Hypertension among the uninsured: Tensions and challenges

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Purpose:To explore the experience of living with hypertension (HTN) in uninsured Southern, Appalachian adults who receive care in a nurse practitioner-run clinic.Data sources:Focus groups with 16 clients.Conclusions:Living with hypertension encompassed living with many tensions and challenges. It was described by five organizing themes, each of which involved two basic themes held in tension. The organizing themes were: (a) centrality of HTN; (b) controllability of HTN; (c) visibility of HTN, (d) accessibility and quality of health care; and (e) existential reality.Implications for practice:Interventions are needed to help clients deal with the tensions and challenges; these include a greater focus on partnering with clients, individual and group educational activities, and developing community partnerships.

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