The Role of Patients’ Explanatory Models and Daily-Lived Experience in Hypertension Self-Management
| Autor: | Nancy R. Kressin, Paul Haidet, Barbara G. Bokhour, A. Rani Elwy, Dharma E. Cortés, Jeffrey L. Solomon, Gemmae M. Fix, Lois A. Katz, Nora Mueller, Ellen S. Cohn, Ann M. Borzecki, Alexander R. Green |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
Health Knowledge Attitudes Practice Models Educational Urban Population Cross-sectional study Health Behavior Psychological intervention MEDLINE Severity of Illness Index Patient Education as Topic Nursing Severity of illness Internal Medicine Humans Medicine Disease management (health) Life Style Antihypertensive Agents Aged Original Research Aged 80 and over Self-management business.industry Lived experience Disease Management Blood Pressure Determination Middle Aged United States Self Care United States Department of Veterans Affairs Cross-Sectional Studies Treatment Outcome Hypertension Patient Compliance Female business Clinical psychology Qualitative research |
| Zdroj: | Journal of General Internal Medicine. 27:1626-1634 |
| ISSN: | 1525-1497 0884-8734 |
| DOI: | 10.1007/s11606-012-2141-2 |
| Popis: | Uncontrolled hypertension remains a significant problem for many patients. Few interventions to improve patients' hypertension self-management have had lasting effects. Previous work has focused largely on patients' beliefs as predictors of behavior, but little is understood about beliefs as they are embedded in patients' social contexts.This study aims to explore how patients' "explanatory models" of hypertension (understandings of the causes, mechanisms or pathophysiology, course of illness, symptoms and effects of treatment) and social context relate to their reported daily hypertension self-management behaviors.Semi-structured qualitative interviews with a diverse group of patients at two large urban Veterans Administration Medical centers. PARTICIPANTS (OR PATIENTS OR SUBJECTS): African-American, white and Latino Veterans Affairs (VA) primary care patients with uncontrolled blood pressure.We conducted thematic analysis using tools of grounded theory to identify key themes surrounding patients' explanatory models, social context and hypertension management behaviors.Patients' perceptions of the cause and course of hypertension, experiences of hypertension symptoms, and beliefs about the effectiveness of treatment were related to different hypertension self-management behaviors. Moreover, patients' daily-lived experiences, such as an isolated lifestyle, serious competing health problems, a lack of habits and routines, barriers to exercise and prioritizing lifestyle choices, also interfered with optimal hypertension self-management.Designing interventions to improve patients' hypertension self-management requires consideration of patients' explanatory models and their daily-lived experience. We propose a new conceptual model - the dynamic model of hypertension self-management behavior - which incorporates these key elements of patients' experiences. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink