Perceived Influencers of Self-management among Chinese Older Adults at Risk for Stroke: A qualitative study
Keywords:
Chinese older adults, High risk stroke, Self-management, Qualitative studyAbstract
Background: Similar to other part of the world, Stroke is a major global health issue in China due to rapid population ageing and the increasing prevalence of non-communicable diseases. Effective self-management is considered as essential for stroke prevention among high-risk older adults. However, evidence on the barriers and facilitators influencing self-management of Chinese older adults to prevent stroke were limited. Objective: This qualitative study aimed to explore multilevel perceived barriers and facilitators of self-management among Chinese community-dwelling older adults at risk of stroke. Methods: Purposive sampling was employed to select participants from a community health center in Xinxiang City. Data saturation was reached with a final number of 18 older adults at high-risk for Stroke, 8 family caregivers, and 11 health care professionals. Data were collected by a researcher using a semi-structured interview and a focus group guideline. Themes and sub-themes were extracted by using Braun and Clarke’s six-phase thematic analysis. Results: Three interconnected perceived influencers of stroke prevention self-management were identified across individual, family, and community-level factors. Individual barriers included limited health literacy, complex risk management, functional decline, financial constraints, and fatalistic beliefs; while self-efficacy and supportive environments facilitated self-management engagement. Family barriers involved fragmented caregiving roles and caregiver burden, whereas family support enhanced self-management. Community barriers included fragmented health services, limited accessibility, and heavy workloads; while integrated care, peer support, and tailored health education promoted self-management engagement. Conclusion: Strengthening multilevel strategies, professional competency, and integrated community health service can enhance sustainable self-management to prevent stroke among high-risk Chinese older adults for strengthening primary stroke prevention within community-based primary health care (CB-PHC) systems.
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