Presenting the Model of Psychological Factors Affecting Teachers' Blood Pressure Based on the Grounded Theory

Nowadays, in different societies, due to the changes in lifestyle and the prevalence of stress and anxiety, cardiovascular diseases have increased significantly. One of the factors that directly affects cardiovascular diseases is blood pressure. Primary blood pressure is blood pressure that does not have a specific organic cause and is usually caused by physical and psychological factors. High blood pressure is an unusual disorder that lacks any apparent symptoms. A person with blood pressure disease may not have any symptoms, feel it, or pay attention to it. Cardiovascular diseases account for half of adult deaths. The characteristic of this disease is an increase in systemic arterial pressure. From a clinical point of view, a person with high blood pressure is said to have an arterial blood pressure of more than 140/90 mm Hg. The majority of people who suffer heart attacks every year have one or more underlying risk factors, including high blood pressure, diabetes, smoking, poor nutrition, high blood fat, and inactivity. Most of these factors can be controlled or corrected, but high blood pressure can cause some restrictions on affected people's lives. Based on the Grounded theory, the current research aimed to provide a model of psychological factors affecting teachers' blood pressure.

The participants in this research were selected through a purposeful snowball sampling among teachers with high blood pressure and experts (specialists in the field of cardiovascular diseases). Sampling continued until the data saturation. Therefore, the number of participants reached 25 people (14 teachers and 11 specialists). The inclusion criteria were as follows: having consent to participate in the study, knowing proper information about the study topic, having blood pressure (history or chronic form), and having expertise in treating cardiovascular diseases (for study experts). The exclusion criteria were as follows: lacking informed consent, having less than three years of working background, and having chronic psychological disorders like depression, anxiety, and stress (recognized in clinical interview).
The main question of this research was what factors (psychological and physical) can influence the increase in blood pressure among teachers. During the interview, additional and more detailed questions were asked to obtain richer and more detailed information. Twenty–five interviews were conducted, and their duration was between 30 and 65 minutes. Strauss and Corbin's (1998) coding method was used for data analysis, including three stages of open coding (extraction of basic concepts), axial coding (extraction of major categories), and selective coding (determination of core category). In open coding, the analyst extracts categories and their characteristics and then tries to determine how the categories change along the specified dimensions. In axial coding, categories are systematically refined and linked with subcategories. Selective coding is the process of integrating and improving categories.

All the participants in this research were teachers with blood pressure and specialists in internal medicine and cardiology. The logic and method of presenting the findings is based on the general pattern of the research done in the Grounded theory. The research findings are presented in two parts. The first part includes descriptive findings, and the second presents qualitative research findings and data. In the analysis of the interviews conducted with the participants in the open coding stage, 709 primary codes were extracted. In the axial coding stage, 75 concepts were extracted, and in the selection stage, 19 categories were extracted. The results of selective coding showed that six categories were causal factors, four were background factors, three were intervening factors, three were strategies, and three were consequences. These factors were classified in the six classes of Grounded theory.

This research shows the need to pay attention and emphasize the role of education in controlling patients' blood pressure through pursuing a proper lifestyle and following correct behavioral habits. It is obvious that education, in addition to improving patients' performance and preventing the spread of their diseases, can lead to the formation of correct behavior patterns and appropriate lifestyles in society. Notably, modifying people's lifestyles through social and cultural influences, nutrition education, and presenting a reformed model of food consumption and physical activity can be appropriate solutions to improve the health of society. These research findings emphasized the psychological factors affecting blood pressure in different fields. The results highlighted the role of psychological interventions to control patients' blood pressure with proper lifestyle and correct behavioral habits.