders of pregnancy in a tertiary care facility in Abuja, Nigeria: a qualitative research study.

التفاصيل البيبلوغرافية
العنوان: Facilitators and barriers to optimal home blood pressure management in patients with hypertensive disorders of pregnancy in a tertiary care facility in Abuja, Nigeria: a qualitative research study.
المؤلفون: Mahmoud Z; Washington University, 660 S Euclid Ave, Campus, Box 6068, St Louis, MO, 63110, USA. zmahmoud@wustl.edu., Orji AA; Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria., Okoye CF; Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria., Ameh FO; Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria., Jamro-Comer E; Washington University, 660 S Euclid Ave, Campus, Box 6068, St Louis, MO, 63110, USA., Isah A; Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria., Ekele B; Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria., Akaba G; Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria., Ojji DB; Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria., Huffman MD; Washington University, 660 S Euclid Ave, Campus, Box 6068, St Louis, MO, 63110, USA.; The George Institute for Global Health, Sydney, Australia.
المصدر: BMC health services research [BMC Health Serv Res] 2023 Sep 06; Vol. 23 (1), pp. 954. Date of Electronic Publication: 2023 Sep 06.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Hypertension, Pregnancy-Induced*/therapy, Pregnancy ; Humans ; Female ; Male ; Blood Pressure ; Nigeria ; Tertiary Healthcare ; Qualitative Research ; Hospitals, Teaching
مستخلص: Background: Nigeria has one of the highest burdens of maternal deaths globally, and hypertensive disorders of pregnancy (HDP) are the leading cause of maternal morbidity and mortality in the country. There is a significant implementation gap in utilizing evidence-based practices for the management of HDP in Nigeria. This study evaluated facilitators and barriers to implementing a home blood pressure monitoring program to improve management of HDP.
Methods: From August 2022 to September 2022, we conducted 15 semi-structured, key informant interviews and 4 focus group discussions among patients, health care workers, and administrators at University of Abuja Teaching Hospital (UATH), a tertiary care centre in Nigeria. The study used the Consolidated Framework for Implementation Research to assess five domains: individual characteristics, inner and outer settings, intervention characteristics, and process of implementation. Audio files were transcribed, and data were analysed using a combination of inductive and deductive approaches. We also conducted 32 brief surveys on the participants to assess acceptability, appropriateness, and feasibility of a blood pressure monitoring program.
Results: The study sample consisted of healthcare workers (n=22) including specialists in cardiology, obstetrics and gynaecology, maternal-foetal medicine, nurses/midwives and resident doctors as well as patients (n=10). Mean (SD) age was 39.5 (10.9), and 78% were female. Participants identified facilitators including the perceived simplicity of home blood pressure monitoring program, high burden of HDP, and availability of a multi-disciplinary team of healthcare professionals with expertise in HDP management. Barriers identified were cost, limited knowledge of HDP amongst patients, limited transportation networks, inconsistent management protocols, and inadequate manpower and facilities. Survey results indicated that between 81% and 88% of participants reported that a blood pressure monitoring program would be acceptable, 56%-72% reported that it would be appropriate, and 47%-69% reported that it would be feasible.
Conclusion: This study identified facilitators and barriers while highlighting key implementation strategies to leverage and effectively address these respectively to enable successful implementation of a home blood pressure monitoring program. It also demonstrated that a home blood pressure monitoring program was considered acceptable, appropriate and feasible among respondents interviewed at UATH.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
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فهرسة مساهمة: Keywords: Barriers; Facilitators; Home blood pressure monitoring program; Hypertensive disorders of pregnancy; Pregnancy
تواريخ الأحداث: Date Created: 20230906 Date Completed: 20230908 Latest Revision: 20230922
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10481544
DOI: 10.1186/s12913-023-09976-6
PMID: 37674174
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-6963
DOI:10.1186/s12913-023-09976-6