Gender-related determinants of hypertension self-care behaviours in primary care: Perspectives of patients and healthcare professionals.

OBJECTIVE

To identify and analyse determinants of hypertension self-care from a gender perspective, integrating the experiences of patients and primary care professionals.

DESIGN

Descriptive qualitative study using focus groups and Giorgi's phenomenological approach.

SETTING

Public primary care centre in Barcelona, Spain.

PARTICIPANTS

Twenty-four participants distributed across four focus groups: 12 patients with hypertension (6 women, 6 men) and 12 professionals (10 women, 2 men; 8 nurses, 4 physicians), recruited through purposive sampling.

METHODS

Sessions lasting 60-80min followed a semi-structured guide addressing knowledge, beliefs, diet, physical activity, self-monitoring, adherence, stress, social support, roles and gender influences. They were transcribed verbatim and analysed by three researchers using Giorgi's descriptive phenomenological method, with iterative consensus. Factors were subsequently categorised according to the PRECEDE model.

RESULTS

Determinants common to both genders and determinants with gender-differentiated expression were identified. The belief that medication alone is sufficient acted as a cross-cutting determinant. Predominantly female determinants included caregiving-related guilt, subordination of self-care, time poverty, schedule incompatibility, asymmetry of intrafamilial support and family food management shaped by gender roles. Predominantly male determinants included low risk perception, symptom-guided help-seeking, reliance on partners for dietary management and triggers in masculinised social contexts. Professionals reported limited specific training and low confidence in applying a gender perspective.

CONCLUSIONS

The identified determinants support the relevance of gender-sensitive educational interventions in hypertension care. Professional training in applying a gender perspective represents a priority for continuing professional development in primary care.