The purposes of the study were to describe and identify the multiple domains of self-regulation for hypertension among Chinese-American elderly. Leventhal's model of self-regulation was used to guide the conceptual development of the self-regulation for hypertension. Thirty Chinese-American elderly were interviewed. All in-depth interviews were audiotaped. The interview data were analyzed using inductive data analysis technique to identify themes and categories.

The experience of self-regulation of hypertension from the hypertensive Chinese-American elderly's perspective was described. Most informants used symptomology and blood pressure monitoring as indicators for their representations of hypertension. The informants' ideas and interpretations about their hypertension, which they used to manage their hypertension, were identified. The informants performed a variety of self-management behaviors, such as modifying treatment regimens, lifestyle modifications, and emotional strategies. The informants set a desired blood pressure range to evaluate the effectiveness of their self-management activities. Expectations of normalizing their blood pressure and decreasing the possibility of complications were important to the informants in their management of hypertension. The informants learned health information from the mass media, family members, friends, and health professionals. The traditional views of medicine, "cold/hot" foods, and "bu" foods influenced the informants' use of the medical regimens and certain foods. Perceptions of the aging process were important to the hypertensive elderly in regulating their hypertension.

A modified model of self-regulation for person with hypertension emerged from the data with four main themes (see Figure 3). The modified model of self-regulation for hypertension consists of three stages: representations, self-management, and appraisals. These stages are influenced by the self-system. Specifically the modified model identified the variables of three stages of self-regulation and the influencing factors of self-system for hypertension. In addition, three phases of the hypertensive self-regulation model (TP-HSRM), for expanding the modified model to include the perspective over time from past to future self-regulation, were proposed (see Figure 4). The modified model of self-regulation for hypertension recognizes the importance of a continuous process among the three phases from the past experiences to the future of hypertensive self-regulation.

Implications of the study for identifying issues of implementation in clinical practice and the development of nursing intervention are addressed. Recommendations for future research are the need to investigate the relationships among the four concepts of hypertensive self-regulation; conduct cross-cultural comparison studies to assess the differences concerning self-regulation of hypertension; and design a longitudinal study to contribute to substantive theory development.