Nearly 500 people with hypertension participated in the study, which aimed to better understand how patients conceptualize the cause of their high blood pressure in order to develop educational materials that improve patient self-care.
Patients’ perceptions about the cause of their hypertension are important because these beliefs influence their learning about the disease, the strategies that they choose to manage it and how well they adhere to treatment, said Elise A.G. Duwe, the lead author of the study. She is an M.D./Ph.D. candidate in sociology in the Medical Scholars Program at the University of Illinois.
“Understanding patients’ illness representations is particularly important for older adults because they are more likely to manage multiple chronic illnesses and have lower health literacy,” Duwe said. “An in-depth understanding of their illness representations opens up the possibility for developing cognitive interventions in patient education.”
The majority of patients – about 95 percent – are diagnosed with essential hypertension, which has no identifiable biomedical cause, Duwe said. “Still, patients come up with a cause to assist their conceptualization of the illness and their behavior” in relation to it.
The Arizona participants were at least 65 years old and taking at least one prescribed anti-hypertensive medication daily. Their counterparts in Illinois were at least 60 years of age and also had been diagnosed with hypertension prior to the study.
Participants were asked about the cause of their hypertension in an open-ended question on the Brief Illness Perception Questionnaire, a nine-item scale used to assess patients’ cognitive and emotional representations about their illnesses.
Using participants’ responses, the researchers identified six causal categories: behavioral, natural, physical, psychosocial, supernatural and other.
Behavioral causes included actions under a person’s control, while natural causes represented inherent and unchangeable characteristics such as family history, genetics and age.
Physical causes included variable and environmentally responsive characteristics, such as weight, diabetes and cholesterol.
Psychosocial causes involved the social and psychological environments surrounding a person while supernatural causes represented spiritual sources, such as God, destiny or fate.
If participants responded that they didn’t know the cause of their hypertension, or if they left the answer blank, the cause was coded as “other.”
Participants in the Arizona sample mainly attributed their high blood pressure to natural causes (36 percent) – that is, to inherent and unchangeable characteristics beyond their control, such as genetics.
Arizona participants were split over the remaining causes, with psychosocial factors – which included stress related to family and work – narrowly beating out physical causes (25 percent and 24 percent, respectively).
However, Illinoisans mainly attributed their hypertension to physical origins (33 percent), followed by natural causes (25 percent), and psychosocial causes (22 percent).
Illinoisans were twice as likely as their counterparts in Arizona (18 percent versus 9 percent, respectively) to attribute their hypertension to behavioral causes, which included factors under their control, such as diet, exercise and smoking.
The disparity between the two samples relative to behavioral causes may have occurred because the Illinois sample contained a higher percentage of men – 49 percent, versus 25 percent in the Arizona sample. Prior research has shown that men are more likely to believe that their high blood pressure is linked to their behavior.
Minorities, who composed 20 percent of each sample, were more likely to attribute their hypertension to psychosocial and behavioral causes, while white participants more frequently indicated natural and physical causes.
Arizona participants’ higher levels of health literacy and education – 76 percent had a high school education or greater versus 58 percent of the Illinoisans – may explain why they were more likely to view natural causes, the most biomedically accurate explanation, as the primary source of their hypertension, the authors wrote.
The co-authors of the study: Daniel G. Morrow, a professor of educational psychology in the College of Education and in the Beckman Institute of Advanced Science and Technology, at Illinois; and, Kathleen C. Insel, a professor in the Behavioral Science Division, and Kari M. Koerner, research specialist, both at the University of Arizona College of Nursing.Illinois students Nikki A. Falk and Anna M. Madison also contributed to the research.
Editor’s note: To contact Daniel Morrow, call 217-244-1828; email firstname.lastname@example.org. To contact Elise A. G. Duwe, email email@example.com.
Sharita Forrest | University of Illinois
Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland
Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Materials Sciences
24.03.2017 | Physics and Astronomy
24.03.2017 | Physics and Astronomy