Understanding the Psychosocial Factors Affecting Hypertension Management in Vulnerable Populations

Abstract

This study conducted, was cross-sectional and carried out using a mixed approach to explore psychosocial determinants associated with the treatment of hypertension among vulnerable individuals in Uzbekistan. From March to August 2025, 320 patients suffering from hypertension with at least one year since the disease onset were randomly sampled from six health care facilities in urban and rural settings in Tashkent and Fergana provinces. The research employed several instruments including the Cohen Perceived Stress Questionnaire, Patient Health Depression Questionnaire, Perceived Social Support Scale, Adult Health Literacy Questionnaire, and the Morisky Medication Adherence Scale. Out of the sampled patients, thirty were randomly picked based on maximum diversity for semi-structured interviews while analyzing qualitative data using Brown & Clark’s six steps of content analysis. It was observed that 65.9% of patients experienced blood pressure out of control, even though they were under medication. In a multivariate logistic regression, high stress level (OR=1.92), low social support (OR=1.69), poor adherence to medicine (OR=2.64), and low income level (OR=1.74) were found to be the independent predictors for poor control of blood pressure. From the qualitative data analysis, the following five themes emerged: economic strain, emotional exhaustion, breakdown in support networks, mistrust toward health care system, and fatalistic culture. About 80% of participants attributed financial burden of buying medication as the major barrier and 63% reported lack of family support.