Hypertension Case Study

According to Cappuccio (1997) among the British Afro-Caribbean population, high blood pressure tends to develop much early in life and usually is more severe. Furthermore, National Institute for Health and Care Excellence (NICE) (2011) state that some medications tend to be less effective when it comes to treating hypertension in British Afro-Caribbean community. In addition, Mochari-Greenberger and Mosca (2014) claim that the racial differences in hypertension and disease outcomes linked with hypertension are associated with morbidity and mortality risks when compared with the Caucasian community. Researches have highlighted that people of African descent or British Afro-Caribbean are at twice the high risk of suffering from hypertension and the related cardiovascular diseases (Mochari-Greenberger and Mosca, 2014). According to Connell, Wolfe and McKevitt (2007) the risks of a stroke associated with hypertension are two times greater for British Afro-Caribbean than British Caucasian population especially men.

Furthermore, hypertension is linked with significant rates of disease morbidity and mortality (Coward, 2003). Some of these issues can be minimised with effective control of blood pressure and can be prevented through serious awareness as suggested by (Everett and Zajacova, 2015. Therefore, hypertension management by the Afro-Caribbean males should enable them to recognise the various response to drug treatment, the cardiovascular consequences and predisposing factors of hypertension (Everett and Zajacova, 2015). In the UK hypertension is the third biggest health risk. High blood pressure is responsible for many deaths in the UK. It is much easier to use qualitative methods in research because, it uses elements such as pictures, words, and objects to analyse data (Wright,2015). Quantitative analysis on the other hand uses numerical data to analyse data, something that is technical and time-consuming (Bowen and Wiersema 1999).

Interviews will involve having one-on-one conversations with the participants in the selected ward. The participants will be approached with a set of question and explained them beforehand (Appendix 5). This method of interviewing participants and will help obtain adequate information regarding the chosen topic as suggested by (Parahoo, 2014)). , 2012) Case studies and research articles were sampled theoretically for literature review since they were considered appropriate for illuminating and expanding relationships as well as logic among various constructs (Wright et al 2015). Furthermore, the author identified hospitals that have maintained high populations of British Afro-Caribbean patients throughout the years. This is important because it allows the research to focus on a community that has experienced hypertension and to inform better management and treatment procedures (Everett and Zajacova, 2015) Search Limitations when getting data for literature Difficulties encountered while searching for the titles of the case studies that have been listed in the databases (Bowen and Wiersema 1999).

As well there might be difficulties going through the abstracts as well as the index terms that will be used when describing their contents Bowen and (Bowen and Wiersema 1999). One of the most significant components of any search for articles has been through the use of specific words to locate the title of the publications found in the databases (Bowen and Wiersema 1999). These restrictions include date, full text, material , language, and peer reviewed articles. Therefore, a maximum of six articles were examined dating from 2012 to 2017. The author only focused on most relevant articles to the goal of the project and most recent publisher. However, Cronin (2008) suggest that using several limitations could narrow the search target a lot so, applying filters as a substitute is recommended.

However, the author notice that Google Scholars is extensive but not all-inclusive and citation found be problematic to apply and erroneous. This study required an extremely sensitive search and the search strategy employed was adequate to help locate any potentially relevant research article (Raleigh 1997). Search process Keywords need to be selected carefully to pick footings that will produce the information needed (Cronin, 2008). According to Jones (2011), picking keywords could be an easy procedure nevertheless, it is contended by Beck and Polit(2006) similar words can differ in meaning thus; it is suggested to reflect other keywords that have alike meanings and could produce more data. The authors considered making use of unique words that are rarely used Cronin (2008), it is important reasoning wisely about the keywords you pick to direct your thoughts including using unique words.

Applicable articles to hypertension in British men with Afro-caribbean heritage were selected through the university’s comprehensive source of data for nurses. LITERATURE REVIEW Some of the research articles were carried outside the UK. Population composition of 1–2% of the United Kingdom total population, were found in major cities, especially London and Birmingham. In this segment, the author concentrates on Hypertension in British men with afro-Caribbean heritage. Article one is a study conducted by Lane, Beevers, and Lip in 2002 sought to study the occurrence of hypertension and the mean blood pressures in people with an Afro-Caribbean and South Asian origin in England. The authors used quantitative research methods to collect data from a group of participants. The central theme of this article is that hypertension prevalence varies across various ethnic groups with Afro-Caribbean recording the highest rate.

Second article, Agyemang and Bhopal (2003) sought to analyse published evidence regarding blood pressure levels and hypertension incidence in the adult populations of African origin who are living in the UK when compared to the Caucasian population. The authors conducted a systematic literature review and identified 14 studies that have been conducted in the London region. Systematic review summarises the already established studies and provides evidence for the advantages of the proposed intervention (Nielsen, 2011). The findings of the study revealed significant disparities between the studies based on the sex and age of the participants, how Africans are defined, and the methods used in assessing blood pressure. This article was particularly interesting because the findings of higher blood pressure levels as well as the higher prevalence of hypertension in people of the African origin is clear-cut in the adult populations but not in the younger communities.

The dominant article theme is that hypertension prevalence is high in the old compared to the young community. Third article, Victor et al. (2011) studied whether the continuous monitoring of hypertension, as well as the referral programs performed by barbers, encourages male patrons with elevated high blood pressure to pursue physician follow-up, resulting in enhanced control of hypertension. The study was a randomised cluster trial of high blood pressure control carried in a selected group of British Afro-Caribbean male patrons from 17 barbershops owned by British Afro-Caribbean. The central theme of the article is that high blood pressure prevalence is high among individuals from low socioeconomic background (Victor et al. Fourth article, in a commentary by Lane and Lip (2001), it seems that ethnicity is essential when it comes to the managing and controlling hypertension.

The authors claim that most previous studies have reported a higher incidence of high blood pressure among the Afro-Caribbean and South Asian men than their Caucasian counterparts. The authors also state that hypertension prevalence increases with increasing age. They cite a Health Survey conducted in England which revealed that the hypertension occurrence was 27. The participants were people who had never undergone any pharmacological treatment for their elevated blood pressure and were not on treatment during the study. Also, both the Afro-Caribbean and Caucasian subjects were matched for clinic blood pressure and age. The findings of this study revealed that, during the 24-hour normal daily life, Afro-Caribbean hypertensive individuals were not characterised by an elevated sympathetic activity directly to the heart when compared to Caucasian hypertensive individuals (Guzzetti et al.

Hence, other mechanisms, possibly linked to peripheral vascular resistance, could best describe the higher incidence of high blood pressure in Afro-Caribbean people. The aurthor of this article suggest that some other factor, typically involved in the complex pathogenesis of high blood pressure, plays a more vital role in the high blood pressure of Afro-Caribbean people (Guzzetti et al. Discussion Smoking and alcohol do not present any significant impact on the prevalence of hypertension (Gillum, 1999). Lane, Beevers, and Lip (2002) demonstrate that older Caucasian men consumed fewer alcohol units per week than men from other ethnic groups. This shows that Afro-Caribbean men consumed less alcohol and thus it becomes easy to conclude that alcohol does not play a significant contributory role in the development of hypertension.

Lane, Beevers, and Lip (2002) also show that there is no significant difference in the body mass index of men from the three ethnic groups involved in the study. Agyemang and Bhopal (2003) however present contradicting evidence when they report about the lower body mass index of men with an African origin when compared to Caucasian men. This seems to be inconsistent with the findings of other studies where smoking has been linked to hypertension. The nature of the study by Lane, Beevers, and Lip (2002) may have several limitations that may have affected it. Thus, it becomes difficult to compare the findings of that study with the one that will be collected in the present study. In the survey conducted by Lane, Beevers, and Lip (2002) it appears that data was gathered over an extended period.

Agyemang and Bhopal (2003) also back up this argument by stating that the studies span for nearly 20 years. It is also worth noting that these studies have most Afro-Caribbean people living in the United Kingdom are of mixed race or have some Caucusion ancestry, something that may potentially complicate the interpretation of the collected data in the present study. The studies also indicate that hypertension is significantly higher in older people of 35 years and above. This is evident in the survey by Lane, Beevers, and Lip (2002) where age seems to be a determining factor in the development of hypertension. Even though hypertension is more prevalent in younger men since they are predisposed to the modifiable risk factors such as smoking and alcoholism, it appears that older people are also prone to hypertension due to low awareness and poor control and management of the condition.

Agyemang and Bhopal (2003) on the other hand shows that high blood pressure is significantly higher in individuals who consume alcohol and in those whose cholesterol levels seem high. Volounteers will be assigned to drop leaflets in areas of worship such as churches and mosques (Chockalingam 2008). They will be educated on the dangers of hypertension and to encourage them to go for early screening to detect hypertension (Baral-Grant et al. This will help reduce the prevalence of hypertension in this target group (Chockalingam 2008). Alternatively, there will be a selection of clinical health outcomes in event-based blood pressure outcomes in quality improvement tests that are individually meant for the British Afro-Carribean male population (Ibrahim and Damasceno 2012). Community-based interventions will serve the significant purpose of minimising the public health burden of hypertension as well as the related disparities (Cappuccio, 1997).

Implementing Change Using Lewin's Change Management Model Kurt Lewin in1940s formulated the Lewin's Change management model aimed at initiating change in organisations (Cummings et al 2016). In 1940 Lewin developed three stages organisations could employ to start a change in their settings namely Unfreeze, Change and Refreeze. He best demonstrates the three stages using an illustration of changing the shape of a block of ice to cone-shaped. Organisations borrow this illustration in planning and preparing to initiate the recommended change. Health organisations benefit from this model since it prepares them for what to expect during transition avoiding cases of going into change blindly. The community needs to be motivated to embrace change, without motivation it would be difficult for them to participate in the screening exercise (Cummings et al 2016) In introducing the change of screening for hypertension, public health nurses are advised to use vision and strategy as supporting evidence why the public need to embrace the practice (Cummings et al 2016).

In this case, the community can be educated on the significance of conducting screening for hypertension in their health and the vision of a hypertension free community through early screening and treatment. Public health nurses initiating the change also need to know how to manage and understand the concerns and doubts that might arise when introducing the practice to the community (Cummings et al, 2016). During the change process, it is recommended that public health nurses should often communicate why they are introducing the practice and its benefit to the health of the community (Cummings et al 2016). The community needs to be educated on benefits considering early screening for hypertension and how the exercise will influence their health. Extensive research on possible interventions needs to be conducted to come up with more effective strategies for minimizing high blood pressure (Bradby, 2005).

Basing on the above project hypertension is a major problem in the UK (Al-Haddad, Serina, & Kotnour, 2015). Proper interventions are required to reduce the high prevalence of hypertension particularly on Afro-Caribbean population. Also, public awareness and education on prevention against hypertension needs to be adopted. The public needs to be aware on the health complications that accompanies hypertension and how they can adopt the recommended healthy lifestyle and avoid health risky behaviours. and Lune, H. Qualitative research methods for the social sciences (Vol. Boston, MA: Pearson. Cummings, S. , Bridgman, T. , Shahi, M. , Mezzetti, S. , Foale, R. A. , Sever, P. G. and Lip, G. Y. H. Ethnic differences in blood pressure and the prevalence of hypertension in England. Is the blood pressure of people from African origin adults in the UK higher or lower than that in European origin white people? A review of cross-sectional data.

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