Data analysis revealed five themes describing participants’ perspectives of how they used their spirituality to adhere to their antihypertensive medications:
- The Lord Helps Those Who Help Themselves.
- Staying in the Lord for Guidance.
- God Is My Rock.
- Guardian Angels and Saints.
- Brings Me Peace, Ease of Burdens, and Ability to Cope.
The Lord Helps Those Who Help Themselves. This theme described participants’ belief that a person should be held accountable for his or her blood pressure control. Statements such as “You have to take your medications if you want to live” and “It’s important to take your medications to maintain a normal blood pressure” confirmed that participants understood the health implications of medication adherence. Participants explained that if they put some effort into managing their blood pressure, then God would take care of them. They often stated, “The Lord helps those who help themselves” and “If you do your part, then God will do His.” A 63-year-old participant stated:
When it comes to taking care of my high blood pressure, I recognize that I have to do my part. God is there to help you but you need to put in the effort. There is no magic cure. You have to take your medicines and trust that God will take care of you.
Another quote by a 74-year-old participant highlighted this theme:
I do believe that God sends help to us in all forms. Sometimes He helps us directly. The direct help are in the miracles we see every day. Most times, though, the help is indirect. He expects you to make some sort of effort in solving your problems. The medication is His opportunity for me to control my blood pressure. I need to do my part, seize the opportunity, and take the medicine.
Staying in the Lord for Guidance. This theme described participants’ spiritual practices. These practices included praying and reading Bible scriptures and were considered to be important for medication adherence guidance. One participant stated, “You got to stay in the Lord by reading His word and praying.” Praying for guidance was described by a 69-year-old participant in the following quote:
Praying is important to maintain your relationship with God but it’s also important to help guide you. One of the things I do daily is to pray for guidance to keep me on the path to taking care of my blood pressure. When I’m done praying, I feel guided to do what I need to, such as take my medication, even though I may have to deal with some stressful family situations. I know some people may not understand it but this is what works for me.
A 65-year-old participant stated:
You need to be directed by the Lord through prayer. You need to pray and ask for guidance. You need that direction from our Father above. I live by that. It’s how I define my spirituality.
Participants also described that the Bible provided a framework for managing their hypertension. They made statements such as “The Bible can tell you how to take care of your health,” “There are guidelines and principles of living in the Bible,” and “There are a whole lot of Bible scriptures pertaining to health.” One 72-year-old participant said, “The Bible is God’s word. It says that my body is the temple of the Holy Spirit. And that means that I am not supposed to do anything that is going to cause it harm. Not taking my medicine is causing it harm.”
God Is My Rock. Many participants reflected that they had to contend with obstacles to their medication adherence and often used the phrase “God is my rock” in reference to managing those obstacles. “Dealing with family issues” and “financial burdens” were frequently mentioned as barriers to medication adherence. One participant stated, “Sometimes I can’t do it, but He can do it for me.” An 82-year-old participant stated:
When you are done dealing with all of your family issues, the last thing you want to do is take your medicines. You just feel so weak but you have to remember that the Lord is your rock and fortress. You have to remember to lean on Him because He’s there for you when you are feeling weak.
Another participant, age 75, stated:
I can’t do this without God. I’ve had high blood pressure for years and I take my medications but I ask God to give me the strength for that because it ain’t easy. In Philippians it says, I can do all things through Christ who strengthens me. He’s my rock!
A 59-year-old participant described this theme by singing the lyrics to one of her favorite religious songs:
“On Christ the solid rock I stand and all other ground is sinking sand”…. There is no way that I could have the strength to continue taking my medications everyday without God the rock.
Guardian Angels and Saints. Many participants believed that God provided support networks. They described these support networks as “guardian angels” or “saints.” For some participants, guardian angels were their health care providers. A 66-year-old participant stated, “God sends guardian angels. I believe in guardian angels. He put the doctors and the nurses here for a reason; they are here to help you. They are my guardian angels.”
For other participants, supportive family members were described as guardian angels. One 69-year-old participant explained how her daughter was helpful in ensuring that she remained adherent to her antihypertensive medication:
I do believe my daughter is an angel sent to me by God. She calls me every day when I get home from the center. It makes me feel good to know that there is someone who is looking out for me. She gives me the encouragement to take care of my health and continue taking my medication as I am supposed to do. She is my angel from Heaven.
Participants also reflected on their fellowship with other church members. They described other church members as “saints” and shared that when they connected with others who had hypertension, they were able to share both good and bad experiences. Most participants found comfort in sharing these experiences. One 77-year-old participant said:
Most of us have high blood pressure where I go to church. We help each other out. We talk about what medications our doctors prescribed. We talk about the different side effects. I feel like if I didn’t have anyone to talk to about these things and to encourage me, I might get depressed. The saints at my church are amazing and a blessing to me.
Brings Me Peace, Ease of Burdens, and Ability to Cope. Participants emphasized that the medication side effects contributed to feelings of fear, anxiety, and distress. Examples of such statements included, “It makes me go to the bathroom all the time,” “My legs swell up so bad,” and “I’m tired all of the time.” Participants reflected that their spirituality “eased their burdens” because it provided a way to cope with medication side effects and provide peace from the anxiety. Sometimes participants felt as if a weight was being lifted after prayer, as noted by a 79-year-old participant:
When you pray, your burden is lifted from the side effects of the medication and the symptoms of the high blood pressure. That weight gets lifted because you know that His will is being done.
A 57-year-old participant described that her spirit was eased as a result of her spirituality:
In the Book of Timothy, it says it there: I am not given a spirit of fear but of power and a sound mind. I remind myself all of the time about these words God gave to us. It brings me peace, I can cope.
Other participants reflected that their spirituality gave them the ability to cope with medication side effects. An 81-year-old participant stated:
There is different allergies and such that the medicines give to you. Sometimes there ain’t nothing you can do but trust and have faith about it because you have no choice but to take your medicines if you want to live. My almighty God helps me to deal and cope with these allergies and side effects.