Perspectives of Ghanaian pregnant women on family involvement in home blood pressure Monitoring: A qualitative analysis

Objectives: (1) To explore pregnant Ghanaian women's perspectives on family involvement in their home blood pressure monitoring (HBPM); (2) to define forms of family involvement in pregnant women's HBPM; and (3) to understand how family involvement influences HBPM for pregnant women in this setting. Study Design. This phenomenological qualitative study was conducted at a tertiary hospital in urban Ghana. Participants were adult pregnant women participating in HBPM. Enrolled participants received audiovisual and hands-on HBPM training and completed daily BP monitoring for 2–4 weeks. Main Outcome measures. Semi-structured interviews assessed participant perspectives on family involvement with their HBPM. Interviews were audio-recorded, translated, transcribed, coded, and thematically analyzed. Results: Thirty-three participants completed in-depth interviews. Participants had a mean age of 31.2 ± 5.2 years, 30.3 % had not previously given birth, and 39.4 % had less than a senior high school education. Overall, participants felt their family's involvement made HBPM easier and a more positive experience. There were three forms of family involvement: 1) approval, 2) assistance, and 3) participation. All family members approved of HBPM. Assistance and participation were associated with the most positive perceptions. Participants referenced family togetherness, enjoyment of HBPM, and decreased stress as outcomes. Negative aspects of family involvement were disruptions from children and participants’ preference to monitor alone, were experienced rarely, and were able to be overcome. Conclusions: Among pregnant women in urban Ghana, family involvement in HBPM was perceived as helpful and enjoyable, resulted in psychosocial benefits, and may help overcome barriers to HBPM in low- and middle-income countries. Abbreviations: BP, blood pressure; HBPM, home blood pressure monitoring; HDP, hypertensive disorders of pregnancy; LMID, low- and middle-income countries; KBTH, Korle Bu Teaching Hospital; OBGYN, Obstetrics and Gynaecology; ANC, antenatal care.