Table 3 Patients’ enabling and disabling environments in managing their hypertensive condition
Personal factors | Enabling environment | Disabling environment |
|---|---|---|
Knowledge and Skills | • Good literacy contributes to better understanding. • Positive community engagement at residential areas enhances patients’ exposure and opportunities to gain knowledge and skills in managing chronic conditions. • Health information on media (Television and radio programmes, social media, and the Internet) facilitate patients’ understanding of chronic conditions. | • Generic and impersonalised health messages provided by healthcare professionals are ineffective in creating awareness. • Illiteracy or low education level may compromise patients’ understanding of their conditions. |
Management of hypertension (Lifestyle, medications, follow-ups) | • Availability of pedestrian pathway and outdoor gym at residential areas facilitate patients’ active lifestyle. • Physical activity sessions organised by NGOs for elderly at residential areas assist patients to lead active lifestyle. • Efficient public transportation system allows physically-abled patients to access care at low costs. • Good availability of polyclinics and appointment system enable patients to access care easily. | • Wheelchair-bound patients struggle to use low-cost public transports, resort to taking more expensive taxis or receiving more expensive mobile services delivered by private practitioners. • Healthcare professionals are not effective in communicating lifestyle information to empower changes. • Mistrust between some patients and healthcare professionals compromises communication, potentially leading to undetected non-adherence of medication • Side effects deter some patients from taking medications. • Some patients lack financial means to adhere to follow-up schedule. |
Financial ability to afford care | • Availability of multi-layer financial protection measure eases most patients’ burden in affording care. • Additional subsidies for chronic conditions and for eligible patients enable participants to mobilise their resources more effectively. • Being able to obtain employment post-retirement has provided some patients with income to afford medical care. | • Costs associated with seeking care, especially for immobile patients, are hindering access to health facilities. • Lack of knowledge or means to navigate available assistance contributes to compromised ability to afford care. • Low income results in low MediSave funds which essentially depletes quickly when patients have co-morbidities. |