Conceptual Refinement and Empirical Mapping of Self-Management in Patients with Hypertension: A Concept Analysis

Aim: To refine and operationalize the concept of self-management in patients with hypertension by distinguishing its defining attributes from antecedents, consequences, strategies, and related constructs such as self-care, self-regulation, and self-efficacy. The analysis specifically addresses persistent conceptual overlap in the hypertension literature and extends prior concept analyses by providing an attribute-to-indicator empirical mapping. Design: A concept analysis was conducted using Walker and Avant’s eight-step framework, which provided a structured approach to defining and refining the meaning of self-management in the context of hypertension. Data Sources: A comprehensive literature search was conducted in PubMed, CINAHL, the Cochrane Library, and Web of Science for studies published from 2011 to 2025. All references were organized and screened in Zotero. Thirteen empirical and theoretical studies that met the inclusion criteria were analyzed. Review Methods: Thematic coding was used to extract candidate antecedents, defining attributes, consequences, and empirical referents. Walker and Avant’s framework guided concept selection, clarification of uses, case construction, identification of antecedents and consequences, and specification of empirical referents. Extracted items were compared across studies to determine whether each item was a precondition, a core attribute, an outcome, a supporting strategy, or a measurement indicator. Results: Self-management of hypertension was refined as an ongoing, patient-led, and context-sensitive process with five defining attributes: self-monitoring and interpretation of blood pressure-related information; self-regulation and adaptive problem-solving; intentional implementation of treatment and lifestyle actions; collaborative engagement with health professionals and supportive others; and integration of hypertension management into daily life. Antecedents include health literacy, motivation, self-efficacy, functional capacity, social support, access to care, and availability of monitoring resources. Consequences include improved adherence, better blood pressure control, fewer complications, empowerment, reduced avoidable use of services, and improved quality of life. Conclusion: The analysis clarifies that self-management is broader than adherence to self-care and more observable than self-efficacy alone. The proposed definition and empirical mapping support nursing assessment, patient education, intervention design, and measurement selection. Impact: The analysis provides a practical conceptual framework that nurses can use to assess self-management capacity, identify barriers, select appropriate measurement indicators, and design culturally responsive interventions to support hypertension management.