Unintended consequences of follow-up care : patient experiences with hypertension management in Chinese community nursing

Abstract

Purpose: Community follow-up care is essential for managing hypertension, with Chinese community nurses playing a pivotal role in sustaining long-term management. However, little research has examined how rigid or inappropriate care approaches may inadvertently cause patient discomfort. This study addresses this gap by exploring the unintended consequences of follow-up practices among community nurses caring for hypertensive patients in China. Design: A qualitative descriptive study. Methods: Semi-structured interviews were conducted with 23 hypertensive patients in Shenzhen between June and August 2024. Data were analyzed using iterative thematic analysis. Findings: Three themes emerged. First, standardized follow-up protocols often clashed with patients’ individual needs, leading to frustration with the rigid, one-size-fits-all approach. Second, patients experienced emotional distress, feeling alienated by impersonal, task-oriented nurse communication. Third, health education communication breakdowns were prevalent, with patients finding vague lifestyle recommendations impractical and difficult to apply. Conclusions: This study uncovers overlooked complexities in follow-up interactions, critiques the rigidity of current protocols, and challenges the predominantly positive perception of standardized follow-up care. Clinical Evidence: Findings underscore the need for training programs to equip community nurses with patient-centered care skills, emphasizing effective communication and personalized health education to improve patient engagement and clinical outcomes in hypertension management. Graphical abstract: [Figure not available: see fulltext.]