Minimizing and/or Avoiding Disease Progression Risk in Patients With the Three Highs: A Grounded Theory Study

Hypertension, diabetes, and dyslipidemia, collectively referred to as the "three highs," pose a growing global health threat and have a significant impact on individuals' well-being. However, research addressing the primary concerns of patients managing all three diseases simultaneously is limited. In this study, we utilized classic grounded theory to identify the primary concerns of patients with hypertension, diabetes, and dyslipidemia, as well as to explore how these patients address their concerns. First, we employed purposive sampling and conducted open coding on the collected data until the core category emerged. To refine the core category, we then used theoretical sampling and carried out selective coding on the data until the core category achieved saturation. Subsequently, we performed theoretical coding on the data until the theory began to emerge and achieved saturation. Finally, we conducted a literature review and manually sorted the data to refine and ultimately complete the construction of the theory. Data collection and analysis were carried out simultaneously with each other. In the two-stage sampling, 3 participants from a community and 17 from the People's Hospital of Huaxian County, Henan Province, were selected. Semi-structured interviews were conducted between January and February 2024. Our findings indicate that patients with the three highs are primarily concerned about the risk of disease progression. They address these concerns through their perceptions, assessments, decision-making, control measures, and evaluations of those controls. These findings offer a theoretical framework for understanding patients with the three highs and for assisting them in effectively managing their diseases.